Deployment Readiness &
Pilot Governance Protocols
Healthcare AI initiatives fail from un-agreed baselines, missing sponsors, and blurred clinical boundaries. These four protocols eliminate organizational friction before Day 1 of a Schedule M measurement.
DeskGate does not mount in an operator session until all 12 operational conditions are satisfied. This is not administrative bureaucracy; it guarantees that our 14-day frozen-cohort measurement does not suffer from sponsor abandonment or queue contamination.
Healthcare buyers reject vendor ROI models because they omit internal drag. This worksheet explicitly accounts for compliance reviews, coordinator onboarding, and—crucially—Time-at-Gate (~1:52 min) as an added operational cost rather than ignoring it.
| Worksheet Dimension | DeskGate Specification (4-FTE Lane Example) | Impact / Accounting Treatment |
|---|---|---|
| Target Workflow | Residual prior authorization & portal uploader | Mixed-payer non-EDI portal family (e.g. Availity) |
| Current Annual Labor Cost | 4 coordinators × $62,000 loaded = $248,000 / yr | Baseline payroll expenditure on this lane |
| Current Time Burden | ~80 min cumulative touch-time per residual case | Staggered across intake, staging, chase, appeals |
| Software Price | S-Desk: $2,500/mo ($27,000/yr) · 4,000 cases | Design partner: $0 for first two desks |
| Implementation Fee | $0 (Delivered against annual commit; not CapEx) | Sits under director signing authority |
| Governance & BAA Cost | ~3 hours legal/compliance review of Schedule M | One-time internal review (~$1,200 internal allocation) |
| Coordinator Training Drag | ~1 hour live session + 3 test cases in walkthrough | Minimal disruption; runtime sits under existing EHR |
| Hidden Workflow Burden (Time-at-Gate) |
1:52 median review time per staged packet | A new task created by the product. Quantified at ~124 coordinator-hours/yr on 4,000 cases (~$3,850 labor cost) |
| Net Capacity Yield | 48 coordinator-days avoided per 1,000 cases (23% reduction in coordinator days) |
~$24,000 net capacity gain per 1,000 cases after deducting Time-at-Gate drag |
| Gain-Erasing Risks | Payer portal downtime, unannounced UI overhauls | Mitigated via VLM coordinate grounding & 0 unauthorized submits |
To address CMIO/CMO malpractice concerns, we express our boundaries in clinical vocabulary. DeskGate operates strictly on the Shaft and Mid-Shaft (administrative motor cortex) and enforces an ironclad boundary against the Tip (clinical treatment decisions).
Direct Patient-Facing & Treatment-Shaping Actions
Diagnostic determinations, prescribing, patient triage, and clinical efficacy decisions.
Clinician-Facing Decision Support
Medical necessity evaluation, guideline interpretations, clinical chart drafting.
Workflow, Documentation & Portal Assembly
Staging payer portal form fields, merging PDF chart notes, transcription, attachment sorting.
Operational, Administrative & Infrastructure Support
In-browser session inheritance (SSO/VPN), DOM RPA, telephony IVR status chase, SHA-256 audit hashing.
"Have we earned the right to move closer to the patient, or are we still learning on the shaft?"
DeskGate's answer: We stay on the shaft by architectural choice. We do not practice medicine; we execute the digital paperwork.