Capture the administrative intent: move an existing visit because of a work conflict. No appointment details are read out.
Privacy & scope: An incoming number can help find a candidate record, but is not proof of identity. Audio and verbatim transcripts are not retained unless separately approved.
SHARED CONTEXT
Inbound call · Private setting confirmed · Work conflict reported · Identity not verified
02 / VERIFY THE CALLER Same call
A short identity check.
Your voice agent
Could you tell me your full name and date of birth?
Sarah · patient
Sarah Morgan. June 12, 1982.
Your voice agent
Thank you, Sarah.
Full name and date of birth follow the clinic’s configured limited-task verification policy; they are not a universal HIPAA requirement.
Search permitted annual-physical slots the week of October 19 with the same provider, location and duration.
Privacy & scope: Apply clinic-maintained administrative restrictions. Do not independently decide that delaying care is safe or reinterpret the visit’s clinical urgency.
SHARED CONTEXT
Afternoons · following week · Same provider requested · Same visit type & location · No mutation authorized
05 / ANSWER THE INTERRUPTION Same call
“Will I be charged for changing it?”
Sarah · patient
Sorry—will I be charged for changing it?
Your voice agent
There’s no rescheduling fee under the clinic’s policy for this change; you’re outside its late-change window.
Sarah · patient
Okay, good.
The configured fee policy is applied to the call date and appointment date. It does not determine charges for the visit.
The clinic’s approved policy applies fees only within one business day. This change is outside that window; no discretionary waiver is made.
Privacy & scope: A missing, expired or ambiguous fee policy routes to staff. The AI does not waive fees or promise insurance coverage.
SHARED CONTEXT
Fee policy checked · No rescheduling fee · Visit charges not assessed · Search context retained
06 / ADAPT THE OPTIONS Same call
“Thursday would be better.”
Your voice agent
Dr. Patel has Tuesday, October 20 at 4 p.m.
Sarah · patient
Actually, Tuesdays are going to be awkward for a while. Is there a Thursday?
Your voice agent
There’s Thursday, October 22 at 3:30 p.m., still at Oak Street.
Sarah · patient
Yes, that works.
The preference changes, but the provider, location and visit type remain consistent. The first proposed slot was never booked.
AI TEAM AT THIS MOMENT
Change the search, not the record.
Supervisor Voice · patient conversation · Adapts to preference Transaction · appointment rescheduling · Finds a Thursday slot
CONNECTED SYSTEMS & KNOWLEDGE
Athena · scheduling
Offer the returned Thursday, October 22, 2026 slot at 3:30 p.m. with Dr. Patel, for the same annual physical at Oak Street.
Privacy & scope: Only offer returned, permitted availability. A preference or casual “that works” is followed by an explicit old-to-new confirmation.
SHARED CONTEXT
Proposed: Oct 22 · 3:30 p.m. · Dr. Patel · Oak Street · Original Oct 13 still active · No slot hold assumed
07 / CONFIRM THE WHOLE CHANGE Same call
Read back the old time and the new one.
Your voice agent
Shall I move your annual physical with Dr. Patel at Oak Street from Tuesday, October 13 at 8 a.m. to Thursday, October 22 at 3:30 p.m.? The October 13 appointment will no longer be booked.
Sarah · patient
Yes, please move it.
The confirmation authorizes replacing this one appointment—not canceling other visits or changing clinical orders.
AI TEAM AT THIS MOMENT
Confirm before consequence.
Supervisor Voice · patient conversation · Reads back the change Identity & Authority · verification and scope · Checks session authority Transaction · appointment rescheduling · Validates replacement
CONNECTED SYSTEMS & KNOWLEDGE
Governed tool executionAthena · scheduling
Recheck the original record and replacement slot. Validate patient, provider, department, appointment type, duration and clinic rules against Sarah’s approval.
Privacy & scope: Do not issue a stand-alone cancellation first. Use a validated rescheduling path; if its failure behavior is unsafe or unknown, route to staff.
SHARED CONTEXT
Explicit old-to-new approval · Original appointment bound · Replacement slot bound · One reschedule transaction
08 / CHECK AN UNCERTAIN RESPONSE Same call · brief delay
A delay is not permission to try twice.
Your voice agent
One moment—the system is taking a little longer to confirm the change. I’m checking it before I tell you it’s done.
Sarah · patient
Sure.
A response timeout activates Recovery. The system does not blindly repeat the reschedule or promise either appointment state while it is unknown.
AI TEAM AT THIS MOMENT
Reconcile the result before repeating work.
Supervisor Voice · patient conversation · Explains the delay Transaction · appointment rescheduling · Reads appointment state Recovery · reconcile uncertain work · Reconciles uncertain write
The submitted request has no final response. Recovery reads the original and resulting appointment state and compares them to the approved change.
Privacy & scope: A timeout proves neither failure nor success. If state cannot be reconciled promptly, give a truthful status and hand ownership to staff.
SHARED CONTEXT
Request submitted once · Outcome temporarily unknown · No cancellation retry · No success claim
09 / CONFIRM ATHENA’S SAVED STATE Same call
“That’s all changed now.”
Your voice agent
That’s all changed now. Your annual physical is Thursday, October 22 at 3:30 p.m. with Dr. Patel at Oak Street. The October 13 appointment is no longer booked.
Sarah · patient
Great, thank you.
The concierge announces success only after the new booking and the disposition of the old one are verified.
AI TEAM AT THIS MOMENT
One replacement. No active duplicate.
Supervisor Voice · patient conversation · Confirms the result Transaction · appointment rescheduling · Verifies both states Recovery · reconcile uncertain work · Closes uncertainty
CONNECTED SYSTEMS & KNOWLEDGE
Athena · appointment records
Athena’s current state matches the approved replacement. The original October 13 booking is no longer active, and unrelated appointments are unchanged.
Privacy & scope: A new booking alone is insufficient. Confirm the old appointment’s status and preserve the reschedule history before declaring completion.
SHARED CONTEXT
New: Oct 22 · 3:30 p.m. · Old Oct 13 no longer active · Same provider & visit type · No duplicate active visit
10 / KEEP RELATED CARE WITH STAFF Same call
“What about my blood work?”
Sarah · patient
I was supposed to do blood work before the visit. Does that need to move too?
Your voice agent
I’ll ask Dr. Patel’s team to confirm the timing. I haven’t changed any lab appointments or instructions.
Sarah · patient
Okay. They can message me in the portal.
Moving the office visit does not authorize changes to labs, preparation, referrals or medication. The AI makes no clinical judgment about timing.
AI TEAM AT THIS MOMENT
Route the question without changing care.
Supervisor Voice · patient conversation · Acknowledges the question Policy · configured clinic rules · Applies configured rules Human Handoff · authorized staff work · Prepares clinical-team task
CONNECTED SYSTEMS & KNOWLEDGE
Clinic routing policyClinical staff work queue
Prepare a task with the exact question, old and new visit dates, and Sarah’s preferred portal reply. No lab schedule, order or instruction is changed.
Privacy & scope: Do not infer that a later visit makes a lab date, order or preparation instruction invalid. Staff determines clinical timing.
SHARED CONTEXT
Office visit rescheduled · Lab timing question open · Dr. Patel’s team to reply · No clinical changes
11 / CONFIRM THE COMMUNICATION ROUTE Same call
The new details go somewhere private.
Your voice agent
Would you like the updated appointment details in your secure portal as well?
Sarah · patient
Yes. Please don’t text me the details—my kids use this phone.
Your voice agent
I’ll use the portal. Is a generic new-message alert okay, without the appointment details?
Sarah · patient
Yes, that’s fine.
The platform applies the restriction immediately to its own sends and verifies whether connected clinic reminder systems can honor it.
Queue the replacement details inside the authenticated portal. Permit only a generic outside alert if the configured notification route supports it.
Privacy & scope: Calling the clinic is not consent for marketing, recording or unrestricted follow-up. If notification settings cannot honor the request, stop that send and route to staff.
You’re set for Thursday, October 22 at 3:30 p.m. with Dr. Patel at Oak Street. I’ll send the updated details to the portal and pass your blood-work question to his team.
Sarah · patient
Perfect. That helps a lot.
Your voice agent
You’re welcome, Sarah. Take care.
The office visit is rescheduled. The lab-timing question and message delivery still have their own statuses.
The portal accepts the updated appointment, Dr. Patel’s team records its lab-timing answer, and Sarah acknowledges both staff-authored information and the new appointment details.
Old-date reminder jobs are suppressed and one new portal reminder is delivered.
Authorized clinical staff record the lab-timing answer; the AI does not compose or paraphrase it.
Portal delivery and Sarah’s acknowledgment close the message and human-handoff tasks.
Every downstream receipt is recorded separately. Clinical authority remains with staff, while delivery and patient acknowledgment are evidenced.
AI TEAM AT THIS MOMENT
Human judgment returns with receipts.
Supervisor Communications · approved channels · Verifies portal delivery Recovery · reconcile uncertain work · Reconciles reminders Human Handoff · authorized staff work · Records staff answer Outcome · evidence-backed disposition · Closes follow-through
CONNECTED SYSTEMS & KNOWLEDGE
Configured reminder serviceSecure patient portalClinical staff work queue
Reminder reconciliation, the staff-authored answer, portal delivery and Sarah’s acknowledgment are complete.
Privacy & scope: The recorded staff answer is delivered as authored. The AI neither changes clinical instructions nor treats portal acceptance as patient acknowledgment.
SHARED CONTEXT
Old reminders suppressed · New reminder delivered · Staff answer acknowledged · No unresolved downstream task
14 / ACCOUNTABLE FINAL STATE End of workflow
One completed change, fully closed.
EVIDENCE-BACKED CLOSED OUTCOME
Sarah has one replacement appointment, receives and acknowledges the staff answer and private reminders, attends, and the clinic later records the appointment completed.
Rescheduled: October 13 at 8 a.m. → October 22 at 3:30 p.m.; original no longer active.
Staff-authored lab-timing answer and portal details delivered and acknowledged.
Clinic-recorded attendance and completed appointment close the workflow.
The final state is based on Athena, portal, staff-task and clinic-status evidence—not AI clinical judgment or elapsed time.
The reschedule, staff answer, message delivery, reminder, attendance and clinic-recorded completion are all reconciled with no open task or exception.
Privacy & scope: Attendance and completion are recorded only from supported clinic events. The staff answer remains attributed to its authorized human author.
SHARED CONTEXT
One completed replacement visit · No duplicate mutation · All messages acknowledged · No unresolved tasks or exceptions
WHEN THE CALL TAKES ANOTHER PATH
Protect privacy. Protect the selected visit.
The successful change is one path. These alternatives belong to the same workflow.
Identity mismatch / someone calling for a patient
Caller: “I’m her husband. Can you just move it?”
Verify the caller’s identity and authority under clinic policy before discussing or changing the patient’s appointment. A name, relationship claim or incoming number alone does not authorize the change in this model. Resolve guardianship, minors, duplicate records and uncertain delegation with staff. Do not disclose appointment options from an unverified record.
No suitable slot / patient changes her mind
AI: “I haven’t changed your original appointment. Would you like me to connect you with scheduling?”
Use this reassurance only while the original is verified and no mutation is pending. Do not cancel just to search or substitute another provider, location or visit type without approval. A request to cancel without a replacement is a separate confirmed action, not implied by rescheduling.
Original already changed / target slot disappears
Refresh Athena immediately before the write. If someone else moved the original, resolve the current appointment with the patient. If the replacement is no longer available, offer permitted fresh options and obtain new old-to-new approval. No silent replacement.
Uncertain result / partial change / dropped call
AI: “I can’t yet confirm the change. I’m connecting you with scheduling so they can check it.”
Reconcile the submitted operation before a retry. Both bookings active, neither active or conflicting records go to staff. Never promise restoration of the old slot. A dropped call before approval makes no change; after submission, reconcile the result and follow only an approved callback or secure-message route. Reverify identity in a new session.
Patient: “Is it okay to put this off another month?” AI: “I can help with the scheduling, but I’ll need the clinical team to answer whether that timing is appropriate.”
Clinic-maintained restrictions or linked-care dependencies route to staff before an automated move. No AI assessment of whether delay is safe. Labs, procedures, referral visits, orders and preparation are not automatically shifted along with the office appointment.
Policy question / late-change fee dispute
Patient: “Can you waive the fee?” AI: “I’ll connect you with the office to review that.”
Use only the applicable approved policy and business calendar. Do not waive a fee, invent an exception or promise coverage. If a potential fee materially affects approval, resolve or disclose it before confirming the reschedule.
Clinical concern / human or accessible assistance
Honor a request for staff. Transfer symptoms and clinical questions without assessment, triage or reassurance. A caller-stated emergency receives the clinic’s fixed emergency instruction; no AI symptom scoring. Do not imply it is safe to wait if transfer fails. Use approved interpreter, relay or accessibility support without treating disability or language as verification failure.
Portal restriction / failed reminder sync
Keep detailed appointment information inside the approved private channel. Do not switch to detailed SMS because portal delivery failed. Reconcile old and new reminder jobs with one reminder owner. An exception stays assigned to staff; it does not undo or repeat the confirmed appointment change.
FROM “I CAN’T MAKE IT” TO A VERIFIED CHANGE
A new time that works. No uncertainty about the old one.
One replacement appointment
Sarah approves the old-to-new change. Athena confirms the replacement and that the original is no longer active.
The details stay private
Identity is verified before disclosure. The confirmation and reminders follow Sarah’s communication preference.
Clinical follow-up is completed by staff
Dr. Patel’s team answers the lab-timing question, Sarah acknowledges it in the portal, and the clinic records the replacement visit completed.
Integrations, permissions and compliance controls are configured for each healthcare environment. No clinical judgment is performed.
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Who We Are
The Team Behind rundesk360
Complementary perspectives — voice at scale, healthcare operations, and customer impact — building one platform together.
The Voice
Vinay Krishna
Vinay led speech products for the Indian market at Microsoft, including the first ASR and TTS models for Indian languages and Azure Speech deployment for Jio, India’s leading telecom provider. That foundation gives him firsthand expertise in the realities that determine whether voice AI works at scale. At Rajneethi, a reputed premium political consulting brand operating in multiple countries, he took a services firm to 90% software revenue and 80× growth in five years, with recent work focused on agents that act—not simply models that talk.
The Mind
Sawad Thotathil
Sawad Thotathil, MD, MS, MHM, is a physician, healthcare technology founder, and experienced operator who transforms complex healthcare problems into scalable products and businesses. His background spans clinical operations, AI-enabled care, enterprise technology, and healthcare entrepreneurship, including leadership of an international joint venture and a focus on driving innovation and scaling programs across technology implementations and clinical operations.
The Muscle
Anit Parikh
Anit is a global tech executive with over 30 years of experience scaling high-growth businesses. His leadership background includes serving as Managing Director at Slalom, founding PwC’s Salesforce Pharma and Life Sciences practice, and overseeing professional services as a Regional Director at Salesforce.
