Healthcare providers and payers have begun to adopt AI technology; now they need to make the leap to AI orchestration. In the field, we see this disconnect manifest in patient access. Providers made the investment, deployed the solutions, but patients still face friction accessing care. We’re often asked – how do we, and our populations, get the promised value out of this new technology?
For some, AI is delivering. The support and care teams we work with describe real, measurable relief: more capacity, top-of-license focus, and time with patients – less administrative drag. Philips’ 2026 Future Health Index confirms what we’re hearing on the ground: 71% of clinicians report improved workflow efficiency with AI, and half say it has increased their capacity to see more patients. The gains are real, yet they obscure a problem that isn’t going away.
The industry’s AI conversation continues to confuse engagement with orchestration. In that confusion, it abandons the first point of contact for care: the phone. Despite years of digital investment, providers struggle under the weight of inbound calls. This burdens patients with creating access for themselves, persisting fragmentation, and barriers to care.
This is no longer a technology problem; it is an orchestration problem.
High call volumes signal fragmented patient engagement
Fragmentation follows a pattern: a patient misses an appointment; the reminder never landed, because it went to an outdated email address. Follow-up care instructions arrive; the patient can’t follow them, because they’re in the wrong language. A diagnostic procedure needs to be rescheduled; the ordering provider has to secure a prior authorization. A lab result notification sows anxiety; the patient has to wait to hear from the clinician to understand what the results actually mean. The failure points differ, but the next step is consistent: the patient picks up the phone.
Healthcare recognizes this and has invested heavily in digital tools, seeking to prevent this. Patient portals, online scheduling, engagement platforms, and now AI assistants — the industry has committed to digital in a real way. Healthcare deploys AI at more than twice the rate of the broader economy. And yet what we consistently observe is that many patients still rely on the phone for routine questions, referrals, and scheduling. The tools haven’t eliminated the call, nor have they made the answer to the call more impactful. When patients call, it’s almost never because they prefer the phone. They call when something upstream in their digital experience left them without what they needed; then they find what they get when they call no better than what led them to call in the first place.
For a provider or a health plan, a high inbound call volume warns of fragmented patient experiences. Fragmentation in healthcare follows a lack of coordination among providers, payers, and organizations. We’ve seen this systematic disconnect frustrate patients, create inefficiency for providers, and erode access to the care patients need.
When patients receive portal messages, texts, or automated phone calls with confusing or incomplete information, their first instinct is to pick up the phone and call the provider. Fragmentation occurs when this digital disconnect leaves patients with more questions than answers.
At scale, we see this become a compounding problem. Patients calling with questions about appointments, referrals, billing, and care instructions create a backlog that grows faster than staffing can absorb. Here’s the counterintuitive part: adding more engagement tools doesn’t fix it. More technology without orchestration increases the burden on staff: every outreach creates a response – a question that a human must answer over the phone. Because of that, the front desk or support department has to manage new workflows. The vicious cycle continues when decision-makers bring in a new point solution to streamline the new workflow.
Digital disconnects drag down operational efficiency and hurt providers’ bottom line
The data reinforces what we observe on the ground. According to Health Affairs Scholar, nearly 72% of patients schedule medical appointments over the phone. This does not include the number of inbound calls from patients with questions about care. Every one of those avoidable calls pulls a staff member away from top-of-license: direct patient care, complex problem-solving, and the kind of human interaction that requires their training and expertise.
Fragmentation hurts providers’ operational efficiency in multiple ways. Nurses spend approximately 10% of their time on delegable and non-nursing tasks, such as fielding simple questions and patient reminders. That’s time they can’t give back to patients. Furthermore, fragmentation contributes to physician burnout – a problem so serious it was part of the quadruple aim, and persists in the quintuple aim, of healthcare.
The financial impact of this friction is just as striking as the operational one. When patients experience confusion or incomplete communication along their journey, they disengage — canceling appointments or simply not showing up. What we’ve seen is that no-shows are often a communication problem. And the numbers reflect that: by some estimates, the national no-show rate is around 18%, costing organizations approximately $150 billion each year.
Disconnection hurts both the patient’s experience and, fundamentally, access to care. But the solution to the digital disconnect isn’t simply to boost staffing, nor is it to implement more technology. To truly address the disconnect and improve patient access, providers and payers must reduce the number of unnecessary inbound calls – by fixing friction points along the care journey that lead to those calls. The answer is simple to state: orchestration.
Closing the gap between outbound and inbound engagement ensures great patient access to healthcare
The organizations making the most progress on the burden of inbound calls approach it as a coordination problem. They’ve made the leap from communication to orchestration. What we’ve seen work is a shift in strategy: stop asking “how do we handle inbound calls better” and start asking “why are patients calling in the first place.” That reframe tends to reveal a few consistent patterns worth addressing:
- Personalize communications. One of the most common call triggers is communication that arrived through the wrong channel or in the wrong language or was sent to an email address a patient never checks. AI-powered platforms can help providers tailor these communications to individual preferences — right channel, right language, right moment. An older patient may want a phone call or a reminder card. A younger patient might prefer a text message with a link. Neither preference is right or wrong; what matters is that the right information reaches the right person in the right modality; it must drive the right action and the right outcome. When it does, the follow-up need not happen at all.
- Find and address points of friction. What we’ve consistently found is that inbound calls tend to cluster around the same moments in the patient journey: pre-visit instructions, post-visit follow-up, lab and test result notifications, referral status, prior authorization, prescription pick-up, and beyond. Patients hit an information gap at predictable points, where they reach for the phone. AI is helping providers map those moments systematically by identifying where the journey breaks down before the call comes in. The goal is patient experiences that lead to positive outcomes, not just faster call handling.
- Create proactive, timely messages. Once you know where patients tend to disengage or call for help, you can get ahead of it. Mapping the top inbound call reasons to specific moments in the patient journey typically reveals predictable outbound trigger points — places where a proactive, personalized message can answer the question before the patient asks. The providers that do this well change the nature of patient relationships so patients feel informed and seen.
Closing the gap between outbound and inbound engagement does not mean hiring more staff or more training. What it requires is a different orientation. When communication is coordinated around the patient journey rather than built around individual tools, staff have more time and energy to focus on the more complex parts of their jobs that require their training, empathy, and expertise.
This is the throughline we see in every high-performing healthcare organization we work with: they’ve stopped optimizing individual functions and started orchestrating the full patient journey. They focus on what the patient experiences from beginning to end and make sure that experience is coherent, connected, and seamless.
Fragmentation: AI’s next challenge
AI has been instrumental in improving patient care, from providing insight to physicians to improving provider efficiency. But what we haven’t fully unlocked yet is AI’s potential to address the hidden burden of inbound calls and the larger problem of patient fragmentation.
Better communication means better access to care. When providers close the outbound-inbound gap, patients receive individualized information in the ways that benefit them the most. They show up, follow through on care, and don’t fall through the cracks between disconnected systems. When providers orchestrate this kind of seamless experience in a true system of action, patients get answers faster, access to care sooner, and the healthcare they need and deserve.
