New York hospital deploys agentic AI to cut administrative burden and address staff shortages

The Hospital for Special Surgery (HSS) in New York has implemented agentic AI systems to mitigate staff burnout and address global health care workforce shortages. The technology automates complex back-office processes, such as insurance claims, and manages patient scheduling and triage. HSS reports that AI agents now process 1,100 claims monthly, reducing appeal times from 45 minutes to five minutes and increasing success rates to 100 per cent. The system includes safeguards to escalate complex cases to human specialists, aiming to rehumanise care by freeing clinicians for high-level patient interaction.

The global health care sector is under increasing strain, with the World Health Organization warning that current shortfalls will increase to 11 million workers by 2030. In response, many providers are adopting AI agents to reduce the cognitive load on clinicians. According to KPMG, more than two-thirds of health care providers have already adopted AI agents into their workforce. HSS chief digital and technology officer Dr Ashis Barad notes that while previous digitalisation efforts like electronic health records often added to administrative burdens, agentic AI can handle nuanced scenarios and make autonomous decisions.

At HSS, AI agents have taken over complex backend processes that previously required both staff and third-party contractors. The institution now handles all claims in-house, with agents completing 1,100 claims per month. Since implementation nine months ago, the appeals stage duration has been reduced from 45 minutes to five minutes, and the success rate of those appeals has risen from 65 per cent to 100 per cent. Dr Barad states that 90 per cent of non-clinical health care tasks could potentially be administered by AI agents in the future.

Building on this success, HSS is deploying AI agents in non-clinical patient-facing settings through a collaboration with enterprise agentic AI developer Ema Unlimited. The new patient-facing AI scheduling and triage service is accessible 24/7 via web, text, or phone. It uses conversational AI to ask patients clarifying questions about their condition and books appointments with the most appropriate clinician, factoring in location, insurance coverage, and physician availability.

To ensure safety, the triage service includes built-in safeguards where sensitive, complex, or uncertain scenarios are escalated to human specialists. Every decision made by the AI agent is auditable, and human staff can step in at any point. All decisions regarding the technology are scrutinised by an AI subcommittee co-chaired by Dr Barad and a senior nursing executive. HSS is also establishing a dedicated AI lab at its New York City campus to provide training and democratise access to agentic AI technology for all staff.