Every industry reaches a point where incremental improvements are no longer enough. I believe healthcare has reached that point.
In recent decades, we’ve invested heavily in digital transformation. EHRs, patient portals, cloud platforms, and now AI have fundamentally changed what’s possible.
Yet despite extraordinary investment and innovation, many healthcare organizations still wrestle with familiar challenges. Providers spend more time staring at screens than caring for patients. Staff navigate disconnected systems to complete routine tasks. Patients wait weeks for appointments and face unnecessary friction throughout their care journey.
Technology has evolved dramatically, but the way work gets done has remained stagnant.
That raises an uncomfortable but necessary question: If we’ve invested so much in innovation, why do so many healthcare organizations still operate as if constrained by workflows designed decades ago?
The answer isn’t that healthcare has failed to innovate. It’s that we’ve become remarkably good at patching workflows instead of asking why they broke down in the first place. Each patch makes sense in isolation. Collectively, they create operational, experience, and technical debt; collectively, workflow debt.
If we’re serious about transforming healthcare, we need to stop asking how technology can make today’s workflows more efficient, start asking whether those workflows should exist at all, and intentionally redesign them to reflect how providers want to practice and patients want to get care.
That is how healthcare starts paying down this debt.
Every Broken Workflow Eventually Becomes a Patient Problem
Operational inefficiency is often seen as an internal challenge. We associate it with administrative burden, staffing shortages, poor revenue cycle performance, or clinician burnout.
However, these are also patient issues. When clinicians spend evenings completing documentation, patients receive less face-to-face attention during the day. When referrals are delayed because information doesn’t flow efficiently between systems, patients wait longer for diagnoses and treatment. When staff must manually verify information across disconnected applications, patients face unnecessary delays.
It’s true that patients may never see the workflows operating behind the scenes, but they certainly experience the consequences.
How Did We Get Here?
Organizations have historically responded to reimbursement changes, regulatory requirements, staffing shortages, and acquisitions by solving immediate operational problems. Each investment made sense in isolation. One new application solved scheduling. Another improved billing, addressed compliance, and so on.
While these investments created meaningful progress individually, they collectively introduced layers of complexity that few organizations ever stepped back to rethink or redesign. Administrative activities are estimated to account for roughly one-quarter of total U.S. healthcare spending today. While many activities are essential, too much of that cost is paying interest on workflow debt: duplicated effort, disconnected systems, and operational complexity.
We need to stop servicing this debt and start paying it down with three fundamental interventions:
Shift 1: Putting Tech in its Proper Place
Over time, technology has too often become the center of workflow design instead of the enabler of care.
That distinction may sound subtle, but its impact has been profound. Providers have increasingly adapted to systems rather than systems adapting to providers. Clinical workflows have been constrained by software requirements rather than shaped by patient needs.
Technology should enable great care, not define it.
Shift 2: Reimagining Work Altogether
Healthcare has spent years modernizing existing processes. We’ve digitized paper, automated manual tasks, implemented patient portals, introduced bots, and are now rapidly deploying AI.
Those investments have unquestionably delivered value, but modernization is not the same as transformation. Too often, we’ve refreshed yesterday’s operating model instead of asking whether it still deserves to exist.
Adding artificial intelligence to a broken workflow doesn’t transform the workflow. It simply allows us to execute the same process faster. As I often tell our teams: “Magic dust sprinkled on top of broken is still broken.”
The greatest opportunity AI presents isn’t automation, it’s reimagination. Instead of asking, “How can AI automate this workflow?” healthcare leaders should begin asking: “If we were designing this experience today, knowing everything that’s now possible, would we build it this way?”
Shift 3: Democratizing Information
Healthcare organizations have never had more information available to them, from clinical data to operational metrics, financial performance, and quality measures.
Unfortunately, critical information often remains fragmented across applications, departments, and vendor ecosystems. Every team owns part of the story, but no one has the complete picture. When clinicians and staff don’t fully trust the information available to them, they naturally feel the need to recreate it. They verify data that’s already been entered, ask patients repetitive questions, and duplicate work. The future belongs to organizations that democratize trusted information rather than silo it.
AI Changes What’s Possible
AI has quickly become the defining conversation in healthcare, and for good reason. But AI is not the transformation. It is the accelerator.
Organizations that automate fragmented workflows simply automate fragmentation. Organizations that redesign workflows before applying AI unlock something far more valuable: capacity. Capacity for clinicians to spend more time with patients, for staff to prioritize tasks, and for leaders to make decisions with appropriate context.
Perhaps the most exciting future isn’t one where clinicians become more efficient at navigating software—it’s one where software increasingly disappears into the background. Technology should quietly orchestrate work, surface trusted information when it’s needed, and eliminate unnecessary administrative effort.
De-Normalizing the Broken
Healthcare has always been defined by resilience. That resilience has carried our industry through extraordinary challenges and will continue to define the people who dedicate their lives to caring for others.
But resilience was never meant to become a permanent operating strategy. Resilience is what allows an organization to keep functioning while it carries debt. It isn’t a substitute for paying down that debt. The next chapter of healthcare won’t be defined by how well organizations adapt to complexity. It will be defined by how deliberately they retire it.
About Gautam “G” Shah, MBA, FACHDM
Gautam “G” Shah, MBA, FACHDM, joined NextGen Healthcare in 2026 as Chief Product and Strategy Officer. His 25 years of global experience span product management, AI, digital transformation, clinical workflow optimization, healthcare finance, and patient experience solutions.
