Workflow / Referral coordination
We work the operational steps between a referral leaving your system and a next step that actually happened, or an explicit, owned reason the loop could not close.
Closure requires evidence from both sides of an organizational boundary.
Rely coordinates the relay. The receiving clinician reviews and decides care.
Track a referral through receipt, scheduling, and closure. Closure requires evidence from both sides of an organizational boundary. The diagram shows Referral sent, Receipt confirmed, Missing information resolved, Appointment accepted, Result returned, Closed or reason recorded. Rely coordinates the relay. The receiving clinician reviews and decides care.
The break
A referral leaves one system and enters another. Neither side owns the space in between. The sending office assumes it landed. The receiving office is waiting on a record nobody knew was missing. The patient is waiting for a call that was never scheduled.
The work that closes that gap is phone work. Confirming receipt. Chasing an authorization. Resending records in the format the other office actually accepts. Calling the patient about a date they never heard about. It is nonclinical, it repeats, and it is nobody's job title.
So it gets done for the referrals somebody remembers, and not for the rest. The status field says sent, which is both true and useless.
Failure map
| Stage | What usually happens | Who absorbs it |
|---|---|---|
| Receipt | Nobody confirms the referral arrived, or that it arrived in a form the other end can act on. | The patient, who finds out weeks later. |
| Requirements | A missing field, record or authorization stops the referral, and no notification travels back to the sender. | Referral coordinators, once somebody complains. |
| Scheduling | The receiving office calls once, reaches voicemail, and the referral goes dormant. | Clinical staff, at the next visit. |
| Status | There is no shared view, so both sides check by calling each other. | Both offices, repeatedly. |
| Closure | The loop is marked closed because time passed, not because anything happened. | Quality reporting, which now contains a fiction. |
Operating contract
The routine chase is the part that repeats almost identically every time, and that is the part the AI agent runs: receipt confirmation, approved outreach to the patient, collecting a missing field, checking status, coordinating a scheduling window, and writing the result back.
The part that does not repeat is the part a person takes. Where navigator support is included in scope, a Rely navigator accepts the case and works the external-office follow-up, the transportation or access barrier, the missing record, the authorization friction, and the dependency that needs somebody to call back four times.
Required output
Referral work is the one place where half the case sits inside an organization you cannot see. So the record is built around that split rather than around a single case timeline.
Contact attempts, outcomes and timestamps for the patient and for the receiving office, kept separate. A referral where the office confirmed and the patient never answered is not the same case as the reverse, and averaging them hides which side is stuck.
The specific missing item, who was asked for it, when, and whether it was ever supplied. A referral that is waiting is always waiting on something nameable.
The final state, the reason, the owner who accepted it, the fallback taken if the intended path failed, and the system where the state was verified.
One specialty, one sending location, one date range. We will map the ladder, the owners and the reconciliation path before anybody quotes a percentage.
