HIPAA-grade voice agents for a multi-state clinic group
We replaced a 38-person inbound desk with sub-second voice agents that handle 78% of patient calls without escalation — and made the remaining 22% measurably better.
Inbound volume had grown 31% YoY against a frozen support headcount. The CIO's mandate was unambiguous — automation that nursing leadership and counsel both signed off on, or no automation at all.
We started with a 5-day discovery sprint: stakeholder interviews, a sample of 1,200 historical calls hand-labeled into 17 intents, and a HIPAA risk model. From there, we built a streaming voice pipeline (Twilio → Deepgram → policy gate → GPT-4o-mini routing → ElevenLabs) with PII redaction at every hop and a per-call lineage record auditors could query.
After 11 weeks, the system handled 78% of inbound volume autonomously with a 9.2 CSAT — higher than the human baseline of 8.4. Operations re-deployed 21 of the original 38 desk staff to clinical care coordination roles.
“We expected a deflection bot. We got an agent our nursing leadership trusts to talk to patients before they reach a person.”
Dr. Renée Allard · CIO, Smile Dental
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