From PegaWorld: enGen's Richard Rutkowski on moving agentic AI from theoretical to practical

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Gregg Hillstrom: Hi, I'm Gregg Hillstrom, host of the Agile Brand, and here's a question for you. Most leaders think about AI as a tool to analyze data and assist with tasks. But what happens when your AI becomes an autonomous agent, not just providing insights, but actively orchestrating complex processes on its own?

Greg Kilstrom: Today we're here at uh, Pegaworld 2026

Gregg Hillstrom: at the MGM UM grand in Las Vegas and we're going to talk about moving AI from a theoretical concept to a practical value driving reality. Specifically, we're going to explore the transition from predictive AI to agentic AI and what that means for orchestrating complex customer journeys. The architectural and data foundations required to successfully deploy autonomous AI agents at an enterprise scale, and how this approach enables a new level of proactive personalized engagement that improves outcomes and drives business value.

Greg Kilstrom: Welcome to season eight of the Agile Brand Podcast. This season we're going all in on expert mode. MarTech AI and customer experience Talking with the People and platforms behind the brands

Gregg Hillstrom: you know and love.

Greg Kilstrom: Again, I'm your host, Greg Kilstrom and I help Fortune 1000 companies make sense of MarTech AI and marketing ops. Hit, subscribe or follow to make sure you always get the latest episodes and leave us a rating so others can find us as well. PEGA provides the leading AI powered platform for enterprise transformation. The world's most influential organizations trust pega's technology to reimagine how work gets done by automating workflows, personalizing customer experiences and modernizing legacy systems. Since 1983, Pega's scalable flexible architecture has fueled continuous innovation, helping clients accelerate their path to the autonomous enterprise. Learn more@pega.com

Gregg Hillstrom: to help me discuss this topic, I'd like to welcome Rick Rutkowski, Director of Product and Technology at Engine. Rick, welcome to the show.

Rick Rutkowski: Hey, Greg, thanks for having me today. Yeah, yeah.

Gregg Hillstrom: Looking forward to talking about this and great to be here at pegaworld. Ah. Um, before we dive in, why don't you give a little background on yourself and your role at Engen?

Speaker E: Sure.

Rick Rutkowski: I'm the clinical product director at Engen. Um, we are a wholly owned subsidiary of Highmark Health, which is the third largest Blue Cross Blue Shield plant in the country. Um, my background is about 28 years in healthcare. Uh, the last 10 have been in the clinical space. And I have to say this is, um, an explosion, I think, in an area, um, that I've never seen before in the 28 years. It's just clinical is just where it's at if you want to make a difference.

Speaker E: Yeah, yeah.

Gregg Hillstrom: So, um, I know you touched briefly, but let's talk a little bit more about Engine and, um, you know, what's the company's core mission and the types of organizations that you primarily serve?

Rick Rutkowski: Yeah, Engine's a health tech company. Um, we support other health plans on their journey to improving the way they manage care, deliver care, things like that. Um, we focus on the underpinnings of that, the platform, the systems, the capability. But for me, my focus is predominantly predictable, um, that I help them with their clinical journeys.

Speaker E: Got it, got it.

Gregg Hillstrom: So, yeah, let's dive in here and certainly we're going to talk about a few things, but I want to start with really the strategic approach here and this strategic shift to agentic AI. Certainly lots of people talking about it. Uh, but in extracting value from it, a lot of organizations are running into challenges and certainly there's a lot of headlines about things like that. Uh, from your perspective at Engine. Um, how do you define agentic and what's the fundamental strategic shift required for an organization to move towards it?

Rick Rutkowski: Yes, with AI, you're taking information to analytics that a human will then step in, interpret and act upon. With agentic AI, you're kind of replacing that human. Okay. Not that a human's not in the loop, but you're replacing that human when you're making that determination or decision. The driving need to shift though, to move to an agentic world I think is really scale. And it sounds a little odd, but if I talk about a few of the, I'll say storms that are out there in the health care world, you've um, got aging populations with chronic illness on the rise. We've got clinician burnout to levels we haven't seen before. So there's a work shortage. Regulatory, uh, policy. With CMS ratcheting down, SLAs means more, faster and again clinicians are burning out. Right. And rising costs and those other items. But if you want to scale, you can't go with traditional care management which is fragmented, disconnected. So you have to move to something that's a little bit more orchestrated or interoperable, uh, that utilizes data, it's modular, can connect to other systems, other vendors, other data sources. And then you gotta layer AI and add intelligence on top of that to be effective.

Speaker E: Yeah, yeah.

Gregg Hillstrom: And you know, healthcare being a highly regulated and complex industry to boot, you know, what are the strategic considerations and stakeholder buy in necessary to make the case for doing something like the agent? You know, again, AI, it can sound intimidating or things like that in such an environment.

Rick Rutkowski: Yeah, especially in healthcare. Right. So regulations, we have to be extremely thoughtful with how we advance, um, with all the privacy concerns that are out there and security concerns. Um, but we've established governance, um, that includes measures, um, clear measures, dashboards, um, results, auditing, traceability. You have to have a full picture of each and every agent that you put out there. Or even if you're thinking about AI, you have to understand the data. Um, then you got to align the buy in. You need your operations team and you need something that's going to bring them value. And I like to, I tend to start with, or have started with, um, use cases that are there today that you can maybe scale. Right, right in the workflow. Um, again they're a part of fully testing and piloting. And then, you know, I think the desire from their side is those pressures I talked about, they don't really have a choice. But you do have to kind of get on board. I think that's the way to go.

Speaker E: Yeah, yeah.

Gregg Hillstrom: So now I want to talk a little bit more about, you know, how we take that strategy and implement it. So um, one of your colleagues, um, uh, had a session describing uh, you know, building the architectural chassis, um, of the, of the operations on Pega to leverage this agentic AI. Can you break down what that means from a tactical perspective? You know, what are the core components? Things like data integration, process automation, or other things that need to be in place for something like this to work?

Rick Rutkowski: Yeah, that's a good question. So that chassis is what makes it possible, right, for agents to work across the entire ecosystem, not even just in predictable, um, and this is embedded in the workflows, the AI summary, the decision making, etc. Agents can react to data events. I guess a good example would be, and try and explain before I tell you why we did it, a discharge event. It's a data event that comes from an EMR letting you know that somebody was in the hospital for something urgent potentially. Now they're being let out. What we like to do is several things. An agent can look at that, find it, determine the criticality of it. I wasn't just in because I went because my arm hurt. I was in for maybe a cardiac event. Then it would update the authorization in one system. It would start a case for care and schedule with a skilled case manager and another system and it would send a nudge to the member via uh, digital means. Maybe it's a text, maybe it's their portal, their application, their app, whatever it might be. Um, that's all orchestrated through this architecture. So to get to that, okay, to get to that you have to hit several core capabilities. And what we did was we focused on diverse data. They're structured, unstructured data, monitoring data claims. All your traditional datas are out there, but you have to bring them in, organize them, have them available to the entire ecosystem.

Gregg Hillstrom: But I mean what you're describing, I mean not only are there a lot of moving pieces in there that are, know, automated, but they're, it's critical that they're, they are right. I mean it's, I know I'm stating the obvious here, but you know, we're talking healthcare, we're talking about, you know, these are pretty mission critical systems and the right data needs to go to the right place for the right person, so on and so forth. So getting that right is, you know, that, that's, that seems like the key challenge.

Speaker E: Right?

Rick Rutkowski: Yeah. You're 100%. Right. And you know, the business operations, they're not going to buy in unless you actually prove this out. And we all hear some of the horror stories that are out there. Most of what I described has a human in the loop or on the loop depending upon what the situation may be. So generating summaries still requires clinical acumen to review it, but before when a clinician had to go look in three different systems to find data and try and bring it together, it's now presented within sites that they can confirm or deny and then that's all part of the process. Right. So human in the loop is a good way to gain their trust. Um, it's also less about replacing, you know, there's always the worry about jobs. Right. It's less about replacing the individual, more about supplementing their ability to do what they do best, which is their clinical acumen, and free them up to actually work with the member. So um, those are the types of things I think you have to get the business on board with.

Speaker F: Right.

Gregg Hillstrom: But I think also on the flip side of that, there's so much that a human has to do, you know, in the, in the pre automation part of that, there's so much that a human is responsible for that they have to get right as well, you know, so it's kind of, it's critical that the automation gets it right. But the human, the cognitive load on a human to get all of those things right and route it to the right place. It's, there's a, it seems to me like there's a huge opportunity for AI to kind of, to what you just said, get the human focused on the right thing, not just overburdened with all the things they have to put in the right buckets.

Rick Rutkowski: Basically the non clinical events are just burning out the clinicians and.

Speaker E: Right.

Rick Rutkowski: You know, um, you can just, you can't scale that way. Here's what it comes down to. And like I said, when you've got chronic illness on the rise and cms ratcheting down SLAs, it's just not going to be possible.

Speaker E: Yeah, yeah.

Rick Rutkowski: So plans have to get on board.

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Gregg Hillstrom: So let's talk a little bit about um, how we measure success here. So with a system designed for earlier clinical detection and optimized prioritization, how do you measure success?

Rick Rutkowski: So success for us is uh, focused on um, how we're enabling, I guess, more care faster. Didn't um, say that? Well, um, the way we're freeing up the clinicians to do more, we're not necessarily positioned around specific outcomes yet we're doing a lot of piloting and proof of concepts. We do have ambient listening in production, so we are seeing some results there. I think in that front, um, we actually do a bit of a traditional measure because when you can do more and gain more engagements, it's proven over the years that you're going to have better outcomes. Less ER visits or revisits I should say, which allows you to save X amount of dollars because their outcomes are better.

Narrator: Right.

Rick Rutkowski: So you're helping member the health plan benefits by saving money.

Speaker E: Right.

Rick Rutkowski: Ah, this type of engagement, even when I explained before with ambient listening, is what's allowing us to scale that. So those numbers are going to go up. Um, outside of that, we haven't done a lot of measures yet, but we are seeing uh, increased value. When you talk to the clinician about, wow, it is great that I have this summary and I can actually look at it and interpret it. Okay. Because not everything's agentic, but then some of the actions that come out of that could be automated in the future once you see the results are functioning well.

Gregg Hillstrom: Well, and I would say, you know, those things that you just mentioned are their proof points, right. Of, you know, some, somebody listening to this that may be a little behind the curve on things, but needs to get started. You know, are those the types of proof points where, you know, you can, uh. It's anecdotal, but it's still powerful, right?

Rick Rutkowski: It is, it's very powerful. Especially if you're in a clinical space, I would say on the case management side's a good place to kind of lean into that a little bit or lean in there. You know, from a utilization management standpoint, doing it responsibly I think is what's important. Uh, if you're out there thinking, how do I do this? Right.

Speaker E: Yeah.

Rick Rutkowski: Um, um, when you make a utilization management determination today, it's always a clinician, it's always a nurse and a medical director with agentic AI. You can now take all the clinical data you have, everything you know about that individual and the auth, and compare it to the medical policy and render a decision. But it can be done in parallel to what the medical director's doing until you feel comfortable enough that, yeah, they're aligned all the time or to a certain percentage that you say, yeah, the risk of it being wrong isn't really something we would worry about at that point. So you can shift it left, if you will, from that parallel processing to putting it right in front of the medical director, then human in the loop to saying, you know what, we're just going to let that go because it makes sense. We approve it in 95% of these situations and the agent knows that type of thing.

Gregg Hillstrom: Yeah, yeah. And I mean in that, in that shift left approach, it's not getting rid of the, the approval and, or the verification, it's just moving it left, right? Yeah, yeah, definitely. So, um, you know, looking ahead a little bit at ah, how does a platform based approach like the one that you've built with pega, um, you know, what does that look like from a future innovation standpoint?

Rick Rutkowski: So I think it'll better support, uh, your flexibility in the future and your ability to scale. We talked about that. I think I've said the scale word several times today.

Gregg Hillstrom: It's important.

Rick Rutkowski: Yeah, right. So understanding being able to orchestrate from a platform perspective the entire Care journey as seamless as possible is important. So you're unifying the data, the workflow and the AI, that intelligence in there, right? Yeah, um, it's easier to evolve other capabilities over time, meet the changing needs, regulatory needs and just the needs of the population. Um, because I guess a chronic illness is on the rise. But if you're staying put in traditional systems and you're nervous about getting into this, I think you're gonna be left behind and you're not probably doing a bit of a disservice to your members. Um, I'm not saying you go full force into AI. AI, uh, can be a dangerous thing, but if you do it responsibly, it can be really effective.

Speaker E: Yeah, yeah.

Gregg Hillstrom: I mean it sounds like starting with a measured approach and watching it and adopting slow, I mean that's what I've heard from other, several others here as well, is just, you know. Yeah, it's not, it's not go, go all in. But it's at, at, you know, at the beginning, let's say. But, um, you know, but taking those initial wins and building on them and learning.

Speaker E: Right.

Rick Rutkowski: That's 100% right. And I, I again, I think we've seen, we've seen value, again, not necessarily quantifiable yet in our pilot stage for some of these. Um, but we're seeing a lot of value and we're seeing clinician buy in, which is important.

Speaker E: Yeah, yeah, love it.

Gregg Hillstrom: Well, Rick, uh, thanks so much for joining today. Um, two last questions as we wrap up here. First, uh, you know, we're here at pegaworld in Las Vegas. Uh, what's been a highlight for you so far?

Rick Rutkowski: Alan's a great speaker as always. Um, but I think just where AIs advanced, I mean, we've been talking about AI for the last few years and it just seems like it's finally really moving from theory to practice. The more people I interact with around here, I'm starting to find that out too. And it's across all industries, so I think that's important.

Speaker E: Yeah, love it.

Gregg Hillstrom: And last question for you. What do you do to stay agile in your role and how do you find a way to do it consistently?

Rick Rutkowski: Uh, to stay agile in my role, I try to stay flexible and open minded. Um, I try to build good relationships with my peers and stakeholders and understand where the industry is going. Um, and when you think you have it figured out, you should keep looking because there's always something else and there's always something new that's going to advance um, case management or utilization management for me specifically.

Speaker E: Yeah, love it.

Gregg Hillstrom: Well, again, I'd like to thank Rick Rutkowski, Director of Product and Technology at Engine, for joining the show. You can learn more about Rick and Engine by following the links in the show.

Speaker E: Notes

Greg Kilstrom: PEGA provides the leading AI powered platform for enterprise transformation. The world's most influential organizations trust pega's technology to reimagine how work gets done by automating workflows, personalizing customer experiences, and modernizing legacy systems. Since 1983, Pega's scalable flexible architecture has fueled continuous innovation, helping clients accelerate their path to the autonomous enterprise. Learn more at pega. And thanks again for listening to the Agile Brand podcast. If you like the episode hit, subscribe and drop a rating so others can find the show too. And if you're interested in consulting, advisory work, or if you need a speaker for your next event, feel free to reach out. Just visit GregKillstrom.com that's G R E G K I H L S T r o m m.com the Agile brand is produced by Missing Link, a Latina owned, strategy driven, creatively fueled production co op. From ideation to creation, they craft human connections through intelligent, engaging and informative content. Until next time, stay curious and stay agile.

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