The distinction is not intelligence. It is whether the system acts, and how many steps it takes before a human sees the result.
Agentic AI describes systems that pursue a goal across multiple steps, choosing actions and calling other systems along the way, rather than producing a single response to a single prompt. In healthcare this typically means a system that can read a record, check eligibility, draft a submission and route it, instead of answering a question about any one of those. The governance implication is that oversight has to shift from reviewing outputs to constraining actions.
A conventional assistant responds. You ask, it answers, the exchange ends. Whatever it produced, a human reads before anything happens.
An agentic system is given an objective and works towards it across multiple steps. It decides what to do next, calls other systems, reacts to what comes back, and continues until it reaches a stopping point. The human sees the result, and often not the twelve decisions taken to get there.
Take prior authorisation. A conventional tool drafts a letter when asked. An agentic implementation retrieves the relevant clinical record, checks the payer's criteria, identifies what evidence is missing, requests it, assembles the submission and tracks the response.
That is why adoption concentrates where it does. Deloitte's September 2025 survey of 100 US healthcare technology executives found 61% already building or with budget secured, and the use cases clustering in repetitive, rules-heavy, administratively painful workflows rather than in clinical decision-making.
The word "agentic" is doing heavy commercial lifting at the moment, and a meaningful share of what is marketed as agentic is a conventional workflow with a language model inside one step. That is not a criticism of the products, several of which are useful. It is a reason to ask precisely what the system decides for itself.
The question we would put to any vendor: what actions can this take without a human in the loop, and what is the widest blast radius of a wrong decision at each of those points. If the answer is that a human approves everything, it is a drafting tool, which is fine and should be priced accordingly.
The genuine shift is that autonomy is a spectrum, and most healthcare organisations have not decided where on it they are comfortable. That decision belongs to governance, before procurement, and it is being made by default in most institutions we see.