If you're evaluating Microsoft agent frameworks and wondering what belongs in a research lab vs what belongs in a hospital's ops center—this one's for you.
Let’s cut to the chase: Microsoft now offers two very different agentic frameworks under the same roof. One comes from its research labs (AutoGen). The other, Semantic Kernel, is backed by Azure AI’s enterprise engineering team. You’ve probably seen both in demos. But which one do you bet your compliance budget on?
I’ve done the work. Here’s the breakdown.
TL;DR
AutoGen is the rocket ship—most GitHub stars, fast agent experiments, great for research and early prototyping.
Semantic Kernel is the runway—GA support, audit trails, Azure integration, and mission-critical readiness baked in.
Which Has More Support?
Community velocity → AutoGen wins on stars, Reddit buzz, and frequency of PRs.
Enterprise-grade backing → Semantic Kernel, hands down. It’s GA, it’s got an Azure SLA, and it’s where Microsoft is anchoring real-world deployments.
If you're building something that runs in prod with real patient data, skip the GitHub hype. Look at who's holding the liability bag when something fails.
Which One Belongs in Healthcare?
In my view: Semantic Kernel wins for anything critical to compliance, operations, or financial performance. Why?
Azure-native observability – Built-in hooks to Azure Monitor, structured logs, and token tracking. You’ll need this for CMS and NIH audits.
Compliance posture – SK is already being used in HIPAA and FedRAMP environments. You get Entra ID, scoped policies, and proper support channels.
Deterministic tool calling – Using MCP (Model Context Protocol), you can force the agent to only use whitelisted tools. That’s not optional when a hallucinated call could trigger a compliance event.
Multi-language support – .NET for your existing health system stack, Java if you’re interoperating with Epic, and Python for the data science teams.
Roadmap clarity – Microsoft has committed to stable APIs and long-term support. That matters when you’re selling to legal, risk, and IT.
Where AutoGen Shines
Don’t write it off.
AutoGen is the tool if you need to:
Rapidly prototype agent teams
Test planning strategies and reasoning loops
Build skunkworks PoCs that may or may not ever hit prod
Think of it as your garage. Once the engine runs reliably, move it to the showroom—aka Semantic Kernel.
Final Word
If you’re deploying into a regulated environment—SK is your framework. You’ll get the governance, auditability, and tooling Microsoft actually supports long-term.
If you're just tinkering or building research-grade multi-agent flows—AutoGen is fun, fast, and flexible. But don't mistake it for something ready to protect your hospital’s NPI, wRVUs, or FTEs.