Why efficiency is a global clinical safety issue

Administrative burden is universal; automation delivers measurable savings. The CAQH Index estimates that digitising and automating high-friction US transactions could save $15B+ annually, largely by removing manual eligibility, status, and authorization steps.

At the same time, policy moves are accelerating: the CMS Interoperability & Prior Authorization Final Rule sets API and turnaround obligations (standard prior auth in 7 days; 72 hours expedited) with major deadlines in 2026–2027 for impacted payers—driving process redesign now.

Globally, digital health adoption remains a priority across regions (EU/WHO), but capacity constraints mean tools that remove admin friction create outsized impact.

Where AI helps most (and how Glean fits)

1) Knowledge in flow of work (search + assistant)

Clinicians and non-clinical teams lose time hunting for policies, payer bulletins, referral and prior-auth steps, and runbooks. Glean indexes approved sources (SharePoint/Google Drive/Confluence; ServiceNow/Salesforce/Zendesk) and returns permission-aware answers with citations in Teams/Slack and ticket sidebars—reducing escalations and handle time.

2) Fewer avoidable denials (agents + revenue cycle checks)

Many denials trace to documentation gaps and policy mismatches. AI agents can pre-check draft claims against payer rules, flag missing elements, and route edge cases for human review—improving clean-claim rates and cash flow. CAQH’s data underscores the financial upside of automating these transactions.

US context: Align pre-submission checks to CMS prior-auth and attachment workflows so providers aren’t caught by the 7-day/72-hour clocks as APIs roll out.

3) Staff self-service and service operations

From IT/HR to estates and rota queries, AI deflects repetitive questions and accelerates triage so clinicians spend less time on administration and more on care.

Security, privacy, and regional compliance (board-ready)

• Foundational controls: Glean publishes security practices and certifications (SOC 2 Type II, ISO 27001) and states alignment to HIPAA and GDPR, with permission-mirroring so results respect source access.
  
  

• United States (HIPAA): Ensure Business Associate considerations, map safeguards to the Privacy/Security Rules, and track the 2025 NPRM proposing stronger controls (e.g., MFA, encryption, incident response).
  
  

• Canada (PHIPA/PIPEDA): For Ontario providers/insurers, PHIPA AMPs are now in force; PIPEDA applies to private-sector personal information processing nationally—align audit trails and consents.

90-Day rollout (global pattern you can localise)

Phase 1 — Foundation (Weeks 1–3)

• Prioritise journeys: top denial reasons, top prior-auth procedures, top 50 staff queries.

• Connect core sources (M365/SharePoint, Confluence, ServiceNow, Salesforce, Zendesk).

• Enable citations and permission sync; define retention/telemetry behaviours per region.

Phase 2 — Assist in-flow (Weeks 4–8)

• Roll out the assistant in Teams/Slack and ticket sidebars.

• Stand up two agents: (1) prior-auth checklist builder; (2) claim/charge pre-submission audit. Track clean-claim %, touches per claim, and turnaround.

Phase 3 — Govern & scale (Weeks 9–12)

• Adopt an “AI formulary”: approved prompts, data sources, exception paths.

• Map evidence to HIPAA/PHIPA/PDPL artefacts and—where relevant—CMS prior-auth reporting.

Example impact by workflow

FAQs

How does AI streamline healthcare operations?
By removing search time and automating routine checks. Staff get trusted answers in-flow, while agents validate authorisations and claims up front—freeing capacity for patient care. docs.glean.com+1

What role does AI play in reducing denials?
Most denials stem from documentation and policy mismatches. AI agents flag gaps before submission and align to payer rules, improving clean-claim rates and reimbursement speed. caqh.org

Is AI adoption secure in healthcare settings?
Yes—when paired with strong controls. Glean documents SOC 2/ISO practices and alignment to HIPAA/GDPR, while regional laws (PHIPA, PDPL) require auditable access and governance you can evidence. LawNow+3Glean+3Glean+3

Summary

Across regions, the fastest wins are administrative: find the right guidance in-flow, prevent avoidable denials, and deflect repetitive requests. Glean’s Work AI platform delivers those wins with permission-aware search, assistants, and targeted agents—wrapped in controls your compliance teams can evidence under HIPAA/PHIPA/PDPL. Ready to tailor a rollout? Let’s talk.