Digitized Dysfunction: Why Healthcare Must Eliminate Work — Not Just Automate It

Healthcare didn’t set out to digitize dysfunction. Five decades ago, digital transformation started with optimism and a compelling promise of less friction, more efficiency, and better care. As clinicians and healthcare leaders, digitization liberated us from paperwork, reduced errors, and enabled our systems to scale quality without scaling cost. 

Today, most organizations are in an uncomfortable position–struggling to articulate clear ROI from their technology investments. As with any system where rapid technological advancement outpaces industry adoption, we are operating with outdated transactional models that were built incrementally over time rather than designed with intention.

The impact of an ecosystem that wasn’t designed with a human-centric approach means patients — the very people the industry is built to serve — suffer the most. Instead of empowered, they feel lost, hopeless, and frustrated. Instead of better care, they get confusion, complexity, and delayed treatment. 

We’re at the doorstep of a transformation not yet fully realized. Just as sometimes the poison is also the cure, technology will help us redesign healthcare.  

The promise left on the doorstep  

The industry has invested heavily in tools like electronic health records, patient portals, clinical decision support, revenue cycle automation, and workflow software. But, adoption is uneven and challenges persist.

Every major technology implementation in healthcare seems to require hiring more people rather than fewer to keep the system running. That’s costly and time-consuming for hospitals and clinics who are doing their best to build healthier communities. 

After her kids are asleep, a primary care physician is still at her kitchen table typing away. She isn’t thinking about complex diagnoses or clinical strategy. She’s reconciling problem lists across two systems, responding to portal messages that arrived after hours, and re-documenting information already captured so that it meets billing requirements. This growing administrative burden is part of the broader staffing strain rippling across healthcare systems today.

None of this work makes a patient healthier. None of it changes an outcome. Yet it consumes hours and cognitive energy that should be reserved for care.

Physicians now spend more than half their workday in the EHR, with only a fraction of time spent face-to-face with patients.

The technology didn’t eliminate work. It redistributed it.

Here are a few salient examples:

• Because they were designed for billing, compliance, and to standardize documentation, EHRs created clerical work for clinicians. Even after clinic hours, physicians spend additional “pajama time” in the EHR, averaging six additional minutes per patient. This, in turn, meant organizations hired entire teams of scribes, trainers, and analysts to solely support EHR workflows.
• Patient portals created new streams of work, increased message volume without reimbursement, and fragmented communication across the system. Health systems had to hire nurses, medical assistants, and call center staff to triage the noise. 
• When layered on top of each other, best-of-breed solutions require dozens of logins, manual handoffs between systems, and the stitching together of data. Instead of efficiency, we’ve seen increased coordination costs. 

All of these tools were add-ons, not replacements. Our industry’s challenges are only growing more complicated as we introduce more digital health technologies, wearables, and other wellness and lifestyle devices into the mix. 

Healthcare’s dysfunction is systemic. It is not the fault of a single platform, vendor, regulatory body, or innovation. Nor have healthcare professionals grown averse to technology usage, despite the challenged systems. 

We digitized healthcare workflows, but we never redesigned how the system actually operates. Real transformation will not come from adding more technology, but from rebuilding the way care is organized and delivered.

Asking what to automate next is too narrow. Fixing isolated tasks like message routing or appointment scheduling still risks adding fragmentation to the existing system. Instead, we should return to the question that has always been at the center of healthcare: how do we ensure patients receive the care they need to live healthier lives?

The question that opens the door

No single stakeholder in healthcare fundamentally owns the end-to-end workflow, especially when it comes to the patient experience. 

Where automation is focused on tasks, healthcare needs to transform at the systems-level. While there are AI tools for coding and prior authorization, leaders need to first ask whether these are the primary processes to be targeted. Answering that question requires us to reconsider what transformation should actually accomplish.

This in part means digging deeper to define true ROI beyond AI adoption. Transformation efforts need to focus on designing around the patient journey, eliminating unnecessary work, and embedding intelligence where it adds context. 

When we open the door, here’s what real transformation may look like:

• Platforms over tools. Transformation requires fewer, more connected systems that actively coordinate work. Instead of separate tools for intake, diagnosis, scheduling, and follow-up, organizations need platforms that manage the full workflow from start to finish. This reduces the need for manual reconciliation, workarounds, and shadow processes. For instance, in cardiology, a connected platform could take a referral, trigger the right tests, schedule the patient, and guide follow-up without staff re-entering data or chasing next steps.

• Work elimination not digitization. No technology will be purchased or implemented unless it removes steps. If it doesn’t remove work, it’s hard to call it transformation. Leaders need to ask these three questions when considering any new tool:
  • What work should no longer exist? 
  • Which handoffs can be eliminated entirely? 
  • What decisions can be made once instead of repeatedly? 

• Systems designed around the patient journey, not departments. More often than not, healthcare tech is built around billing units, services lines, and administrative silos. Our redesign should be around longitudinal patient journeys–from home to clinic to hospital and back. We need ownership of outcomes, not tools. 

• Embedded intelligence instead of alerts. Alert fatigue is real. Healthcare workers do not need another dashboard or any more alerts. We need workflows and context-aware automation that informs users of the next best action to take. Ultimately, that information should translate into action within the healthcare system. 

• Redefinition of ROI beyond adoption. We’re beyond measuring success by click counts, and our primary goal is no longer to reduce the number of clicks. Success should be measured by time returned to clinicians and roles shifted from administration to care. Let’s look at roles eliminated, patient outcomes, reduced handoffs and exceptions, and money saved; decisions that were automated instead of escalated. 

Stated simply: if staffing models do not change, the technology has not transformed anything. Transformation only happens when every element of the system is elevated to its highest value: clinicians practicing at the top of their license, staff freed from low-value work, and AI and workflows carrying what humans no longer should. If cost doesn’t come down for every stakeholder across the system, it hasn’t worked.

Redefining healthcare’s future

Navigating our industry is fraught with hurdles, challenges, headaches, and so many missed opportunities. It doesn’t have to be that way. As counterintuitive as it sounds, technology will help us reimagine healthcare’s digitized dysfunction. 

Healthcare inefficiency is rarely about a single task. It is typically about disjointed systems, misaligned incentives, and fragmented accountability. When we automate broken processes like these, we simply fail faster and at scale. 

We do not need smarter tools layered onto broken systems. We need the courage to redesign the system itself. Technology can be the accelerant, but only if we stop automating dysfunction and start remembering the purpose behind it all: healthier humans.

Photo: Tajuddin Molla, Getty Images

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