Healthcare
Patients reach the right person, the first time.
An Epic-integrated workspace, AI guidance and governed knowledge for patient access, member services and clinical teams — on the contact-center platform you already run.
How does Upstream Works help healthcare organizations?
Upstream Works gives patient-access and member-services teams one workspace with the Epic record, upcoming appointments and provider popped as the contact arrives, AI guidance and governed knowledge for scheduling, referrals and benefits questions, and analytics for abandonment and speed to answer — all on the Cisco or Amazon Connect platform the health system already runs. AgentNow adds telehealth and remote pharmacist consultations from a QR code.
For health systems and hospitals, health insurers and brokers, NHS trusts, ICBs and GP federations, private providers and pharmacy: the VP of patient access or member services and the CIO who owns the Epic and contact-center platforms, with compliance as a mandatory stakeholder.
The pressure on healthcare.
Patient access is the front door, and the door is sticking. Up to 40% of scheduling interactions go unresolved on first contact, 40–50% of calls still need a person, and up to 60% of agent time goes to tasks AI could take on — agent-assist tools typically cut handle time by 30–40% (BCG). One in three medical groups reports higher no-show rates in 2026, and phone access is a top-four access priority (MGMA Stat).
The money follows the experience. CMS withholds 2% of base operating payments under Hospital Value-Based Purchasing and redistributes it on scores that include patient experience (CMS); 56% of providers say patient-information errors at the front end are a primary cause of denied claims (Experian Health, State of Patient Access 2025). For payers, CMS-0057-F brings 72-hour expedited and 7-day standard prior-authorization decisions, denial reasons by phone or portal, and FHIR APIs due 1 January 2027 (CMS fact sheet) — and the Medicare annual enrollment surge still means “people waiting for six hours just to speak with a licensed human agent” (CX Dive).
In the UK the 8am scramble is national policy. Only 52.9% of patients found it easy to contact their practice by phone (GP Patient Survey 2025); the 10 Year Health Plan commits to “end the 8am scramble” (Secretary of State, July 2025); NHS England now publishes practice-level cloud-telephony data every month, including 8–10am waiting times, and its own guidance is blunt: “a new telephony system alone will not reduce the 8am rush” (NHS England).
AI is moving from pilot to platform — one academic medical center’s Epic-integrated agent has handled 2.2 million calls and another system automated 44% of repetitive calls (Becker’s) — while HIPAA enforcement continues: OCR’s Risk Analysis Initiative reached its twelfth action in March 2026 (McDonald Hopkins). The platform clock applies here too: Cisco UCCE 12.6 end-of-support is 31 December 2027 (Cisco).
What changes with Upstream Works.
- FromThe patient repeating their storyToThe Epic record, upcoming appointments and primary-care provider on screen as the call connects.
- FromAbandonment you can’t explainToSpeed to answer, abandonment and no-show follow-up by clinic, by hour, by channel.
- From“Wait until the Epic go-live settles”ToA workspace that survives both the EHR and contact-center migrations.
Where it fits in healthcare.
The platform comes in five editions and four deployment models; the edition that leads in this sector comes first. UWXP, UW Knowledge & Assist, UW Insights and AgentNow run inside every edition or on their own.
Totalix for Cisco
Most large health systems run Finesse on UCCE or PCCE. Totalix adds the Epic-integrated workspace and AI without touching routing, and carries the estate past the 2027 end-of-support date.
Totalix for Amazon Connect, Totalix Embedded and Totalix Mobile
A native edition for the Epic-on-AWS pattern; the workspace inside Salesforce Health Cloud or ServiceNow; and the same workspace on a phone for community nurses, pharmacists and clinic staff.
Epic integration
Screen pop by phone number across voice, SMS, WhatsApp and chat; patient and provider views (name, date of birth, MRN); upcoming appointments and primary-care provider as data chips; open the record in Epic Hyperdrive in context. Listed on the Epic Connection Hub. Also Salesforce Health Cloud, Dynamics and ServiceNow, with payer core systems via API.
UWXP
Appointment status, refill and referral-status automation with a human handoff, governed models and no training on patient data. It runs beside Epic Cheers or an existing bot rather than replacing them — UWXP’s Coexist stage.
UW Knowledge & Assist
Clinically governed knowledge in the workspace (scheduling logic, prep instructions, benefits rules); an employee help center for access teams; a patient self-service portal with secure forms — all from one authored content layer.
UW Insights
Abandonment, speed to answer, first-contact resolution, callback performance and no-show follow-up; payer prior-authorization clocks and enrollment-season dashboards.
AgentNow
Telehealth and nurse-line video from a QR code on the discharge letter or clinic poster, remote pharmacist consultation at the counter, registration-desk kiosks and interpreter escalation.
Use cases we build for.
- 01
Patient access desk with Epic on screen
Scheduling, referrals and reminders from one workspace; route to the last agent spoken to.
Totalix for Cisco + Epic
- 02
Payer member services in enrollment season
Surge absorption, prior-authorization status with the CMS clocks visible, denial reasons delivered by phone.
Totalix + UW Knowledge & Assist + UW Insights
- 03
Nurse line and telehealth on demand
A QR code on the discharge letter or clinic poster opens a video consult, with no app.
AgentNow
- 04
Remote pharmacist consultation
A counter kiosk connects the patient to a pharmacist at another site.
AgentNow
- 05
NHS practice and trust contact centers
8–10am demand visible and reported the way NHS England asks; callback and digital deflection to the NHS App.
UW Insights + UWXP
- 06
Community and deskless clinical staff
The same workspace on a phone for district nurses and outreach teams.
Totalix Mobile
Proof
A national health insurer — 250,000 calls a month eliminated
One desktop for voice, email, chat, SMS, manual tasks and co-browse, with members routed to the agent they spoke to last. The insurer reports higher agent productivity and retention, unified systems and data across channels, and 250,000 fewer calls a month.
Trust
Upstream Works is ISO 27001:2022, SOC 2 and HIPAA compliant. The platform holds interaction records only — no patient profile store — and never trains on your data.
Questions healthcare buyers ask first.
The questions healthcare buyers ask us first, answered the way we answer them on a call.
What is an Epic-integrated contact center?
One where the patient’s Epic record, appointments and provider pop to the agent as the contact arrives, and the agent can open Epic Hyperdrive in context. Upstream Works is listed on the Epic Connection Hub.
How do I screen-pop the Epic record on my Cisco or Amazon Connect platform?
Totalix for Cisco and Totalix for Amazon Connect do it natively, by phone number, across voice and digital channels.
Can agents stay in Epic while taking calls?
Yes. The workspace embeds beside the record, so there is no swivel between screens.
What is a good abandonment rate for a patient-access center?
It varies by clinic type and hour. The first step is seeing your own rate by clinic, channel and hour, which UW Insights provides, and setting a target against that baseline.
Which CMS prior-authorization deadlines affect payer call centers?
72-hour expedited and 7-day standard decisions, and denial reasons by phone, since 1 January 2026; the prior-authorization APIs by 1 January 2027.
Can AI agent assist be used under HIPAA?
Yes, when the models run in a governed environment under a BAA with no training on PHI. UWXP and UW Knowledge & Assist run in the cloud, your VPC or on-premise.
How does NHS cloud-based telephony data get reported?
NHS England publishes practice-level call volumes, abandonment and 8–10am waits monthly. UW Insights mirrors those measures, so you see them before the regulator does.
What happens when Cisco UCCE 12.6 support ends in December 2027?
Totalix for Cisco keeps the estate current and gives a cloud path on your timetable, without disturbing the Epic integration.
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