The current tension in healthcare tech isn’t just about software; it’s a collision of two incompatible philosophies.
On one side stands the EMR companies with their own boundaries. These are the clinical titans of our industry, the giants that are optimized almost exclusively for the patient/physician encounter. They are massive systems of record. They are not, however, systems of human behavior. For these incumbents, the hesitation to daily “nudge” a patient isn’t a lack of technical capability. It’s a deliberate design choice. It is a feature of a liability envelope designed to stay safely within the clinic’s four walls.
And then there is the consumer AI explosion. It’s seductive but flawed. While tools like ChatGPT offer breathtaking processing power, asking a sick patient to upload their EMR (most have no clue how to do that) and to “prompt engineer” their way toward a diagnosis is a fundamental oxymoron. It’s a sophisticated tool for a general audience that essentially demands a medical degree to navigate safely.
Here is the inconvenient reality: clinical intent evaporates the second a patient pulls out of the hospital parking lot. The most expensive failures in our healthcare system, the preventable ER visits and the unclosed care gaps, occur in that 99% of life that happens between doctor visits. This is where the friction lives.
To truly advocate for patient health and preventive care, consumers need a “Third Way.” That path rejects the idea that a patient must be their own clinical curator. It also rejects the idea that care ends at the hospital or physician office exit. We need an agentic layer capable of fetching a longitudinal medical record and translating that static clinical intent into a daily, living context. We consumers need to know what to do next as our daily routine and environment changes – and we often benefit from reminders. Physicians have long lamented low levels of engagement by their patients, and new technologies are helping solve this frustration.
By moving beyond protecting institutional turf and focusing on the messy “micro-moments” outside the clinical encounter, we can finally solve the engagement gap. The future of healthcare isn’t a race for better data during the visit. It’s a race for better intelligence during the quiet moments in between.
Photo: verbaska_studio, Getty Images
Kris Narayan is the Founder and CEO of MediKarma. A veteran entrepreneur in the health-tech space, Kris has spent his career developing technologies that bridge the gap between clinical data and patient action. He is a frequent speaker on the role of agentic AI in value-based care and is dedicated to building systems that empower patients through personalized, longitudinal health intelligence.
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