There is no shortage of innovation in healthcare. But what has been surprising is that despite all the innovation, it is still very difficult to navigate the healthcare system as a patient.
For years, healthcare has focused on building smarter point solutions, from smarter EHR workflows, to smarter authorization tools and copay programs. However, for people using the health system, healthcare has not become meaningfully simpler. A recent KFF survey reported about one in five AI health users say a major reason they are using AI is because they don’t have a health care provider, or aren’t able to get an appointment. That number rises to four in ten (38%) among users ages 18 to 29.
It’s not a front door, it’s a maze
While it’s a catchy saying, the concept of a ‘front door’ to healthcare doesn’t really capture the current issue. Witnessing friends and family struggle with provider search, provider communication, insurance verification and employer sponsored programs shows that there are a lot of doors to healthcare.
Rather than a front door, a newly diagnosed person experiences healthcare as a complicated maze of physicians, specialists, pharmacies, insurers, deductibles, formularies, prior authorizations, benefit explanations and coverage rules that rarely speak to one another and often contradict each other.
These barriers can lead to significant patient drop-off at every step, from finding a doctor to figuring out the costs of medication. Around 20%–30% of prescriptions are never filled at the pharmacy, and roughly half of Americans report having trouble filling a needed prescription due to cost or confusion around coverage. As a result, we see people abandon therapy, not because they lack intent, but because the system is exhausting.
The macro system will be slow to change
AI has entered the conversation as the next transformational technology in healthcare. Recent data show spending on healthcare AI increased to $1.4 billion in 2025, nearly tripling 2024’s investment. But most AI in healthcare today mirrors the fragmentation it claims to solve. These solutions are built to inform; they find the doctor, provide the price range, or summarize the benefit. But in 2026, healthcare systems (the doctors, hospitals, insurers) still are not all communicating, things are happening in silos.
What’s missing is not another point solution. What’s missing is the glue tying it all together.
So how do we help patients navigate a healthcare system this complex?
What a real navigation layer looks like
Working within a system that is slow to change calls for a need to create a single navigation layer that sits above the system, one that is not owned by a health plan, not restricted to a provider portal, not confined to a pharmaceutical brand site. There are many point solutions that aspire to be an overarching operating layer, and point solutions masquerading as operating layers, but a real intelligent and simple navigation layer that serves as the glue has the ability to connect with patients without the need for technical integration.
It doesn’t just tell you there’s a physician in your network, it schedules the appointment. It doesn’t give you a price range for your medication, it pulls your plan, shows you what you’ll pay, and enrolls you in a savings program without having to know what portal to log into. It is available to people 24/7, knowing that most of us are checking the details of our insurance plans or figuring out the side effects of a medication after hours, when 1-800 numbers and live chat bots are closed. It is sharing accurate information coming from a trusted, vetted source. And it is low cost or free to use for both patients and HCPs. Otherwise, it becomes what the industry already has too many of: another login, another app, another portal that patients abandon before it can help them.
From a technical perspective, this is becoming possible. However, the industry question is who will own it and whether the incentives allow it to be built neutrally. Health systems can support patients as long as they are within their walls. Pharma can support medication journeys but not total care coordination. Employers want simplicity but lack the infrastructure.
The result is a gap that everyone acknowledges and no one is structurally positioned to close.
The orchestration imperative
Healthcare doesn’t suffer from a lack of data, innovation or ideas. But for many people, they are still very much navigating their healthcare experience alone.
If AI is going to meaningfully improve outcomes, its greatest contribution may be something more foundational than automating paperwork or drafting notes. It may be reducing the mental burden for patients navigating one of the most complex industries in the economy.
The next wave of healthcare AI won’t win by being the smartest tool in the room. It will win by being the simplest guide in the maze.
Image: Syolacan, Getty Images
Sage Khanuja is the co-founder and president of The Rx Assistant, an AI powered digital navigation hub built for pharmaceutical manufacturers to better engage with healthcare providers and patients. An engineer by training, Sage is focused on using AI and design to eliminate the inefficiencies that slow healthcare decisions and improve patient outcomes. Prior to The Rx Assistant, Sage co-founded Spira, an AI platform focused on automating back-office workflows for providers. Spira was acquired in 2021 by Galileo, built by the founder of One Medical and Epocrates.
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