Tuesday, October 13, 2026

Tamal Chakraborty’s Final Gift Saved Three Lives. Why Is Healthcare Still Automating Its Own Mistakes?

One family’s extraordinary decision in Kolkata inspires a contrarian question for healthcare leaders: What if the next major breakthrough in medical billing is not doing more work faster, but eliminating the work that should never have existed?


“I'm looking for technology to enhance the science of medicine so that I can lean into the art of medicine.”
— Judd Semingson, president and CEO of Community Clinic, as reported by Axios

 

Three Lives. One Family’s Decision. A Question Healthcare Needs to Answer.

In October 2026, a family in West Bengal, India, faced a loss no family wants to experience.

Tamal Chakraborty, 59, of Dharampur, Chinsurah, in Hooghly district, suffered an intracranial hemorrhage and was taken to Apollo Multispeciality Hospitals in Kolkata.

Doctors later confirmed brain death.

Then came a decision that would change other families’ lives.

His wife, Soma Chakraborty, and son, Sagnik Chakraborty, consented to organ donation. According to The Times of India, Tamal’s liver and kidneys were transplanted into three patients. His corneas were also collected and preserved at Disha Eye Hospitals. The recipients were not identified by name in the report.

Sagnik explained that the family had heard about organ donation but did not know how to navigate the process. When the hospital team approached them, his mother was the first to decide that her husband’s organs should help others survive.

Consider the weight of that moment.

A family was navigating grief and uncertainty. A medical team had to communicate clearly. Information had to reach the right people. Multiple clinical teams and institutions had to coordinate their work.

And amid an unimaginable loss, three patients received the possibility of a new beginning.

The family’s generosity deserves the attention. The clinicians and transplant teams deserve recognition. This story is not evidence that administrative inefficiency affected Tamal’s care, and organ donation should never be reduced to a business-process analogy.

But the story does invite a broader question about healthcare systems.

When the stakes are high, we understand that communication, accurate information, and coordination matter. Why do we tolerate so much preventable confusion in everyday healthcare administration?

In medical billing, a missing detail can trigger a correction. A poorly defined handoff can trigger another phone call. An incomplete record can send a claim into a cycle of rework.

The consequences are different from those of organ transplantation, but the operational question remains worth asking: Could better preparation and clearer processes prevent avoidable problems before they become everyone else’s emergency?

That is where healthcare innovation needs a rethink.


The Contrarian Question: What If We Are Making the Wrong Work Faster?

Healthcare has developed a serious appetite for speed.

Faster documentation. Faster coding. Faster claim submission. Faster denial analysis. Faster appeals. Faster follow-ups.

Now AI promises to accelerate even more of the process.

Some of these advances are genuinely useful. Automation can reduce repetitive tasks, identify inconsistencies, and help staff find relevant information. AI can support documentation, classification, and analysis when it is implemented with appropriate safeguards.

But speed is not the same as improvement.

Imagine a practice that repeatedly submits claims with incomplete information. It buys software that identifies missing information sooner.

That is progress.

Now imagine another practice redesigns its intake and documentation processes so the required information is captured correctly before the claim is submitted.

That may be an even greater improvement.

The first practice becomes better at detecting errors.

The second reduces the conditions that create them.

Both approaches can be necessary. But they solve different problems.

One improves the response. The other improves the process.

What if healthcare’s next big innovation is not automating more work, but preventing unnecessary work from being created in the first place?

That question is less glamorous than an AI product demonstration. Nobody is likely to applaud a redesigned intake field or a clearer handoff between registration and billing.

But preventing a recurring error can be more valuable than repeatedly processing it.

Healthcare organizations can become remarkably good at compensating for broken processes. They build queues for unresolved tasks, dashboards for incomplete records, alerts for delayed responses, and reports explaining why the earlier reports were wrong.

Eventually, the organization becomes extremely efficient at managing the consequences of its own design.

It is a little like installing a sophisticated water-monitoring system while refusing to fix the leaking pipe.

The dashboard is beautiful. The floor is still wet.

Automating unnecessary work is still unnecessary work.

Before buying another tool, healthcare leaders should ask whether the underlying task is necessary, whether its cause can be removed, and whether automation will genuinely reduce complexity or simply move it somewhere else.


The Hidden Price of “Just One More Follow-Up”

Ask a medical billing specialist what happens when required information is missing.

The answer is rarely, “Nothing much.”

A staff member identifies the gap. Someone contacts the patient or clinician. The record is updated. Another person checks whether the update reached the correct system. The claim is corrected and resubmitted. Someone else tracks the response.

If the correction is incomplete, the cycle starts again.

Each task might take only a few minutes. But those minutes accumulate, and the true cost extends beyond the clock.

There is context switching. A medical assistant stops preparing for the next patient to investigate an administrative issue. A clinician is asked to clarify documentation after the encounter. A billing specialist must reconstruct events from weeks earlier. A practice manager tries to determine which step is holding up payment.

The work crosses departments, systems, and people.

Every handoff creates an opportunity for information to be lost, misunderstood, duplicated, or delayed.

For a small physician-owned practice, the impact can be especially painful. The person managing billing may also be handling patient calls. The front-desk coordinator may be checking eligibility, arranging referrals, and answering the phone. The physician may finish seeing patients only to start reviewing documentation queries.

The practice was established to deliver healthcare—not to become a full-time help desk for disconnected systems.

Yet that is what administrative friction can create.

The more interesting question is not whether every follow-up is necessary.

It is how many follow-ups exist only because an earlier step failed to provide the information or clarity needed to complete the job?

This is where practices can begin to distinguish necessary administrative work from preventable rework.


The Numbers Behind the Administrative Problem

The administrative burden in healthcare is not simply a collection of frustrating anecdotes.

The American Medical Association’s 2025 Prior Authorization Physician Survey, reported in May 2026, described a persistent burden on physician practices. The survey included 1,000 practicing physicians.

Among the reported findings:

  • 95% said prior authorization delays access to necessary care.
  • 79% reported that patients abandon treatment because of prior authorization challenges.
  • 26% said prior authorization had contributed to a serious adverse event for a patient in their care.
  • Physicians reported completing an average of 40 prior authorization requests per week.
  • Physicians and staff spent an average of 13 hours per week on prior authorization work.
  • 94% said prior authorization contributes to physician burnout.

These are survey findings based on physicians’ reported experiences. They do not establish that every authorization causes harm or that every practice experiences the same burden. They do, however, illustrate why administrative processes deserve serious attention.

Source: American Medical Association — Prior authorization reform survey.

The financial opportunity is substantial, too.

The 2024 CAQH Index estimated that healthcare’s medical and dental administrative transactions involved approximately $90 billion in annual spending, with an additional $20 billion in potential annual savings from moving remaining manual transactions to fully electronic workflows.

These figures concern the administrative transactions measured by CAQH. They do not represent the entire cost of healthcare administration or medical billing alone.

Source: CAQH — 2024 Index report.

The easy conclusion is that administrative inefficiency is expensive.

The more important conclusion is that digitizing a process does not automatically make it a good process.

A digital form can still ask the wrong question. An automated workflow can still move incomplete information from one system to another. An AI model can still generate a polished summary of a poorly documented encounter.

Technology can remove friction. It can also disguise friction beneath a more attractive interface.

A paper form that creates rework is frustrating.

A digital form that creates the same rework is not a breakthrough. It is the same problem wearing a better outfit.


Garbage In, Beautifully Summarized, Is Still Garbage

Much of the AI conversation in healthcare focuses on what happens after information has been created.

Can AI read a clinical note? Suggest a code? Summarize an encounter? Identify a possible denial? Draft an appeal?

These capabilities may be valuable. But a deeper question comes first.

Was the necessary information captured correctly, completely, and consistently at the source?

If documentation is incomplete, AI may help identify the gap. If information is contradictory, it may flag the inconsistency.

But a practice should not expect an AI system to invent missing facts, silently resolve conflicting records, or substitute plausible language for evidence.

AI can generate a convincing explanation. Convincing is not the same as correct.

It can make a process faster. Faster is not the same as complete.

It can identify patterns in past denials. That does not mean every future denial can be prevented.

And it can help staff process more information without necessarily reducing the amount of administrative work.

There is a fundamental difference between using AI to process information and designing a process that reliably captures the right information in the first place.

The second challenge is less glamorous. It rarely produces a spectacular product demonstration.

Nobody is likely to post a viral video celebrating a well-designed field that prevents a missing insurance identifier. Nobody will applaud a clean handoff between a medical assistant and a billing specialist.

Yet those improvements can prevent hours of rework.

The right question is not merely, “What can AI do with the information we have?”

It is also, “Why did we not have the right information when we needed it?”

This is not an argument against AI. It is an argument for putting AI in the right place.

The best technology may not be the technology that does the most work. It may be the technology that makes unnecessary work disappear.


Medical Billing Is Not Just a Billing Problem

Medical billing is often treated as a downstream function.

The encounter happens. Documentation is completed. Codes are assigned. A claim is submitted. Payment is pursued.

If something goes wrong, the billing team investigates.

This sequence makes billing look like the final stage of the process.

But many billing problems begin much earlier.

Consider a hypothetical example.

A patient visits a specialist. The appointment is completed, but insurance information was not verified correctly. A referral document has not reached the appropriate location. A required detail in the clinical record is unclear. A staff member assumes someone else has checked the authorization.

The claim goes out.

Then it comes back.

The billing specialist may be excellent at identifying the denial. The software may correctly classify it. The practice may have a well-organized follow-up queue.

But the problem may have begun during scheduling, registration, eligibility verification, authorization, documentation, or a handoff between these functions.

That distinction changes the questions a practice should ask.

Instead of asking only, “How do we resolve this denial?” ask:

  • Where did the missing information first become relevant?
  • Who was responsible for capturing or verifying it?
  • Was the required information available at that point?
  • Did the process make the next action clear?
  • Could the problem have been detected before claim submission?
  • If this issue has occurred repeatedly, what has changed to prevent it from recurring?

These questions move the conversation from individual blame to process design.

They also help avoid a common trap: blaming the last person who touched the claim for a problem created several steps earlier.

A denial is an outcome. It is not necessarily the origin of the problem.

When practices treat the outcome as the origin, they can become trapped in a cycle of corrections without meaningful prevention.


Activity Is Not the Same as Completion

Healthcare administration often measures activity because activity is easy to count.

How many claims were submitted? How many calls were made? How many tasks were closed? How many denials were appealed?

Those numbers can be useful, but they can also create a misleading sense of progress.

A submitted claim is not a payment.

An authorization request is not an approval.

A task marked complete is not necessarily a resolved problem.

An appeal sent is not an appeal won.

A message delivered is not proof that the recipient understood it or acted on it.

This is not an argument against operational metrics. It is an argument for measuring outcomes alongside activity.

A practice might track claims submitted each day. It should also understand how many claims are accepted on the first pass, how many require correction, how long payment takes, and which recurring issues generate the most rework.

Likewise, a practice might count completed denial follow-ups. But the more revealing question is whether the underlying causes of those denials are becoming less common.

A team can close hundreds of tasks while the same problem continues to return.

That is not necessarily a staff performance issue. It may be a signal that the system rewards closure more clearly than prevention.

Imagine a leaking pipe.

One employee spends the day mopping the floor. Another identifies the leak and fixes the pipe.

Both are busy. Only one has reduced the need for future mopping.

Healthcare needs fewer celebrations of the mop.

It needs better plumbing.


Seven Ways Physician-Owned Practices Can Prevent Rework

This does not require replacing every system or redesigning an entire practice overnight. Start with one recurring problem and investigate where it begins.

Step 1: Trace the problem backward

Choose one frequent administrative issue: a common denial, missing documentation, an eligibility discrepancy, or a delayed authorization.

Trace it backward from the point where it becomes visible.

What happened immediately before it? What information was missing? When was that information first needed? Who could reasonably have captured or verified it?

Do not begin by asking who made a mistake.

Begin by asking why the process allowed the mistake to pass unnoticed.

Step 2: Measure rework, not just output

Record how often the problem recurs and how much staff time is spent correcting it.

A practice does not need an elaborate analytics platform to begin. A carefully maintained spreadsheet may be enough.

Track a small number of measures:

  • First-pass claim acceptance.
  • Denials by reason and payer.
  • Missing-information corrections.
  • Days in accounts receivable.
  • Time spent on repeat follow-ups.
  • Percentage of recurring issues with a documented corrective action.

Define each measure consistently. Interpret changes alongside payer mix, claim complexity, and other relevant factors.

The goal is not to create another dashboard staff must feed.

It is to discover which problems are worth preventing.

Step 3: Capture information when it first becomes available

Information is often easiest to obtain at the moment it is created.

Insurance details may be available during registration. Referral information may be available before the appointment. Documentation questions may be clarified while the encounter is still fresh.

Waiting until a claim is rejected can turn a simple clarification into an investigation.

Capture essential information at the earliest appropriate point, without burdening clinicians with unnecessary data entry or collecting information the practice does not need.

The aim is not to ask more questions.

It is to ask the right questions at the right time.

Step 4: Make handoffs explicit

A handoff should not depend on a vague assumption that someone else will take care of it.

Define what information must accompany the task, who owns the next step, and what counts as completion.

If a task is blocked, the reason should be visible. If another person must act, the responsibility should be clear.

This does not require turning every interaction into a bureaucratic checklist. The goal is to remove ambiguity, not create a new species of paperwork.

Step 5: Separate preventable errors from unavoidable complexity

Not every denial is caused by poor data. Payer policies, coverage exclusions, changing requirements, clinical documentation standards, and legitimate disputes all matter.

A practice should not assume that every denial can be eliminated by improving its own process.

Classify problems by cause. Some may be preventable through better registration or documentation. Others may require payer clarification, clinical review, an appeal, or a policy change.

This distinction helps teams focus on what they can control without blaming themselves for every external obstacle.

Step 6: Automate only after examining the process

Automation can reduce repetitive effort, improve consistency, and help staff identify problems earlier.

Examples may include eligibility checks, claim-status inquiries, structured data validation, reminders, and routing work to the appropriate person.

But before automating a process, ask whether the process itself is necessary.

If the same information is entered into three systems, automating all three entries may preserve the duplication. If a task exists because two systems do not exchange information reliably, adding another task-management tool may not solve the underlying issue.

Map the workflow first.

Remove unnecessary steps where possible.

Then automate the steps that still need to happen.

Step 7: Check whether the problem actually declined

After changing a process, measure what happened.

Did the same denial category become less frequent? Did correction time decrease? Did first-pass acceptance improve? Did staff spend less time chasing missing information?

If the metric did not improve, investigate why.

A new workflow is not a success simply because it has launched. A software implementation is not a success simply because employees have been trained to use it.

The test is whether the change improves the work and the outcome.

The ultimate measure of a better process is not how efficiently the team manages the problem. It is whether the problem becomes less likely to return.


A Practical 30-Day Experiment

Small practices do not need to wait for a major technology project to begin improving administrative work.

A focused 30-day experiment can reveal useful opportunities.

Week 1: Find the recurring problem.

Select one frequent source of rework. Review a sample of recent cases and document where each problem first appeared. Use de-identified or appropriately authorized information for the analysis.

Week 2: Identify the earliest practical intervention.

Look for a missing field, unclear responsibility, delayed verification, inconsistent process, or failed handoff. Ask the staff who perform the work what actually happens rather than relying only on the written procedure.

Week 3: Test one change.

Make a limited adjustment. This might be a clearer intake requirement, an earlier verification step, a more explicit handoff, or a rule that flags incomplete information before submission.

Avoid introducing multiple changes simultaneously if doing so would make the results difficult to interpret.

Week 4: Compare the results.

Review the same measures used in the baseline. Did the problem occur less frequently? Did the change create extra work elsewhere? Did it introduce new risks or delays?

Keep the change if the evidence supports it. Modify it if the results are mixed. Stop if it makes the process worse.

This is not glamorous. It is disciplined operational learning.

And it may be a better starting point than buying software in the hope that a vendor will somehow discover how the practice actually works.


Five Questions to Ask Before Buying Another AI Tool

AI can be useful, but physician-owned clinics should evaluate it against the actual problem they need to solve.

1. Which specific problem will this solve?

“Improve efficiency” is too vague. Identify the task, failure point, or measurable outcome.

2. Does the problem originate in the workflow or in the information?

If information is incomplete at the source, a tool that only processes it downstream may not address the root cause.

3. What happens when the system is uncertain?

Healthcare administration involves consequential information. A useful system should make uncertainty and exceptions visible rather than quietly treating a guess as a fact.

4. How will the practice measure success?

Agree on baseline measures before implementation. Include error rates, staff time, rework, and meaningful financial outcomes where appropriate.

5. What work will the tool add?

New technology brings implementation, training, oversight, integration, security, and maintenance requirements. Those costs belong in the evaluation.

The right question is not whether a product uses AI.

It is whether the product improves a process that matters—and whether the improvement outweighs the new complexity.


Efficiency Must Never Become an Excuse to Cut Corners

Preventing rework is important, but efficiency is not a reason to compromise accuracy, privacy, or compliance.

Medical billing and practice operations involve protected health information, documentation requirements, payer contracts, and applicable federal and state laws.

Practices should consider several safeguards:

  • HIPAA and privacy: Access to protected health information should be appropriate to the task. Vendors handling protected health information may require appropriate agreements and safeguards.
  • Documentation integrity: Automation must not invent clinical facts, silently alter records, or encourage documentation unsupported by the encounter.
  • Billing compliance: Claims must accurately reflect the services provided and applicable coding and coverage requirements.
  • Human oversight: Staff should be able to review uncertain results, correct errors, and escalate exceptions.
  • Transparency: Practices should understand how automated decisions are made, what information is used, and where the system has limitations.
  • Security and accountability: Technology should support clear responsibility for decisions, corrections, and incident response.

The details depend on the tool, workflow, payer, and circumstances. Practices should seek qualified compliance and legal advice when needed.

The objective is not to make healthcare administration faster at any cost.

It is to make the work more accurate, less wasteful, and more accountable.


The Human Cost of Administrative Noise

It is easy to describe administrative burden in hours, dollars, denial rates, and days in accounts receivable.

Those measures matter. But they do not fully capture the human experience.

A patient may never see the spreadsheet used to track a missing authorization. A family may not know how many calls were needed to resolve an administrative issue. A physician may not mention the time spent correcting documentation after clinic hours.

Yet these tasks consume attention.

And attention is finite.

When clinicians and staff spend more time navigating avoidable administrative problems, less time remains for work that requires human judgment, compassion, and expertise.

That does not mean every administrative task is wasteful. Verification, documentation, authorization, and accurate billing can serve legitimate purposes. Nor does it mean billing inefficiencies caused or affected Tamal Chakraborty’s organ donation story. There is no basis for making that claim.

The connection is broader: healthcare depends on people and systems coordinating around important information.

Tamal’s family was able to make a meaningful decision after communication with the hospital team helped them understand the possibility of donation. That is a reminder of the human importance of clarity and coordination.

In routine practice operations, the same principles deserve attention, applied in a very different context.

Clear information helps people act. Explicit responsibilities reduce ambiguity. Well-designed handoffs make it easier to complete the next step.

Preventing avoidable administrative work can give people more time to focus on the work that truly requires them.


What OnnX Believes: Fix the Source, Not Just the Symptom

As a physician-entrepreneur and founder of OnnX, an AI-powered medical billing SaaS focused on small and medium-sized physician-owned clinics, I believe the industry needs to ask a different set of questions.

We should not only ask how to code claims faster, pursue denials more efficiently, or automate repetitive revenue-cycle tasks.

We should also ask:

  • Why did the information arrive incomplete?
  • Why did the process depend on someone remembering an undocumented step?
  • Why did the same error require multiple people to correct it?
  • Why was the problem not visible until the claim reached the payer?
  • What can we eliminate before we decide what to automate?

This is not an argument that technology cannot help with downstream work. It can.

It is an argument that better downstream tools cannot compensate indefinitely for poor upstream information and process design.

The premise behind OnnX is that healthcare billing is not only a tooling problem. It is also a data-quality and process-design problem.

The earlier information is captured correctly, the clearer the handoffs, and the more visible the exceptions, the less unnecessary rework the practice may need to manage later.

That is the direction worth exploring: fewer preventable errors, less repetitive follow-up, more reliable information, and a clearer view of where a problem actually begins.

The objective should not be to make the billing team heroic at rescuing broken claims.

It should be to create fewer claims that need rescuing.


The Future of Healthcare Innovation May Be Less About Doing More

Healthcare innovation often celebrates what a new system can do.

Can it generate a note? Summarize a chart? Identify a denial pattern? Automate another step?

These are reasonable questions.

But perhaps the next generation of meaningful innovation will also be judged by what it makes unnecessary.

How many duplicate entries disappear?

How many avoidable corrections never occur?

How many handoffs become simpler?

How many hours of repetitive follow-up are returned to staff?

How often does the right information reach the right person at the right time?

And how much administrative complexity can be removed without compromising safety, accuracy, or accountability?

This is a more demanding standard than simply measuring software adoption.

It asks technology companies, healthcare organizations, and practice owners to demonstrate that the work itself has improved.

In the end, healthcare does not need every administrative task to become an AI-powered task.

Some tasks need better tools.

Some need clearer ownership.

Some need better information.

And some need to disappear.


Final Thought: Stop Celebrating the Mop

Tamal Chakraborty’s story is a reminder that extraordinary human outcomes can emerge when families and healthcare teams navigate difficult moments with compassion, communication, and coordination.

His family’s decision helped three people receive transplanted organs. Their generosity should remain at the center of the story.

For those of us working on healthcare systems, the story also invites a wider reflection: the quality of a result often depends on what happens before the decisive moment.

In medical billing, that means looking beyond the denial, beyond the correction, and beyond the next follow-up.

It means asking whether we are fixing the problem—or merely becoming more efficient at managing its consequences.

Perhaps healthcare’s next big innovation will not be the system that produces the most work in the least time.

Perhaps it will be the system that knows which work should never have existed.

And perhaps the most impressive dashboard will not show how many tasks we completed.

It will show how many preventable tasks we no longer need.

A provocative question for healthcare leaders and physician-owners: If AI can help us automate almost any repetitive task, shouldn't we first ask whether that task deserves to exist?

Share your perspective in the comments: What is one recurring administrative task in your practice that should be eliminated—not merely automated?

If this perspective resonates, repost it to encourage a more practical conversation about healthcare innovation, medical billing, and the work we can prevent.


About the Author

Dr. Daniel Cham is a physician-entrepreneur and founder of OnnX, an AI-powered medical billing SaaS focused on small and medium-sized physician-owned clinics. His work explores medical billing, revenue-cycle management, healthcare technology, data quality, and practical ways to reduce administrative friction so practices can focus more of their attention on patient care.

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References

  1. Yengkhom, Sumati. “Year’s 13th organ donation in city saves three lives.” The Times of India, October 12, 2026. Read the report
  2. Axios. “Axios Live: How health care providers can reach patients in an era of mistrust.” October 12, 2026. Read the report
  3. American Medical Association. “AMA survey: Prior authorization reform pledge falls short with physicians.” May 2026. Read the report and survey findings
  4. CAQH. 2024 CAQH Index. Administrative transaction costs and potential savings from automation. Read the report

Disclaimer: This article is for general educational and commentary purposes. It does not provide medical, legal, billing, coding, or compliance advice. The organ donation story is used as a human-interest starting point for a broader discussion of coordination and process design; no claim is made that billing or administrative inefficiencies affected the events described.


#HealthcareInnovation #MedicalBilling #RevenueCycleManagement #HealthcareAI #PhysicianEntrepreneur #MedicalPracticeManagement #PhysicianBurnout #HealthcareOperations #DataQuality #ClaimDenials #AdministrativeBurden #DigitalHealth #OnnX

 

Monday, October 12, 2026

Seven Months Waiting for a Heart: Selma Davis’s Story and the Healthcare Work We Should Eliminate

Why healthcare’s next breakthrough may not be doing more work faster—but preventing unnecessary work from happening in the first place.



“These burdens can be reduced or eliminated through thoughtful interventions at all levels of the health care system.” — Centers for Medicare & Medicaid Services (CMS), Optimizing Care Delivery: A Framework for Improving the Health Care Experience.


Six-year-old Selma Davis’s transplant journey offers a powerful reminder of what healthcare is ultimately about: people. But while the industry races to automate everything from documentation to billing, a more uncomfortable question remains: How much of the work we are getting better at managing should never have existed in the first place? For physicians and clinic owners, the answer could reshape how we think about AI, administrative burden, and the future of medical billing.

 

The word worth paying attention to is eliminated.

Not merely automated. Not transferred to another department. Not buried beneath a more attractive dashboard.

Eliminated.

That distinction matters more than ever as healthcare embraces artificial intelligence, automation, and increasingly sophisticated software.

We are becoming very good at doing things faster. But are we getting equally good at questioning whether those things need to be done at all?

Consider what happens when a claim contains incorrect insurance information.

The claim is rejected. A biller investigates. Someone contacts the front desk. A staff member checks the patient record. The information is corrected. The claim is resubmitted. Another employee monitors the outcome.

Now introduce AI.

The system detects the rejection faster, categorizes the reason, drafts a message, prioritizes the follow-up, and produces a beautiful report.

Impressive.

But if the original information could have been captured accurately and validated earlier, how much of that downstream activity was necessary?

We may have made the recovery process more efficient without preventing the problem.

In other words, we have built a faster ambulance for an accident we might have prevented.

And healthcare is not short of ambulances, digital or otherwise.

My contrarian view: the next major opportunity in healthcare technology may not be automating more work. It may be eliminating the work that should never have existed.


Seven months waiting for a heart

A story from Nashville, Tennessee, makes the human stakes of healthcare innovation impossible to ignore.

Six-year-old Selma Davis spent more than seven months waiting for a donor heart at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

For a child, seven months is an enormous stretch of life. For a family waiting for a transplant, every day carries uncertainty that most of us can scarcely imagine.

Selma’s father, Jessie Davis, carried her toward surgery. Her mother, Rachel Elder Davis, accompanied her. Her grandmother, Donna Elder, known as “DeeDee,” and her grandfather, Charles Elder, were part of the family supporting her through the ordeal.

Her medical team included pediatric heart transplant surgical director Dr. Ziv Beckerman, congenital heart surgeon Dr. Garrett Coyan, transplant surgeon Dr. Aaron Williams, and pediatric heart failure and transplant cardiologist Dr. Rachel Harris. One of Selma’s favorite nurses, Kaylee McGuire, helped comfort her. The hospital’s therapy dog, Squid, offered another kind of companionship.

According to reporting by The Tennessean, Selma’s transplant involved a donor heart recovered after circulatory death and a preservation approach developed at Vanderbilt that could help expand the pool of hearts available for transplantation.

This is innovation with a deeply human purpose: expanding possibilities for patients who need a second chance at life.

Selma’s story is not evidence that medical billing inefficiencies affected her treatment. There is no basis for making that claim. Her transplant journey and the administrative problems faced by physician-owned practices are different subjects.

But the story prompts a broader question about healthcare.

When we talk about innovation, are we measuring the sophistication of the technology—or the meaningful problem it helps solve?

That is a question worth asking whether we are discussing transplant medicine, clinical workflows, or medical billing.

A breakthrough should be judged by what it makes possible, what burden it removes, and whether it improves an outcome that matters.

Technology is the means. Human benefit is the point.


Healthcare has an automation addiction

The current technology conversation often follows a predictable pattern.

A problem appears. We introduce software.

The software adds steps. We introduce integration.

The integration fails. We assign someone to reconcile the data.

The reconciliation produces another exception. We create a dashboard.

The dashboard becomes overwhelming. We introduce AI to summarize the dashboard.

At some point, it is fair to ask whether we are improving healthcare or simply creating increasingly sophisticated ways to manage its complexity.

If an unnecessary process can be automated, we may have created a more efficient unnecessary process.

That is not transformation. That is administrative friction with better branding.

To be fair, automation can be tremendously valuable. It can reduce repetitive work, identify exceptions, improve access to information, and help staff focus on tasks requiring human judgment.

The mistake is assuming that automation automatically produces improvement.

Imagine a clinic that repeatedly contacts patients to obtain information missing from their records.

A new system sends reminders automatically. Staff no longer have to make every call manually.

That may save time.

But suppose the information was missing because the registration process was confusing, the required fields were unclear, or the information captured during scheduling was never transferred into the billing workflow.

The reminders may be useful, but they do not resolve the source of the problem.

The clinic has automated the chase.

What if the better solution is to prevent the missing information in the first place?

The answer will depend on the circumstances. Some information cannot be obtained in advance. Some patients need assistance. Some processes involve legitimate uncertainty.

But those realities are reasons to design better systems, not reasons to stop asking questions.

AI should help healthcare eliminate unnecessary work—not simply help it become more productive at repeating it.


The hidden economics of “just one more step”

Small and medium-sized physician-owned clinics understand the cumulative cost of administrative friction.

One missing field may seem insignificant. One insurance discrepancy may take only a few minutes to correct. One unclear handoff may require a quick message.

But multiply those events across a busy practice, and the work accumulates.

A front-desk employee corrects patient information. A medical assistant tracks down missing details. A clinician clarifies documentation. A biller investigates a rejected claim. A practice manager tries to understand why payment is delayed.

Everyone is working.

Yet the underlying problem may be a small piece of information that was not captured correctly at the beginning.

This is how administrative burden grows: not necessarily through one enormous failure, but through hundreds of recurring exceptions that become part of the daily routine.

Eventually, people stop questioning the process.

“That’s how we’ve always done it.”

“The system requires it.”

“We need someone to double-check.”

“We tried fixing it before.”

Sometimes these explanations are legitimate. Healthcare has real compliance obligations, clinical safeguards, payer requirements, and operational constraints.

But sometimes a recurring manual check is a warning sign.

It may indicate that information is not reliable, that systems cannot share it properly, or that no one can tell whether a task has actually been completed.

A recurring workaround may be evidence of a recurring process failure.

And when organizations respond by adding another check without investigating the cause, they can end up paying several people to compensate for a weakness nobody has taken ownership of fixing.

That is not always a staffing problem.

Sometimes it is a design problem.


Medical billing begins before the claim

Medical billing is often treated as a downstream function.

The patient receives care. The encounter is documented. The claim is created. The billing team takes over.

When the claim is denied or payment is delayed, the billing department is expected to investigate and resolve the issue.

But the person who encounters a problem is not necessarily the person—or process—that created it.

A claim can be affected by missing information, inaccurate demographics, coverage discrepancies, incomplete documentation, authorization issues, coding questions, or a breakdown in the handoff between departments.

Each issue has a different cause and requires a different response.

Yet the billing team often inherits the consequences after the original opportunity to prevent the problem has passed.

This is why I believe medical billing is a data-quality problem as much as it is a workflow problem.

A billing system can process information efficiently. It cannot reliably compensate for information that is absent, inaccurate, or inaccessible.

An AI tool can summarize a clinical note. It cannot make an undocumented fact true.

A dashboard can flag an authorization request. It cannot turn that request into an approval.

An automated claim system can identify a discrepancy. It cannot always determine the correct resolution without additional information or human judgment.

Garbage in, beautifully summarized, is still garbage.

The answer is not to abandon billing tools. Practices need effective systems to submit claims, track payments, manage denials, and resolve exceptions.

The opportunity is to improve the information and processes feeding those systems.

Was the relevant information captured accurately? Was it available to the people who needed it? Was the handoff clear? Could the problem have been detected earlier? Is the practice paying staff to repair the same category of mistake repeatedly?

Those are not merely billing questions.

They are questions about how a practice operates.


Stop measuring activity as if it were achievement

Healthcare technology often celebrates activity.

Claims processed. Tasks automated. Messages generated. Exceptions identified. Minutes saved.

These metrics can be useful. But they do not automatically demonstrate that a practice is performing better.

A system that identifies twice as many exceptions may be more capable—or it may be exposing a process that generates too many exceptions.

A tool that sends more reminders may increase activity without reducing delays.

A dashboard that reports more detailed denial data may improve visibility without changing the reasons claims are denied.

The important question is what happens next.

Are fewer errors recurring? Is the information more complete? Are staff members spending less time reconstructing events? Are claims more likely to be accepted on the first submission? Are unresolved issues being addressed earlier?

A claim submitted is not necessarily a claim paid.

An authorization request is not an approval.

A task marked complete is not proof that the intended outcome occurred.

Activity is not the same as completion.

The distinction should shape how practices evaluate technology.

Rather than asking only how many tasks a system performs, ask how many unnecessary tasks it prevents, how much avoidable rework it reduces, and whether it improves the final result.

Not every improvement will produce immediate financial savings. Some will improve reliability, reduce risk, or free staff capacity for other work.

Those benefits matter, but they should be measured honestly rather than buried beneath a vendor’s impressive productivity statistics.


Before buying more AI, ask three uncomfortable questions

AI can be part of the solution, but it should not be the starting assumption.

Before adopting another tool, physicians and clinic owners should ask:

1. Should this task exist at all?

Is the task required for patient safety, accurate billing, compliance, or another legitimate purpose? Or does it exist because the process is unreliable?

2. If the task is necessary, why is it so difficult to complete correctly?

Is the information missing? Is the system disconnected? Is responsibility unclear? Are requirements poorly communicated? Is there a genuine constraint the practice cannot control?

3. What would make the task unnecessary—or prevent it from recurring?

Could the practice improve data capture, validate information earlier, clarify a handoff, or make status information accessible? Would automation help after the process is redesigned?

These questions sound simple. Their implications are not.

They challenge the assumption that every existing task deserves to survive simply because it has become familiar.

A process may be necessary. It may also be poorly designed.

A task may be unavoidable. The repeated corrections surrounding it may not be.

And sometimes the most effective solution is not a new technology product. It is a clearer process that everyone can follow reliably.

The best tool is the one that addresses the actual problem—not necessarily the one with the most impressive demonstration.


A practical framework for eliminating avoidable rework

The good news is that a practice does not need to redesign its entire operation to begin.

Start with one recurring problem.

1. Identify the work everyone has learned to tolerate

Ask the people doing the work:

  • What do you have to correct repeatedly?
  • Which information is hardest to find?
  • Where do handoffs break down?
  • Which tasks require repeated follow-up?
  • What causes the same exceptions to return to the work queue?

Listen before selecting a solution. Staff members closest to a process often understand its weaknesses better than anyone looking at it from a distance.

2. Trace the problem to its origin

Suppose billers repeatedly contact clinical staff to clarify documentation.

Do not immediately conclude that the practice needs a better messaging tool.

Investigate the pattern. Are requests concentrated around particular encounter types? Are documentation expectations unclear? Is the information available but inaccessible? Is a payer requirement being misunderstood?

The visible problem may have several possible causes. Find the actual one before prescribing a solution.

3. Separate necessary work from avoidable rework

Map the process from its beginning to its final outcome.

Identify which steps are required for clinical, legal, operational, or payer reasons. Then identify where work is repeated because information is missing, inconsistent, delayed, or inaccessible.

Do not remove safeguards simply because they add time.

Instead, ask whether they can be made more reliable or whether the conditions requiring repeated checks can be corrected.

4. Fix the source before adding another layer

If information is inaccurate, improve how it is captured and validated.

If systems cannot share necessary information, examine integration and access.

If responsibility is unclear, define ownership.

If tasks depend on memory, make status and next steps visible.

If a requirement is unavoidable, make compliance with it as clear and efficient as possible.

Then determine whether automation can reliably support the redesigned process.

5. Measure the outcome

Establish a baseline before changing the workflow.

Depending on the problem, useful measures might include:

  • First-pass claim acceptance or clean-claim rate.
  • Denial rate and the reasons for denials.
  • Frequency of corrected or resubmitted claims.
  • Staff time spent on repeated data entry and follow-up.
  • Time required to resolve missing-information exceptions.
  • Days in accounts receivable, interpreted alongside payer mix and other relevant factors.
  • The proportion of tasks completed correctly without intervention.

Compare results over a reasonable period. Account for changes in volume, staffing, payer behavior, and other relevant factors.

Do not assume that every improvement automatically becomes a cash saving. Reduced staff time may free capacity rather than reduce payroll.

That capacity still has value, but the business case should reflect what actually changed.

6. Confirm that the work really disappeared

This is where many improvement efforts fall short.

A new tool is installed. The team likes the interface. The vendor reports successful automation. Everyone celebrates.

But did the work disappear, or did it move somewhere else?

Perhaps the AI drafts a message, but an employee must still verify every detail. Perhaps a claim is flagged automatically, but no one owns the exception. Perhaps duplicate entry disappears from one screen but remains necessary in another.

A task is not eliminated just because the software no longer displays it.

Follow the process all the way to the outcome.

If the work has simply moved, the improvement may be smaller than expected.


The financial case for preventing problems

Avoidable rework has a cost.

Staff spend time finding information, checking records, communicating across departments, correcting errors, resubmitting claims, and monitoring unresolved issues.

Those hours have an opportunity cost.

A staff member correcting a preventable mistake cannot spend that same time helping a patient, resolving a complex claim, or improving the practice’s operations.

The actual financial impact varies by clinic, specialty, payer mix, staffing model, and error type. It would be misleading to promise that eliminating a particular number of administrative steps will automatically produce a specific return.

A better approach is to calculate the local cost.

Estimate the staff hours consumed by a recurring problem. Determine the relevant labor cost. Measure how much of the work remains after an intervention. Separately assess whether the change affects payment timing, denial recovery, or other financial outcomes.

Avoid double-counting benefits. An hour saved is not necessarily an hour of direct cash savings if staffing costs remain unchanged.

It may instead be capacity that can be redirected toward higher-value work.

The strongest business case is grounded in evidence: a clearly defined problem, a targeted intervention, and a measurable result.

No magic AI multiplier required.

Just a problem worth solving, a thoughtful approach, and a way to determine whether it worked.


The human cost of unnecessary work

There is another cost that does not always appear on a dashboard.

Administrative friction changes how people experience their work.

When employees repeatedly correct the same errors, they can begin to feel that the system is designed to make them fail. When responsibility is unclear, people spend time protecting themselves from blame rather than improving the process. When queues constantly refill, completion can feel permanently out of reach.

This is not to say that administrative work is the sole cause of burnout or that technology alone can solve workforce problems. Healthcare teams face many pressures.

But avoidable rework is worth examining because it consumes time without necessarily adding value.

It can also reveal an organizational habit: expecting the people closest to the problem to compensate indefinitely for weaknesses in the system.

A better question is not simply, “Who made the mistake?”

It is, “What conditions made the mistake likely, and what would make the correct outcome easier to achieve?”

Accountability matters. Training matters. Human judgment matters.

But blaming the final person in a chain does not necessarily fix a problem that began several steps earlier.

Sometimes the best way to support staff is not to give them another tool to manage the workload.

It is to stop generating so much unnecessary workload.


Where OnnX fits into this conversation

As a physician-entrepreneur and founder of OnnX, I think about this problem through the lens of medical billing and practice operations.

OnnX is being developed around a simple premise: for small and medium-sized physician-owned clinics, better billing should begin with better information and more reliable processes—not simply more downstream activity.

That means looking beyond the final claim and asking what happened before it was created.

Was the relevant information captured accurately? Was it available to the people who needed it? Did the handoff preserve the context? Could an avoidable error have been detected earlier? Is the practice repeatedly paying staff to repair a problem that the process could prevent?

These questions matter because adding another layer of software is not automatically the right answer.

Sometimes a practice needs automation. Sometimes it needs integration. Sometimes it needs clearer processes or better data capture. Sometimes it needs to stop doing something that no longer serves a legitimate purpose.

The solution should follow the problem.

This is especially important for smaller practices, where time and resources are limited. A tool that creates more alerts, more dashboards, and more steps can become another obligation rather than a meaningful improvement.

The objective is to help practices reduce avoidable rework, improve reliability, and make billing less dependent on repeated manual intervention.

That is the philosophy behind OnnX—not the idea that AI should do everything, but that healthcare should not have to keep doing the same unnecessary things.


Healthcare needs fewer heroic workarounds

Selma Davis’s story is ultimately about a child, her family, a donor, and the clinicians who worked to give her a chance at a new heart.

The medical innovation described in the reporting mattered because it expanded what the transplant team could consider possible. It addressed a real constraint.

That is a useful standard for healthcare technology.

Start with a meaningful problem. Understand why it exists. Develop an approach that addresses the cause. Evaluate whether it improves the outcome.

Then ask whether the solution reduces the burden on the people who must live with the process every day.

In medical billing, that may mean preventing inaccurate information from moving downstream. In practice operations, it may mean designing clearer handoffs. In technology, it may mean choosing not to automate a task until someone has established that the task is necessary.

We do not need to romanticize inefficiency. We do not need to assume every old process is bad. And we should not pretend that one transplant story proves a theory about billing.

We do need to become more disciplined about what we call progress.

A system that processes more work is not necessarily a system that works better.

A team that resolves more errors may still be trapped in a process that generates too many of them.

And a clinic that buys more technology may still be asking its staff to compensate for information that was never captured properly in the first place.

Perhaps the next wave of healthcare innovation should come with a different question on the evaluation form:

What unnecessary work did this eliminate?

If the answer is “none,” that does not automatically make the technology useless. But it should make us curious about whether we are solving the right problem.

The future of healthcare will undoubtedly include more AI, more automation, and more sophisticated tools.

The more important question is whether those tools will help healthcare teams spend less time managing preventable problems—and more time doing the work that genuinely matters.

After all, we do not need AI to make every administrative task faster.

Sometimes we need the wisdom to stop creating the task.

And perhaps the most innovative workflow is the one that quietly gives a busy clinic something increasingly rare:

One less problem to solve.


A question for physicians and clinic owners

What is one recurring administrative task in your practice that everyone has accepted as “just part of the job”—even though it may be preventable?

Is the opportunity to automate the fix, or to eliminate the cause?


About the author

Daniel Cham, MD, is a physician-entrepreneur and founder of OnnX, an AI-powered medical billing SaaS initiative focused on small and medium-sized physician-owned clinics. His work explores how better data quality and more reliable processes can help practices reduce avoidable administrative work.


References

  1. Centers for Medicare & Medicaid Services (CMS). Optimizing Care Delivery: A Framework for Improving the Health Care Experience. Official CMS framework.
  2. The Tennessean. Beth Warren, “Doctors worried a storm might thwart their flight to save a 6-year-old,” October 11, 2026. Read the report.
  3. Vanderbilt University Medical Center. “First-of-its-kind heart transplant gives Sissy a second chance,” October 7, 2026. Read the institutional report.

#HealthcareInnovation #MedicalBilling #HealthcareAI #RevenueCycleManagement #PhysicianEntrepreneur #PracticeManagement #HealthcareAdministration #DataQuality #OperationalEfficiency #OnnX

 

Sunday, October 11, 2026

David Curran’s Journey From “Healthy” to Quadruple Bypass: The Healthcare System Has a Workflow for Everything—Except Listening

How David Curran’s frightening journey from feeling healthy to quadruple bypass surgery exposes a deeper healthcare contradiction: a system can deliver extraordinary treatment while making patients work too hard to be heard.

 


“Too often, PWLE are asked to share their stories but excluded from decisions. Meaningful engagement extends beyond simply being heard.” —  World Health Organization, World Mental Health Day 2026: Lived experiences heard: real voices, real change.

David Curran’s coronary calcium score of 2,627 changed everything. His story raises a difficult question about healthcare’s design: why must patients sometimes fight to be heard while physicians and clinic staff spend hours navigating administrative complexity? From the ICU bedside to AI-powered medical billing, the opportunity is not simply to automate more work. It is to prevent avoidable friction before it begins.


The patient who had to prepare a legal argument to get his heart checked

David Curran was trying to live his life. He played tennis, hiked in Tilden Park, and believed he was reasonably healthy.

Then his breathing began to deteriorate.

He had a family history that should have made the issue especially concerning. Three grandparents had died of heart attacks. His mother had died of one. His father had undergone open-heart surgery. His sister had recently been hospitalized with an enlarged heart.

Yet getting a cardiology referral from his HMO primary-care physician had been an ongoing struggle.

Curran eventually advocated for a coronary calcium scan. His score was 2,627, in the 98th percentile. Further testing revealed severe coronary artery disease, including a completely blocked artery. What initially seemed like a possible stent became a quadruple bypass operation.

In his October 11, 2026, first-person account for SFGATE, Curran describes the fear, frustration, dark humor, and human kindness that accompanied his journey.

One detail stands out. Before his appointment, he had prepared to argue for further evaluation, presenting his family history and worsening symptoms. He described the experience as having to prepare an argument almost as if he were going to court.

A medical appointment should not feel like a courtroom drama in which the patient must prove that a symptom deserves attention.

Of course, good medicine does not mean ordering every test a patient requests. Clinical judgment, evidence, risk assessment, and appropriate testing all matter. We also do not have the complete medical record or every consideration behind the decisions in Curran's case.

But his account raises a question that deserves serious attention:

Why can a patient sometimes have to work so hard to get a concern investigated, only to have the system move at extraordinary speed once the danger becomes unmistakable?

Healthcare can be remarkably sophisticated at treating a crisis.

It should also be capable of making the path to appropriate evaluation less difficult to navigate.

Curran's story is not proof that every doctor dismisses symptoms or that every healthcare organization operates this way. It is a human account of one patient's experience—and an opportunity to examine the systems surrounding care.

The uncomfortable question is whether we have become better at responding to emergencies than at listening before they happen.


A score of 2,627—and absolutely no reason to celebrate

In school, a high score is good news.

Curran's coronary calcium score was 2,627.

This was not the kind of achievement his mother had hoped he would earn.

His humor makes the number memorable, but the medical situation was serious. A coronary calcium score measures calcified plaque in the coronary arteries and helps clinicians assess coronary atherosclerotic burden in the appropriate clinical context. It is not, by itself, a complete diagnosis or a guarantee of what will happen next.

Curran's subsequent evaluation revealed severe blockages requiring surgery.

The lesson is not that one particular test should be ordered for every person. Testing decisions depend on individual symptoms, risk factors, clinical guidance, and professional judgment.

The lesson is that symptoms, history, and changing circumstances deserve appropriate attention—and that patients need a clear path toward evaluation when concerns warrant it.

A test can produce a result in minutes. Understanding that result, communicating its implications, coordinating follow-up, and helping a frightened patient make decisions require something more than a number on a screen.

Healthcare is not merely the production of information.

It is the ability to move the right information to the right person, at the right time, with the right context and a meaningful next step.

A diagnostic system can be technically excellent while the surrounding process remains difficult to navigate.

The same distinction matters in medical practices. A billing system can process a claim correctly when all the necessary information is present. But if the information is incomplete, inconsistent, or delayed, the people downstream may have to spend time reconstructing what should have been clear from the beginning.

Different clinical and administrative problems require different solutions. Yet both remind us that the quality of a system depends on more than the capabilities of its individual tools.


Marcella: The human intelligence no dashboard can replace

After his operation, Curran woke in the intensive care unit facing a reality far removed from his former routine.

Breathing was difficult. Moving was uncomfortable. Eating required effort. Even small activities became accomplishments.

Then there was Marcella, the ICU nurse identified by first name in his article.

Curran describes her as experienced, engaged, practical, and kind. She helped him eat, showed him how maple syrup could make his oatmeal more tolerable, offered advice on taking his pills, and coached him through breathing exercises. She also helped him begin walking again.

These details are not incidental.

They show what care looks like when it reaches beyond a checklist and responds to the person experiencing the illness.

There was no grand technological breakthrough in the maple syrup. No sophisticated algorithm was needed to understand that a patient who had just undergone major surgery might need a little help making hospital food tolerable.

The intervention was small. The difference it made to Curran was not.

Technology can monitor oxygen saturation, display vital signs, record medication administration, and organize clinical information. These capabilities matter. But they do not make the patient's experience interchangeable with the data describing it.

Marcella helped Curran through a frightening and physically vulnerable experience. Her attention mattered because she was present, understood what he was facing, and could respond.

The point of healthcare technology should not be to make human attention unnecessary. It should be to make human attention available where it matters most.

That is a useful test for every new healthcare tool.

Does it remove repetitive work and give people more time to care? Or does it add another screen, another alert, another reconciliation task, and another reason to look away from the person in front of them?

Automation is valuable when it improves the work. It is less impressive when it simply relocates the burden.

The objective should not be a hospital or medical practice in which nobody needs help.

It should be a system in which the people who provide that help have better information, fewer avoidable obstacles, and more time to do it well.


The other David: A reminder that we rarely see the whole system

Curran's account includes another patient, also named David, who experienced postoperative confusion and delirium.

Separated by a curtain, Curran heard the other patient repeating that he was David and that he was very funny. Nurses, physicians, and family members came in and out of the neighboring space.

Curran, hungry, uncomfortable, and eager for assistance, initially wondered why the other patient was receiving so much attention while he waited for a blanket and something to eat.

Then he realized that the other David was confused and required close observation.

The moment is funny because Curran does not portray himself as a perfectly patient patient. He admits to the irritation and petty thoughts that can arise when someone is uncomfortable and feels overlooked.

But there is a deeper lesson.

From one side of a curtain, it can look as though someone is receiving unnecessary attention. From the other side, the situation may involve a patient who is disoriented and needs monitoring.

One person sees a delay. Another sees a clinical priority.

Neither person necessarily has the whole picture.

This happens outside hospitals, too.

A physician may believe a billing specialist has all the documentation needed to submit a claim. The billing specialist may be waiting for a missing detail. An administrator may believe an authorization has been completed, while a clinician is still waiting for confirmation.

Everyone may be working hard. Everyone may be frustrated. The system may still be failing to provide a shared understanding of what needs to happen next.

The answer is not to assume that one person is lazy, careless, or incompetent.

It is to design processes that make relevant information visible, clarify responsibility, and reduce unnecessary handoffs.

Sometimes, the problem is not that people are failing to do their jobs.

It is that the system makes doing the right job harder than it needs to be.

Healthcare has plenty of technology. Why is there still so much friction?

Healthcare has electronic health records, practice-management systems, scheduling software, patient portals, clearinghouses, payer portals, analytics platforms, and a rapidly expanding collection of AI tools.

And yet, clinicians and administrative staff still spend substantial time searching for information, entering data, correcting errors, reconciling discrepancies, and following up on unfinished tasks.

We have digitized a great deal of healthcare.

We have not necessarily simplified it.

A phone call becomes a portal message. A paper form becomes a digital field. A manual handoff becomes an automated notification. A missing piece of information becomes a work queue.

The process looks more modern. The burden may remain.

This is the difference between digitizing an activity and redesigning the system that produces it.

Consider a medical practice in which information is entered into one system, transferred to another, reviewed by a third party, and re-entered somewhere else. Each tool may function as intended. But every transition creates an opportunity for information to be lost, changed, duplicated, or misunderstood.

If something goes wrong, someone must investigate.

If it happens repeatedly, someone must investigate repeatedly.

Eventually, the practice may buy another tool to make those investigations faster.

That tool might be helpful. But a more fundamental question remains unanswered:

Why does the same problem keep occurring?

A faster mop is useful when the floor gets wet. It is not a complete solution when the pipe keeps leaking.

Healthcare sometimes invests heavily in the mop.


The administrative burden is measurable

This is not simply a complaint about inconvenient software or paperwork that nobody enjoys.

Administrative requirements consume real time.

The American Medical Association's May 2026 report on prior authorization described findings from its survey of 1,000 physicians. Among the reported results:

  • Physicians handled an average of 40 prior authorization requests per week.
  • Physicians and staff spent approximately 13 hours each week on prior authorization.
  • 94% of surveyed physicians said prior authorization contributes to burnout.
  • 95% said prior authorization delays access to necessary care.
  • 79% reported that patients abandon treatment because of prior authorization challenges.

These are survey findings, not universal measurements of every practice. Prior authorization is also not the same as medical billing, and the two should not be treated as interchangeable.

However, the results illustrate the wider issue: healthcare professionals spend substantial time navigating administrative processes that can interfere with access, efficiency, and attention.

The broader financial context is enormous. The Centers for Medicare & Medicaid Services reported that U.S. healthcare spending reached $5.3 trillion in 2024, equivalent to 18% of gross domestic product. That figure includes the full range of healthcare spending; it is not an estimate of administrative waste. CMS National Health Expenditure data.

The important question is not whether healthcare can eliminate all administrative work. It cannot, nor should it. Documentation, payment integrity, clinical review, privacy, and accountability are essential.

The question is how much repetitive work is necessary—and how much exists because the systems responsible for coordinating that work were not designed to function well together.

For smaller physician-owned practices, this distinction can be especially important. They may have fewer staff members to absorb exceptions, less capacity to build custom integrations, and limited time to evaluate competing software.

A recurring administrative problem does not disappear because the clinic is busy treating patients.

Someone still has to fix it.

And if the same problem returns next week, someone has to fix it again.


The contrarian argument: Stop measuring progress only by speed

Healthcare technology often promises faster work.

Faster documentation. Faster coding. Faster claims. Faster eligibility checks. Faster denial management.

Speed matters. But it is not the only measure of value.

If a task is necessary, making it faster can be useful.

If a task exists because information was captured incorrectly, making the correction faster may help—but it does not address the original cause.

If two systems disagree, moving the disagreement from one platform to another in milliseconds is not the same as resolving it.

If staff must repeatedly reconcile inconsistent information, a dashboard showing the work in real time may improve visibility without reducing the work itself.

We should not dismiss those improvements. Visibility, speed, and automation can make a meaningful difference. But we should ask whether they solve the underlying problem or merely make it easier to manage.

The next stage of healthcare automation should ask not only, “How do we do this faster?” but also, “Why do we keep having to do this?”

That question changes the starting point.

Instead of beginning with a task to automate, begin with the problem that generates the task.

Where does the information originate? What is required? What is missing? Where does context disappear? Why does someone need to intervene? Could the same issue have been prevented earlier?

This is harder than adding a new feature because it requires examining the entire process.

It also demands intellectual honesty. Some problems arise from legitimate clinical complexity, payer rules, coverage decisions, or regulatory requirements. Not every exception is preventable, and not every denial signals a system failure.

The objective is to distinguish necessary complexity from avoidable complexity.

That is where good process design and well-targeted AI can make a difference.


Medical billing: The problem may begin before the claim exists

Curran's story concerns his health, diagnostic evaluation, surgery, and recovery. It does not establish that medical billing caused his delayed referral or his cardiac condition. It would be misleading to claim otherwise.

The connection is a broader one: healthcare depends on information moving through complex systems, and friction can consume the time and attention of the people who rely on those systems.

Medical billing is one place where this becomes visible.

A clinical encounter generates information. That information must be documented, translated into the appropriate codes and claim data, checked against applicable requirements, and submitted through the relevant processes. Depending on the practice and payer, the claim may pass through practice-management software, a clearinghouse, and payer systems.

When the information is incomplete or inconsistent, the process may require additional review, correction, resubmission, or follow-up.

Some of that work is unavoidable. Claims must accurately represent services provided and meet applicable requirements. Human review remains important where clinical interpretation, judgment, or accountability is needed.

But some rework can arise from preventable problems.

A required detail may not have been captured. Information may be inconsistent across systems. A handoff may not communicate what the next person needs. A recurring exception may be treated as an isolated incident rather than a pattern worth correcting.

The result is an administrative burden that extends beyond one claim.

For a small practice, every hour spent resolving avoidable exceptions is an hour that cannot be spent on another operational priority. Staff may still provide excellent service, but they are doing so while managing a process that repeatedly demands their attention.

The central question for medical billing technology is therefore bigger than processing speed.

Can the technology help practices identify and prevent recurring information problems earlier in the revenue cycle?

That is a more demanding goal than automating the last step.

It requires understanding how information is created, how it moves, what the downstream process requires, and where avoidable inconsistencies originate.

OnnX: Don't just automate the mess. Prevent the mess.

This is the problem OnnX is designed to address.

OnnX is an AI-powered healthcare revenue-cycle intelligence platform focused on improving the upstream structure and quality of clinical and operational information that supports medical billing.

Its central premise is that some downstream billing problems begin upstream—before a claim is submitted.

When information is incomplete, inconsistent, or poorly structured, downstream teams may have to repair problems they did not create. Automation can help them work faster, but a stronger approach is to identify recurring problems earlier and reduce the conditions that cause avoidable rework.

This is not a promise that every denial can be prevented or every claim will be paid. Payer policies, coverage decisions, clinical complexity, and legitimate documentation requirements will continue to matter.

It is a different way to frame the problem.

Instead of looking only at the rejected claim, ask what made the rejection possible.

Instead of treating every correction as an isolated task, look for patterns.

Instead of adding another tool to the end of a fragmented process, examine whether the information entering that process can be made more reliable.

For a small medical practice, that could mean asking:

  • Which recurring billing problems consume the most staff time?
  • Which problems originate in missing or inconsistent information?
  • Which corrections are repeated because the same issue keeps returning?
  • Which handoffs create delays or confusion?
  • What can be validated earlier without adding unnecessary burden to clinicians?
  • Where should AI assist, and where should a qualified human remain responsible?

These questions move the discussion from simply processing work to understanding why the work exists.

The goal is not to replace every person involved in billing. It is to reduce avoidable administrative effort so that the people who manage the revenue cycle can focus on work that genuinely requires their expertise.

The most useful AI may not be the AI that completes the most tasks. It may be the AI that helps a practice stop needing so many corrective tasks in the first place.

That is the difference between automating a mess and designing a better system.


Three questions every healthcare leader should ask before buying more AI

1. Are we eliminating work—or simply making it faster?

Before automating a task, establish why it exists.

Is it necessary for safety, compliance, clinical judgment, or payment integrity? Or does it repeatedly occur because information is missing, duplicated, inconsistent, or difficult to locate?

Necessary work deserves better tools.

Unnecessary work deserves investigation before it receives a larger technology budget.

2. Can we identify the source of recurring errors?

A denial report can reveal what happened to a claim. It may not explain the full chain of events that led to the problem.

Track recurring exception categories and distinguish payer-driven issues from documentation gaps, data-quality problems, workflow failures, and other causes.

The goal is not to assign blame to an individual. It is to discover which conditions keep generating the same work.

3. Does the technology return attention to people?

Measure more than processing speed.

Does the system reduce duplicate entry? Make missing information visible earlier? Improve handoffs? Reduce repeated corrections? Help staff find relevant context more quickly?

Does it preserve appropriate human review and make errors easier to identify and correct?

If a new tool reduces one task but creates three others, its actual value may be considerably smaller than the product demonstration suggested.

The right measure of progress is not how much technology a practice uses. It is how much meaningful improvement the technology delivers.


Four myths keeping healthcare stuck

Myth 1: More automation automatically means less work.

Not necessarily. Automation can accelerate a poorly designed process or reproduce errors at scale. The quality of the inputs and the design of the process still matter.

Myth 2: Every billing problem is a denial-management problem.

A denial is an outcome, not a complete explanation. Its cause may involve documentation, eligibility, coding, coverage rules, claim construction, timing, or other factors. Effective improvement requires identifying the cause rather than treating every denial as identical.

Myth 3: Human attention is the part of healthcare technology should eliminate.

Human attention is often the resource healthcare most needs to preserve. Technology should reduce repetitive administrative work while supporting the judgment, empathy, and problem-solving that patients and clinicians depend on.

Myth 4: Patients can solve system problems by advocating more forcefully.

Self-advocacy can be valuable. But it should not be the only mechanism through which concerns receive attention.

Patients differ in their time, confidence, health literacy, language access, resources, and ability to navigate complex organizations. A process that works only when someone knows how to push repeatedly is not equally accessible to everyone.


What practices can do now—without buying another platform

Healthcare organizations can begin reducing avoidable friction before making a major technology investment.

Map one recurring problem. Choose a common billing exception or repeated handoff. Trace the process from the original information to the final outcome. Identify every point where the information changes, gets checked, or requires intervention.

Separate the symptom from the cause. A delayed claim is a symptom. The cause might be missing information, a payer requirement, a system-interface problem, or a process that depends on manual follow-up. Investigate before prescribing a solution.

Measure repeat work. Track the most common correction categories, the time required to resolve them, the number of repeated handoffs, and how often the same issue returns. Establish a baseline before changing the process.

Improve information quality at the point of capture. Where practical, make necessary information easier to record correctly and validate early. Avoid adding fields or steps that create unnecessary work for clinicians.

Listen to the people doing the work. Billing staff, clinical teams, and administrators often see recurring failures long before those failures appear in a leadership dashboard. Give them a practical way to identify patterns without turning every discussion into a blame exercise.

Preserve appropriate human oversight. Automation should support professional judgment and accountability, not obscure how a decision was reached or make it harder to correct an error.

Reassess after implementation. A tool should be evaluated in the real environment where it is used. If it reduces one category of work but creates another, measure the net effect rather than counting only the tasks it automates.

The goal is not to eliminate every administrative process. It is to make necessary work more reliable and proportionate while identifying work that should not have to recur.


The future of healthcare depends on more than smarter software

Curran's account is memorable because it is not a technology success story.

It is a story about a person confronting a frightening diagnosis, the uncertainty of surgery, the vulnerability of intensive care, and the people who helped him recover.

Marcella mattered because she paid attention. The other patients mattered because their experiences revealed how much of healthcare happens beyond a chart or monitor. Curran's own reflections mattered because he described both the failures and the moments of kindness without pretending the experience was simple.

Technology can help organize healthcare. It can improve access to information, identify patterns, support workflows, and reduce repetitive administrative tasks.

But technology is not the mission.

A hospital is not successful because it has more software. A medical practice is not successful because its staff can process more administrative work. A revenue cycle is not necessarily healthy because it has a dashboard for every exception.

The point is to support good care, reliable operations, and appropriate payment while reducing avoidable burdens on the people involved.

For AI companies, this requires resisting the temptation to treat every problem as an invitation to automate another task.

Sometimes the right answer is better information. Sometimes it is a clearer process. Sometimes it is improved coordination. Sometimes the work is necessary and should simply be made easier to complete.

The important thing is to know the difference.

For OnnX, that means approaching revenue-cycle intelligence from upstream: improving the information and processes that shape billing outcomes, rather than focusing only on the corrections required after a problem appears.

The opportunity is not to promise a frictionless healthcare system. Healthcare is too complex for that.

It is to make preventable friction less common—and to give people more time for the work that cannot be reduced to a transaction.


The final contradiction

David Curran's journey from feeling healthy to quadruple bypass surgery is a powerful reminder of the importance of listening, clinical judgment, patient advocacy, and human care.

It does not prove that billing technology could have prevented his cardiac crisis. His account does not establish that connection, and it should not be used to make one.

But it does invite a broader question about how healthcare is designed.

Why do we celebrate systems that can respond to a crisis while tolerating processes that make people work unnecessarily hard to navigate the system before, during, and after that crisis?

Why do we invest in making work faster without always asking whether the work needs to exist?

And why do we sometimes treat administrative complexity as inevitable when some of it may be the result of preventable design choices?

The answers will vary across clinical care, hospital operations, and medical billing. Not all complexity is waste. Safety, accuracy, privacy, and accountability require real work.

But healthcare should be willing to examine its own processes with the same rigor it applies to clinical problems.

The patient is not the workflow.

The claim is not the purpose.

And administrative activity is not the same as value.

The next breakthrough may not be another system that automates the work we have accumulated. It may be a system that helps us understand which work is necessary, which work can be simplified, and which work should never have been created in the first place.

What if the most meaningful use of AI in healthcare is not teaching machines to do more work—but helping healthcare stop creating unnecessary work for people?

I would welcome perspectives from physicians, clinic owners, nurses, billing professionals, and healthcare technology leaders: Which recurring administrative task in healthcare do you believe should not exist in its current form?

Share your experience in the comments, and repost this article if you believe healthcare technology should create more room for care—not simply more efficient bureaucracy.

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About the author

Dr. Daniel Cham, MD, is a physician, healthcare consultant, and entrepreneur focused on the intersection of medical practice, healthcare technology, and medical billing. Through his work on OnnX, an AI-powered medical billing and revenue-cycle intelligence platform for small and medium-sized clinics, he explores how better-structured information and better-designed processes can reduce avoidable administrative friction.

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References and further reading

  1. David Curran, SFGATE, “How I went from 'healthy' to a quadruple bypass in weeks”, October 11, 2026.
  2. World Health Organization, “World Mental Health Day 2026: Lived experiences heard: real voices, real change”, October 10, 2026.
  3. American Medical Association, “AMA survey: Prior authorization reform pledge falls short with physicians”, May 13, 2026.
  4. Centers for Medicare & Medicaid Services, National Health Expenditure data fact sheet.

Disclaimer

This article provides general educational commentary on healthcare operations, technology, and administrative design. It is not medical, legal, coding, billing, financial, or compliance advice. The discussion of David Curran's experience is based on his published personal account and should not be interpreted as an independent clinical assessment of his care. Individual medical decisions depend on the patient's circumstances and the judgment of qualified healthcare professionals.


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