The article examines the transformation of end-to-end automation in large organizations driven by generative and agentic AI. The aim of the work is to conceptualize the gap between formal regulations and actual process execution and, on this basis, to propose architectural principles for multi-agent orchestration. The relevance of the topic is determined by the limitations of classical robotic automation and workflow management systems when confronted with rich context, high variability, and stringent requirements for decision traceability. The novelty of the article lies in synthesizing research on intelligent automation, BPM, and human-in-the-loop approaches into a foundational multilayer architecture, in which agents function as specialized executors with explicit I/O contracts, decoupled from the orchestrator; policies and knowledge formalize the boundaries of autonomy; and human participation is treated as a regularized risk-management procedure. It is shown that such an architecture shortens process cycle times, reduces errors at role interfaces, supports reuse of agent roles, and shifts process management toward a regime of observable execution. It also provides an industry-grounded illustration of these principles through an enterprise-scale clinical service launch in which a new treatment modality was evaluated, governed, and rolled out across distributed sites under strict evidence discipline, risk controls, and measurable financial outcomes. This case exemplifies how multi-agent orchestration, contractual handoffs, and formalized escalation can translate into accelerated adoption, reduced execution friction at interfaces, and auditable value creation. The article is intended for AI system architects, process owners, and digital transformation leaders.