Challenge 02
From engagement to action
Reaching a member or patient does not mean they will take action. The next frontier is helping people accomplish something—understand, navigate, complete, and follow through.
01 — The problem
Healthcare is hard to finish.
People are asked to enroll, recertify, schedule, refill, appeal, find a provider, and complete forms across a maze of portals, contact centers, departments, and mailers. Many never complete the step that would actually change their care or coverage.
Orchestration can determine who needs an interaction and when. If the interaction itself leads to another disconnected process or dead end, the journey still stalls.
02 — What has changed
Conversational and agentic technology can carry the interaction forward.
Emerging conversational and agentic AI creates an opportunity to move beyond communicating with people toward helping them complete tasks: understand what they need to do, navigate a process, answer questions, provide information, resolve issues, and follow through on a call to action.
This is an extension of orchestration—not a replacement for it. Orchestration determines who needs an interaction, why, and when. The action layer helps the person complete what comes next.
Strategic implementation partner
Ushur helps turn digital interactions into completed actions.
Ushur enables intelligent, conversational experiences that can guide members and patients through complex healthcare and administrative processes.
Embel Assist brings the healthcare use cases, experience design, implementation, integration, operating model, and governance required to apply the technology effectively. Together, these capabilities help organizations move from sending another message to guiding a person through the action itself.
The experience can answer questions, gather information, complete defined tasks, and carry context into a human handoff when additional support is needed.
03 — What action means
“Action” is seven different jobs.
Action is not a single behavior. Each job breaks down differently, and an effective program must address the specific barrier preventing the person from completing the next step.
Which job an organization addresses first should be determined by the healthcare use case, the barrier preventing completion, and the value that can be measured—not by a product feature.
Understand what to doComprehension
Translate a notice, benefit, or clinical instruction into what the person specifically needs to do next.
Understand what to doComprehension
Translate a notice, benefit, or clinical instruction into what the person specifically needs to do next.
Where this can make a meaningful difference
Conversational and agentic experiences can create value wherever people encounter friction between receiving a message and completing the next step.
Contact centers
Resolve routine questions and administrative tasks digitally, reducing avoidable live-agent calls while carrying the complete context into a human handoff when needed.
Enrollment and recertification
Guide members through forms, documentation requirements, eligibility questions, and incomplete steps without forcing them to restart the process.
Scheduling and care-gap closure
Help people understand what is needed, identify the appropriate next step, schedule services, and follow through on incomplete actions.
Benefits and provider navigation
Answer benefit questions, locate appropriate providers, explain available options, and guide people through the process of accessing care.
Medication and treatment adherence
Support refill reminders, education, required follow-up, and escalation when assistance from a pharmacist, clinician, or care team is needed.
Appeals and administrative resolution
Help people understand requirements, gather missing information, check status, and complete complex administrative processes with fewer handoffs.
04 — The work
What responsible agentic implementation requires
The conversation is only one part of the solution. The critical work is defining what the technology may do, what must be escalated, how it connects to systems of record, and how every action can be understood afterward.
Find where completion breaks
Start with a journey that has a measurable drop-off, such as enrollment, recertification, scheduling, or appeals—not with technology looking for a use case.
Find where completion breaks
Start with a journey that has a measurable drop-off, such as enrollment, recertification, scheduling, or appeals—not with technology looking for a use case.
05 — What Embel Assist does
We connect the orchestration layer to the action layer.
Embel Assist helps healthcare organizations identify where agentic experiences can create meaningful value and then designs, implements, and operationalizes those experiences within existing systems and workflows.
Healthcare use-case definition
Identify member, patient, provider, and administrative journeys where guided interaction can improve completion, reduce friction, or make access to support easier.
Experience and conversation design
Design the questions, responses, actions, decision paths, escalation points, and follow-up needed to guide someone through the process.
Solution architecture and integration
Connect the action layer with existing engagement platforms, CRM systems, contact centers, systems of record, and operational workflows.
Implementation and deployment
Configure the experience, coordinate integrations, test decision paths, manage deployment, and support readiness across business and technology teams.
Governance and guardrails
Define what the technology can handle, what requires verification, when human support is needed, and how interactions remain traceable.
Operational readiness and optimization
Establish ownership, training, measurement, adoption, and continuous improvement so the capability performs effectively after launch.
Across the lifecycle
Strategy
Identify high-value use cases, completion barriers, target populations, measurable outcomes, operational constraints, and the implementation roadmap.
Strategy
Identify high-value use cases, completion barriers, target populations, measurable outcomes, operational constraints, and the implementation roadmap.
06 — Our guardrails
Clear boundaries for agentic healthcare interactions
We apply conversational and agentic technology within defined operational, privacy, compliance, and human-support boundaries. These principles guide how every AI-enabled interaction is designed and implemented.
Always accessible
Human support remains available
People must be able to reach a human without restarting the process. The context already collected should travel with them.
By design
Scope and escalation are defined
What the technology may handle, what requires additional verification, and what must be escalated are established before launch.
Reconstructable
Interactions remain traceable
What was communicated, what action occurred, and which rules or authority supported it should be understandable afterward.
Explicit
Clinical boundaries remain clear
Helping someone navigate or complete a process is different from providing clinical advice. That distinction remains explicit in the design.
Evidence based
Outcomes are measured responsibly
Completion, operational impact, and savings claims should be supported by a baseline and an agreed measurement approach.
07 — Why it matters
The measure is whether the person could finish the job.
When outreach is followed by a guided path to completion, healthcare organizations can reduce avoidable live-agent calls, complete more of the work they have already started, improve the quality of human handoffs, and help more people successfully connect to care and coverage.
- Higher task completion
- Fewer avoidable calls
- Less administrative friction
- Better human handoffs
- Improved connection to care
Start a conversation
Let’s get to work.
Tell us where people are struggling to complete the next step. We’ll help determine where conversational and agentic technology can make a meaningful difference—and help you make it real.