AI Won't Fix Your Broken Workflows

Every healthcare conference I attend looks the same now. Booth after booth of AI startups promising to revolutionize patient care, automate workflows, and slash costs. The pitch decks are slick. The demos are impressive. The ROI projections are aggressive.
And yet, a year later, most of these deployments are dead.
I recently sat down with Paul Hellwig—a guy who's spent 14 years in the trenches of healthcare AI, including a stint as a hospital Chief Data Officer—and asked him why. His answer was blunt: "AI itself as a technology solves only 20% of the equation."
Twenty percent. That's it.
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It's the Workflow, Not the Model
The remaining 80%? That's workflow integration. Data access. Edge case handling. Escalation paths. The unglamorous stuff that doesn't make it
into pitch decks.
Here's the problem: most AI vendors are technology companies first. They've built impressive models. They've benchmarked against OpenAI and Google. They can show you accuracy rates that would make any healthcare executive's eyes light up.
But they've never actually watched a scheduling coordinator try to navigate three different EHR systems to book a single appointment.
Hellwig put it plainly: "Many startups make marketing with their model quality... but if you only look at the technology, it will never work."
Six Million Dollar Systems Don't Get ReplacedThere's a reason healthcare organizations are still running phone systems from 2008. When an MRI machine costs six million dollars, you don't swap it out because a new data format dropped.
Walk through any hospital and you'll see state-of-the-art equipment sitting next to systems that belong in a museum—all operating fine, all talking to each other poorly, all creating the data silos that kill AI projects before they start.
EHR vendors built their systems to capture data, not share it. Twenty years of that approach means twenty years of siloed information that AI tools can't access without massive integration timelines.
And here's what those timelines do: they kill ROI. By the time you've spent nine months trying to connect your shiny new AI to legacy systems, the executives who approved the project have moved on. The budget's been reallocated. The pilot becomes another cautionary tale.
Start with Scheduling, Not Surgery
The healthcare organizations getting real value from AI aren't chasing the flashiest technology. They're starting with workflows they actually understand.
Administrative tasks are the sweet spot. Scheduling. Prior authorizations. Referral management. These are processes with clear inputs, clear outputs, and clear failure modes. When something goes wrong, a human can step in without catastrophic consequences.
That's the hybrid model Hellwig keeps coming back to: "In healthcare, we never can have a fully automated solution because we always have patients we want to care for."
Patients need to trust the person on the other end of the line. They need to know that when their situation is complicated—and in healthcare, situations are always complicated—a human being will actually help them navigate it.
AI handles the routine. Humans handle the exceptions. And the handoff between them has to be seamless.
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The Question That Separates Vendors
If you're evaluating AI vendors for your healthcare organization, here's the question that separates the serious players from the demo-ware: "Walk me through what happens when your AI fails."
Because it will fail. Edge cases are inevitable. The question is whether the vendor has thought through escalation paths, human oversight, and graceful degradation—or whether they're just hoping the model is good enough that failures won't matter.
The vendors worth working with will have boring answers to that question. They'll talk about workflow mapping. Integration timelines. Staff training. Change management. They won't promise that AI will solve everything.
They'll promise that they understand the 80%.
---
This article is based on a conversation with Paul Hellwig on The CX
Report podcast.
Watch the full episode here:
https://youtu.be/PnSWBvTTj8c
EGS provides AI-hybrid healthcare workflow solutions for health
systems and FQHCs.
Learn more at https://emergingglobal.com
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