Transforming urolithiasis pathways through robotic process automation

Objective: To evaluate the implementation of automated digital workflows for the management of urinary tract stone disease using existing National Health Service (NHS) infrastructure and to assess their impact on administrative processes, reliability and data governance. Subjects/patients (or materials) and methods: Clinical and administrative workflows for extracorporeal shockwave lithotripsy referrals, treatment documentation and acute stone clinic management were mapped and automated using Microsoft Power Automate within the National Health Service mail environment. Automated processes included document generation, email communication, task management, imaging requests and clinical correspondence. Workflow activity between July 2023 and March 2025 was analysed. Results: The system was utilised on 2669 occasions involving 2291 patients across 4 National Health Service trusts and 89 users. Automated workflows performed 13,450 administrative actions that would otherwise have required manual completion. No data loss was identified. Twenty-nine workflow failures occurred, resulting in a 98.9% success rate; all failures were attributable to data-entry errors or minor workflow design issues that were subsequently corrected. The system facilitated standardised consultant-led care, reduced reliance on manual administrative processes and generated a centralised database for audit and research. Conclusion: Automated workflows can be safely implemented within existing National Health Service digital infrastructure to support stone disease pathways. They reduce administrative workload, improve pathway standardisation, maintain information governance compliance and enable reliable data collection without bespoke software development.