Administrative load lifted without touching clinical judgement
Referral and administrative handling in a physiotherapy practice, with a hard line between administrative work and anything clinical.
A private physiotherapy and rehabilitation practice turning over just over a million pounds, with eleven practitioners across two sites.
A delivered Orchyn engagement. The client is anonymised at their request. The company and the people are not named. The operation, the workflow, the controls and the outcome are as delivered.
The commercial problem
Referrals, insurer correspondence and patient requests arrive through secure email, portals and phone notes. Administrative staff spend too long identifying the right record, checking completeness and chasing missing information.
Clinicians are interrupted for questions that are operational rather than clinical, which is expensive in both time and attention.
How the work runs before
- A referral or patient request arrives and is downloaded and read.
- Staff search manually for the patient and payer record.
- Incomplete information triggers a chase by email or phone.
- Complete referrals go to the practice manager to allocate the next administrative step.
- Clinicians are interrupted for unclear non clinical questions.
- The record is updated in several places.
What makes it hard to automate safely
- The system must not diagnose, triage clinically, prioritise treatment or offer medical advice. This boundary is absolute.
- Health and contact information is minimised, access controlled and handled under an agreed data protection approach.
- Clinical urgency, safeguarding and patient safety concerns escalate immediately under clinic policy.
- An administrative summary cannot replace the original document. Every record links to source.
What we change first
The administrative and clinical boundary was written down explicitly before anything was built, including worked examples of borderline cases. Data protection review came first, not last, because health data changes what is permissible rather than merely what is advisable.
The redesigned workflow
- A referral arrives into a secure intake.
- The model extracts administrative fields only: patient identifiers, referrer, payer, service requested and stated dates.
- It checks the referral against the administrative completeness checklist and flags what is missing.
- Anything suggesting clinical urgency or safeguarding routes immediately to a clinician under existing policy.
- Administrative staff confirm the record and send drafted chases. Clinical review remains entirely with clinicians.
Where the model stops
The model handles administrative fields and completeness only. It does not read a referral clinically, summarise a clinical opinion, triage or prioritise. Where administrative and clinical overlap, it escalates rather than interprets.
What we learned
The value came from being strict about the boundary. By refusing to touch anything clinical, the workflow became straightforward to govern and easy for clinicians to trust. A broader scope would have been worth less, because it would not have been permitted to run.