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Jul 07 2026
Artificial Intelligence

Healthcare Must Avoid Layering AI Tools on a Broken Foundation

A ServiceNow leader (and physician) discusses why many solutions powered by artificial intelligence haven’t taken off in healthcare.

My husband and I met in residency. I left clinical practice. He stayed. He runs a small private office, and I watch it every day: a brilliant clinician who spends a fraction of his time doing what he is trained to do, what he loves, which is taking care of patients. The rest is prior authorizations, documentation and chasing referrals. It’s what makes him want to walk away from medicine entirely — not the patients, but the administrative burden.

He’s not unique. I spent the early part of my career in surgical training, and I remember spending more time discharging a single patient than I spent in the operating room on the cases I was there to learn from.

Billions of dollars in healthcare technology later, the coordination problems haven’t gone away. Care teams still lose hours to tasks that have nothing to do with patient care.

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An Enterprise Run on a Patchwork of Systems

The reason is structural. The back end of any major health organization runs on hundreds of applications, each owned by a different department, none sharing a system of record. Biomed, facilities, environmental services and IT all use separate tools.

Requests fall into gaps between departments. Shift changes become high-stakes communication failures. And care teams, already stretched, become the connective tissue between systems that were never designed to work together.

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The data is stark: A 2025 time-motion study from Vanderbilt University School of Medicine, published in The Journal for Healthcare Quality, found that registered nurses spent just 34% of their time on direct patient care, while 38% was spent on indirect tasks, primarily documentation.

Margins are under pressure. Clinicians are burning out. We’re asking staff to deliver excellent care while the infrastructure works against them.

AI Bolted Onto a Fragmented Environment Doesn’t Work

There’s been enormous enthusiasm for artificial intelligence in healthcare. Unfortunately, I see organizations make the same mistake repeatedly: They layer AI onto a fragmented foundation and expect it to fix the underlying problem. It doesn’t.

Large language models are powerful, but they are not a system of governance. They don’t enforce ownership. They don’t connect systems of record or complete workflows. An AI copilot on top of hundreds of disconnected applications just exposes fragmentation.

What the Right Foundation for AI Looks Like

For AI to deliver real value in healthcare operations, it needs a unified foundation: a shared operational system of record embedded directly into the clinical environment, including the electronic health records system, so care teams can raise requests as part of their normal workflow without breaking focus.

DISCOVER: Learn how healthcare organizations are unlocking AI’s potential.

When that foundation exists, AI agents can do real work: triaging requests, routing them to the right team and keeping tasks moving without manual intervention.

Consider something as simple as broken equipment on a hospital floor. Today, a nurse calls the biomed department, waits on hold, explains the problem and hopes it gets tracked. With a unified operational platform, she flags it in the system she’s already working in. It’s automatically routed with the context the support team needs. The issue is resolved with clear ownership and real-time status. Every action is captured because the platform recorded it as work happened, not because someone filed a report.

The Stakes To Make Agentic AI Work in Healthcare Are Real

Clinicians trained to heal are spending their days navigating broken systems. That’s not an AI problem; it’s a systems design problem. And when support services move at the speed clinicians need, the effects compound: fewer care disruptions, reduced burnout, and operating margins protected from the waste of manual coordination.

READ MORE: Build a resilient AI ecosystem in healthcare beyond compliance.

My husband didn’t go to medical school to fight with fax machines. Nobody reading this went into healthcare to watch their teams drown in process. The question is whether we keep layering tools on top of a broken foundation or finally build the right one.

The organizations getting this right aren't starting with AI. They're starting with the foundation AI needs to finish work: one operational platform, shared across departments, embedded in the clinical environment.

Jacob Wackerhausen/Getty Images