Citation :

Yeshwanth Macha , 2025. "Integration of Salesforce Einstein AI for Intelligent Case Routing in Healthcare Systems " ESP International Journal of Advancements in Science & Technology (ESP-IJAST)  Volume 3, Issue 4: 17-27.

Abstract :

The constantly growing demands in the healthcare sector have increased the need to possess intelligent and scalable and secure systems to improve the quality of services, efficiency in operations, and patient outcomes. Healthcare routing of cases is a significant factor that defines how much clinical and administrative processes can be utilized fully as they are now able to allocate cases to the appropriate resources depending on urgency, expertise and needs of compliance. The author of the paper gives a detailed observation of the principles of healthcare case routing, the functional requirements, the non-functional requirements, and the artificial intelligence application in the modern healthcare setting. In particular, this paper discusses how Salesforce Einstein Copilot can be applicable in practice as an AI-based assistant in a healthcare CRM environment to support intelligent decision-making, automation, and personal recommendations. The proposed architecture takes into account such significant components as the user interface, AI engine, data layer, and integration layer that enable the application to connect Electronic Health Record (EHR) systems without complications and implement the HL7 FHIR standards. Moreover, the paper addresses the topic of safe data sharing, adherence to healthcare policies including HIPAA and GDPR, and advantages of Salesforce Health Cloud integration with EHR systems to obtain cohesive patient records, better care coordination, and patient engagement. The results prove that AI-based CRM systems can greatly improve the delivery of health care services by increasing the accuracy, scalability, transparency, and compliance with the regulatory framework and promoting the use of data-driven clinical and administrative decision-making.

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Keywords :

Healthcare Case Routing, Salesforce Einstein Copilot, Artificial Intelligence, Healthcare CRM, Electronic Health Records (EHR), Health Cloud.