Automation amplifies the rule it is given. When the rule is contested, changing weekly, or different in every person’s head, machinery creates faster inconsistency.
The team cannot describe the normal path
If three people give three answers about what should happen next, agree the trigger, owner, timing, and exception route first. The clarity may solve most of the problem without a build.
The work is rare or still changing
A low-volume process with many legitimate exceptions often costs more to encode than to perform carefully. Do not automate a protocol while it is still settling.
Success cannot be observed
If the source systems cannot show whether the desired event happened, the automation will optimise activity instead.
The consequence is too broad
When a wrong action could affect many patients before anybody notices, narrow the scope. Use drafting, approvals, small cohorts, and hard volume limits.