01 · Monitor
The Operational Layer + Sentinel
Connect Your Systems. Move the Work Forward.
Your existing systems
EHR
Billing
Scheduling
HR & payroll
The operational layer
One coordinated path from issue to action.
People & approvals
Rules & automation
Work queues
Work completed · Exceptions owned · Outcomes recorded
Your software holds the information. Your people make the handoffs. Simple Fractal helps turn the work between systems into coordinated workflows, and Sentinel is designed to bring requests, human decisions, and bot actions into one shared workspace.
The Work Between the Systems
You Already Have an Operational Layer
It may live in spreadsheets, shared inboxes, manual follow-ups, and the knowledge of a few experienced people.
When work crosses departments or applications, someone checks the details, decides what happens next, updates a record, and follows up. As volume grows, those handoffs become harder to manage.
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Information Gets Copied
Staff move the same details between forms, systems, and trackers.
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Exceptions Lose an Owner
Requests wait in an inbox while teams work out who should act.
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Completion Takes More Follow-Up
Even after a decision, someone still makes the update and closes the loop.
How It Works
Give Each Handoff a Clear Next Step
We design the workflow around your team, your systems, and the actions that need to happen.
02 · Decide
Guide the Decision
Apply configured checks and put the right information in front of the person responsible for review or approval.03 · Execute
Complete and Confirm
Use bots for supported actions, record the result, and return unresolved exceptions to a person.A warehouse tells you what happened. The operational layer decides what happens next, wherever the work shows up.
Portals
A person reviews every request and decides.
Automation
Rules you configure do the matching, not a black box.
Email & Text
AI reads the replies and pulls out what changed.
Every Other Channel
Fax, EDI, SFTP, and payer portals, all one queue.
Sentinel
Put the Operational Layer to Work With Sentinel
A shared queue for incoming work. A focused view for human review. Bot actions that carry approved decisions through to completion. Sentinel’s proposed workflow model brings these steps together.
The scheduling example below is illustrative. Workflow availability and supported actions are confirmed during discovery.
Sentinel
Illustrative workspace
Review a time adjustment
Missing information needs a coordinator’s judgment.
Next step: request clarification
Human review
Process a cancellation
Approved request ready for a supported bot action.
Next step: scheduled bot run
Bot execution
Confirm a completed update
The source record is updated and the result recorded.
Next step: close the request
Completion
Illustrative Application · ABA Scheduling
Follow a Scheduling Request From Start to Finish
When staff cannot make certain schedule changes directly, requests flow to a smaller coordination team. This example shows how human review and automation could work together.
01 · Request
A Request Enters the Workflow
A staff member submits a change through an agreed form or intake process. The request carries the details needed for review and action.
02 · Review
Check the Details Before Acting
Configured checks identify missing fields, mappings, or work that may already be complete. Exceptions go to a coordinator for clarification or judgment.
03 · Approve
An Authorized Person Decides
The coordinator reviews the request and approves, denies, or resolves it. Approval releases only the supported action defined for this workflow.
04 · Automate
A Bot Performs the Supported Update
On the agreed run schedule, a bot makes the approved change in the scheduling system. Failed or unresolved actions return for review.
05 · Confirm
Verify the Result and Close the Loop
The workflow records the outcome, updates agreed source statuses, and notifies the requester after successful completion.
This example does not submit requests or change scheduling records.
| Work to Complete | Manual Handling | Proposed Sentinel Workflow |
|---|---|---|
| Review | Check the request and chase missing details. | Surface missing information and route exceptions to a coordinator. |
| Update | Open the scheduling system and edit the record. | A bot performs the supported change after approval. |
| Close the Loop | Update the tracker and notify the requester. | Record the result, update agreed statuses, and confirm completion. |
A Proposed Workspace for the Team
Know What Needs Attention. Know What Happened Next.
Shared Queue
Find and Claim Work
Bring incoming and unclaimed requests together with ownership and priority signals defined for the process.My Work
Review and Resolve
Give coordinators a focused view of requests needing approval, denial, clarification, or another decision.Operations Analytics
Track Outcomes
See workflow status, blockers, bot actions, and recorded results to understand where work is moving or waiting.Operational Visibility
Watch the Work Flow. See Where It Backs Up.
The Whole Operation on One Screen
- Live queues for every kind of exception
- Each stuck item traced to its root cause
- Conversion and cancellation rates by provider
- Revenue held up, in dollars
Define the Action Boundary
Build Around Your Systems. Keep People in Control.
Start with the applications and people already involved in the work. For scheduling, candidate bot actions may include creating a timestamp, converting it to a timesheet, modifying supported fields, or applying a cancellation.
Each action needs confirmed system access, mappings, permissions, approval rules, and a way to verify the result. Unresolved cases return for human review.
We assess existing data and reporting needs as part of the design, including any integration or infrastructure work required.
Explore data infrastructureActions shown here are candidates for scoping. System connections, execution timing, and supported actions are agreed for each workflow.
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Keep Decisions Accountable
Identify the authorized reviewer and the decisions that need their approval.
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Work With Existing Applications
Assess how requests enter and how approved actions reach the scheduling system.
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Confirm the Outcome
Define completion evidence, failure handling, and requester notifications before rollout.
What AI Does, and What It Never Does
AI does this
- Reads replies written in plain language
- Pulls out preferences and updates
- Summarizes feedback for the person acting on it
- Cuts the administrative back and forth
AI never does this
- Judge clinical qualifications
- Decide who is a good match
- Generate the recommendation
- Assign work
- Decide anything on its own
Rules do the matching. People approve every outcome. Zero automatic assignments.
The Founder’s Perspective
Why the Connections Matter
Henry Xie, Simple Fractal’s founder and CEO, explains why every organization already has an operational layer connecting its software systems, whether it has been deliberately engineered or hidden inside spreadsheets, inboxes, manual handoffs, and institutional knowledge.
Common Questions
Start With a Clear Scope
How are the operational layer and Sentinel related?
The operational layer describes how work moves across systems and teams. It may combine integrations, bots, review applications, reporting, and human decisions. Sentinel is designed to provide a shared workspace for coordinating that work.
Does Sentinel replace our EHR or require a new data warehouse?
The proposed approach works around existing applications. We assess your systems and data environment first, then confirm which connections and any additional infrastructure the selected workflow needs.
Does approval mean an update happens immediately?
Execution timing depends on the agreed bot schedule and operating hours. In a scheduled workflow, approval makes the request eligible for a subsequent run; confirmation follows the verified result.
Can every request be automated?
Supported actions depend on system access, business rules, and the exceptions in scope. People handle decisions and unresolved cases according to the workflow’s approval rules.
Where should we start, and how do we measure value?
Choose a recurring bottleneck with a clear owner. Establish request volume and current effort, assess integration costs and exception rates, then agree how to measure manual touches, cycle time, successful completion, and quality.
Start With One Workflow
Where Does Work Get Stuck in Your Operation?
Let’s map the handoffs, identify the repetitive steps, and explore how an operational layer, with Sentinel where it fits, could help your team complete the work.