In France, as in many countries, healthcare organizations have undergone a major transformation that led them to conduct new thinking to better rationalize their resources and ensure a better optimization of their flows. In this context, automation can play an important role by enabling the creation of value. Most research has focused on the technological aspects of automation and few on the organizational dimension related to the management of the actors. The purpose of this article is to propose based on an exploratory case study, an analysis grid of stakes and changes taking place for flows and actors in hospital context. The research also highlights the importance of anticipating new skills and knowledge needed to design and manage automated flows.