Luca George's story is a reminder that healthcare should create more room for life—not more administrative work for the people delivering it.
“Technology, if done right, is one of the very few deflationary forces we can apply to health care costs right now.” — Dr. Toyin Ajayi, CEO, Cityblock Health
A four-year-old living with an ultra-rare genetic
disorder is teaching us something surprisingly relevant to physician-owned
practices: the goal of better healthcare isn't to make people better at
navigating the system. It's to make the system require less navigation in the
first place.
Luca George is four years old.
He has an ultra-rare genetic disorder.
His parents, Mariah and Nicholas “Nick” George, know
hospitals, specialists, medications, therapies and medical equipment far better
than most parents ever should.
But that is not the life they want for their son.
They want Luca to go to the beach.
They want him to ride an adaptive bike.
They want him to experience adaptive surfing.
They want him to laugh, joke, play with his family and dogs,
watch television and simply be a kid.
Luca cannot walk independently or use his hands
independently. He lives with drug-resistant epilepsy and hearing loss and
communicates with an eye-gaze device. His condition, SPATA5L1-related disorder,
is so rare that fewer than 100 children have been identified worldwide.
And yet his mother, Mariah, says something that should stop
healthcare professionals in their tracks:
“I just want people to see Luca as a little boy first.”
That sentence is bigger than rare disease.
It is bigger than pediatrics.
It is bigger than disability.
It may even be one of the most important questions we can
ask about healthcare.
What if the goal of healthcare isn't to make people
better at navigating the healthcare system?
What if the goal is to make the system require less
navigation in the first place?
Because somewhere along the way, healthcare developed a
strange habit.
We started measuring how much work the system performs.
Then we started confusing that work with care.
And now we have an industry where a task can be completed,
documented, timestamped, assigned, escalated, routed, closed and billed—
while the underlying problem remains completely unsolved.
That is not efficiency.
That is administrative theater.
And Luca's story gives us a very human reason to ask whether
we can do better.
The Healthcare System Has a Weird Definition of “Done”
Healthcare loves the word done.
The referral was sent.
Done.
The authorization was submitted.
Done.
The claim was submitted.
Done.
The fax was sent.
Done.
The task was assigned.
Done.
The patient was contacted.
Done.
The note was signed.
Done.
Except…
The referral never arrived.
The authorization was denied.
The claim rejected.
The fax went into a black hole.
The patient never received the message.
The note contained incomplete information.
And somebody has to do the work again.
Welcome to healthcare.
Where “done” sometimes means:
We have successfully created the next problem.
We have become extraordinarily sophisticated at moving
information from one place to another while occasionally forgetting to ask
whether the information was correct in the first place.
That sounds funny until you are the patient.
Then it is not funny at all.
Luca's Parents Are Not Asking Healthcare for a Miracle
Mariah and Nick George are not asking the healthcare system
to make Luca's condition disappear.
They are asking for something much more ordinary.
A childhood.
That distinction matters.
Healthcare often defines success through clinical outcomes:
- Was
the treatment delivered?
- Was
the test completed?
- Was
the medication prescribed?
- Was
the appointment attended?
- Was
the claim paid?
Patients experience success differently.
Can I go home?
Can I get back to work?
Can my child play?
Can I sleep tonight?
Can I spend an afternoon at the beach without organizing
my entire life around healthcare?
Can I stop being a patient for five minutes?
Those questions rarely appear neatly inside a workflow
dashboard.
But they are often the reason the healthcare system exists.
Mariah described their reality with brutal simplicity: their
life isn't defined only by hospitals and medical appointments, although some
weeks it feels like it is.
That should make us uncomfortable.
Because healthcare is supposed to serve life.
It should not quietly consume it.
The Contrarian Idea: Healthcare Doesn't Have a Workflow
Problem
I think we have diagnosed the problem incorrectly.
We keep saying healthcare needs:
More automation.
More workflows.
More dashboards.
More alerts.
More AI.
More integrations.
More rules engines.
More portals.
More notifications.
More task queues.
More analytics.
More “visibility.”
Maybe.
But there is another possibility.
Maybe healthcare doesn't have a shortage of workflow.
Maybe healthcare has a surplus of workflow.
We have built entire industries around helping people manage
the consequences of information being incomplete, late, inconsistent or trapped
in the wrong place.
Then we celebrate when technology makes the process faster.
That's like inventing a faster way to clean up a spill while
refusing to ask why the pipe keeps leaking.
The technology may be excellent.
The diagnosis may be wrong.
The Most Expensive Person in the Room May Be Entering the
Same Information Twice
Consider what happens when a patient's information changes.
A new insurance plan.
A new address.
A new referring physician.
A new diagnosis.
A new authorization requirement.
A new medication.
A new documentation requirement.
Somebody has to know.
Then somebody has to enter it.
Then somebody else has to check it.
Then another person may have to correct it.
Then the billing team sees something different.
Then the payer sees something else.
Then the claim comes back.
Then someone investigates.
Then someone calls.
Then someone sends a fax.
Then someone documents the call.
Then someone follows up.
And eventually someone says:
“Why wasn't this caught earlier?”
That question is usually asked after the expensive part.
The more interesting question is:
Why was the system designed so that catching it earlier
was so difficult?
That is the upstream question.
And upstream questions are rarely as glamorous as AI.
But they can be much more valuable.
Healthcare Has Become Very Good at Rework
Here is an uncomfortable metric:
How much of the work your organization performs exists
only because another piece of work failed?
Think about that.
A denial creates work.
A missing document creates work.
A bad demographic record creates work.
A failed authorization creates work.
A missed handoff creates work.
An incorrect insurance record creates work.
A coding correction creates work.
A claim correction creates work.
A duplicate entry creates work.
Then somebody builds a workflow to manage the work.
Then somebody builds software to optimize the workflow.
Then somebody sells analytics to measure the workflow.
Congratulations.
You now have a highly optimized machine for producing and
measuring rework.
Healthcare calls this sophistication.
Sometimes it is.
Sometimes it is just expensive repetition wearing a blazer.
The Claim Is Not the Problem
A denied claim is often treated as a billing problem.
I would argue that the denial is frequently the crime
scene.
The real question is:
Where did the problem begin?
Maybe the payer rejected the claim because information was
missing.
Fine.
Why was the information missing?
Maybe the information was never collected.
Why wasn't it collected?
Maybe the workflow did not ask for it.
Why not?
Maybe the system did not know the information would be
required.
Why didn't the system know?
Maybe the data was never structured at the point where it
was created.
Now we're somewhere interesting.
Because the problem that eventually appeared as a denial
may have started much earlier.
Possibly during registration.
Possibly during scheduling.
Possibly during intake.
Possibly during documentation.
Possibly during authorization.
Possibly at a handoff.
The billing department simply became the place where the
problem became visible.
That is different from being the place where the problem
began.
We Keep Optimizing Around Noise Instead of Removing It
This is where healthcare technology gets interesting.
The industry has spent years building better tools for
downstream work.
Better coding.
Better claim submission.
Better denial management.
Better A/R reporting.
Better work queues.
Better automation.
Better analytics.
And these tools can absolutely create value.
But there is a dangerous assumption hiding underneath all of
them:
The data arriving downstream is good enough.
What if it isn't?
What if the real opportunity is not another sophisticated
downstream tool?
What if it is getting the data right earlier?
Because once bad information enters the system, every
downstream department becomes a correction department.
The system starts compensating for variability.
People compensate for software.
Software compensates for missing information.
Billing compensates for documentation.
Clinicians compensate for fragmented records.
Patients compensate for fragmented care.
And everyone wonders why healthcare costs so much.
The AI Trap
Now enter AI.
Healthcare has understandably become fascinated with AI.
And there is good reason.
AI can summarize.
Predict.
Classify.
Draft.
Route.
Prioritize.
Extract.
Generate.
Automate.
But here is the question I think we should ask more often:
What happens when AI makes a bad process faster?
If the input is incomplete, AI can produce a beautifully
organized incomplete answer.
If the workflow is broken, AI can accelerate the broken
workflow.
If information is inconsistent, AI can summarize the
inconsistency with remarkable confidence.
Garbage in.
Beautifully summarized garbage out.
The danger is not that AI is useless.
The danger is that AI is useful enough to hide the
underlying problem.
That is why Dr. Toyin Ajayi's recent comment is so
important.
She did not simply say technology is transformative.
She added the crucial qualifier:
“if done right.”
That three-word qualification may be the most important part
of the sentence.
Technology is a lever.
It does not decide what to lift.
The Better AI Question
Instead of asking:
“What can AI automate?”
Healthcare leaders should ask:
“What work should no longer exist?”
Those are completely different questions.
The first produces automation projects.
The second produces system redesign.
Suppose an employee spends three hours every morning
checking whether information is missing.
AI can potentially make that checking faster.
But maybe the bigger opportunity is preventing the
information from being missing.
Suppose a billing team spends hours chasing authorization
status.
AI can potentially automate the follow-up.
But perhaps the bigger opportunity is creating a process
where authorization requirements are known before the patient reaches the point
of failure.
Suppose staff repeatedly call patients for information.
AI can make the calls cheaper.
But maybe the better question is:
Why did we need to call five times?
That is not an AI question.
That is a systems question.
Luca's Story Makes This Personal
It would be easy to read Luca's story and think:
“This is about rare disease.”
Of course it is.
But it is also about something much more universal.
People have lives outside healthcare.
Luca's life happens between appointments.
Between medications.
Between therapies.
Between specialists.
Between hospital visits.
Between pieces of paperwork.
His parents are trying to protect those spaces.
That is what makes their story so powerful.
They are not trying to eliminate healthcare from Luca's
life.
They are trying to prevent healthcare from becoming his
entire life.
There is a lesson here for every healthcare organization.
The best healthcare experience may not be the one with
the most touchpoints.
It may be the one that creates the most room between them.
The Hidden KPI: Time Returned to Life
Healthcare has thousands of metrics.
Length of stay.
Readmission.
Revenue per encounter.
Days in A/R.
Denial rate.
First-pass yield.
Patient satisfaction.
Provider productivity.
Utilization.
Cost per visit.
All useful.
But I think we need another metric:
Time returned to life.
How many minutes did we give back to the patient?
How many hours did we give back to the physician?
How much unnecessary follow-up disappeared?
How many duplicate requests disappeared?
How many calls became unnecessary?
How many forms disappeared?
How many handoffs disappeared?
How many problems were prevented instead of repaired?
That is not soft measurement.
Time is one of the most valuable resources in healthcare.
Patients know it.
Physicians know it.
Caregivers know it.
Healthcare organizations sometimes forget it.
The Physician's “Pajama Time” Problem Is Not Just a
Burnout Problem
The Office of the National Coordinator for Health
Information Technology recently reported that more than three-quarters of more
than 8,400 family physicians experienced at least one substantial burden
involving external information retrieval, prior authorization or after-hours
documentation.
In 2026, substantial prior-authorization burden remained
high, while substantial after-hours documentation burden improved from previous
years.
That combination tells us something important.
Technology can reduce some administrative work.
But adding technology does not automatically eliminate
administrative work.
Sometimes it simply moves the work.
The physician stops faxing.
Now the physician clicks.
The physician stops searching one system.
Now the physician searches three.
The physician stops writing one note.
Now the physician reviews an AI-generated note.
The work changes clothes.
It does not necessarily disappear.
That distinction matters.
Because automation is not the same thing as elimination.
We Should Stop Celebrating Activity
Healthcare dashboards are full of activity.
Tasks completed.
Messages sent.
Claims submitted.
Calls made.
Notes signed.
Prior authorizations processed.
Tickets closed.
But activity is not the same as completion.
A claim submitted is not a payment.
An authorization request is not an authorization.
A referral sent is not an appointment.
A task marked complete is not a problem solved.
A message delivered is not a patient reached.
This sounds obvious.
Yet entire systems are built around counting activity
because activity is easy to measure.
Outcome is harder.
The uncomfortable question is:
Are we measuring what the system did, or what actually
happened?
The Handoff Is Where Good Intentions Go to Die
Healthcare is a giant network of handoffs.
Patient to front desk.
Front desk to clinical staff.
Clinical staff to physician.
Physician to specialist.
Specialist to facility.
Facility to payer.
Payer to billing.
Billing back to practice.
Every handoff introduces the possibility of information
loss.
And every handoff creates another opportunity for somebody
to say:
“I thought they had that.”
The patient does not care who was supposed to have it.
The patient simply experiences the result.
That is why reducing handoffs can be more powerful than
optimizing them.
The goal should not always be:
“How do we make this handoff more efficient?”
Sometimes it should be:
“Why is this handoff necessary?”
That question is far more dangerous.
And far more interesting.
What OnnX Is Trying to Look At
This is the thinking behind OnnX.
Not:
How do we build another tool for the billing department?
But:
Why did the billing problem happen in the first place?
Healthcare billing is often treated as a tooling problem.
I believe a significant part of it is a data-quality
problem.
The revenue cycle is downstream.
The patient encounter is upstream.
Between those two points, information changes hands, gets
interpreted, gets re-entered, gets transformed and sometimes gets lost.
By the time the claim is denied, everyone is looking at the
symptom.
The opportunity is to move the intervention closer to the
source.
Better information.
Earlier.
More structured.
More consistent.
Fewer unnecessary handoffs.
Less rework.
Less chasing.
Less correction.
And ultimately, less administrative burden on the people who
should be spending their time caring for patients.
That is a very different philosophy from simply adding
another layer of automation.
The Question Every Practice Should Ask on Monday
Pick one recurring administrative problem.
Not the biggest.
Not the most impressive.
Just one.
Then ask five questions:
1. Where does the problem first appear?
Not where it gets fixed.
Where does it first appear?
2. Where was the necessary information originally
created?
Find the source.
3. How many people touch it afterward?
Count the handoffs.
4. How many times is the same information re-entered?
Count the duplication.
5. What would have to change for this problem never to
appear?
This is the important question.
Do not automate the current process yet.
First challenge the process.
Otherwise you may simply build a faster treadmill.
A 30-Day Rework Audit
For the next 30 days, track five things:
1. Rework
How many tasks were repeated because something was
incomplete or incorrect?
2. Preventable denials
How many denials could have been prevented upstream?
3. Duplicate data entry
How many times was the same information entered?
4. Handoffs
How many people touched a single issue?
5. Time spent chasing
How much staff time went into finding information, checking
status or asking someone else for an answer?
Then calculate something most dashboards ignore:
Cost of administrative rework = volume × frequency ×
minutes × labor cost.
The number may surprise you.
Not because healthcare workers are inefficient.
Because the system may be manufacturing unnecessary work.
The Humorously Bad Test
Here's a simple test for every healthcare workflow:
If a competent employee disappeared tomorrow, would the
process still make sense?
If the answer is no, you may not have a workflow.
You may have institutional memory disguised as a workflow.
Another test:
If you removed the spreadsheet, would anyone know what
was happening?
If not, congratulations.
You have created a spreadsheet-based electronic health
record.
And finally:
If three people are checking whether the first person did
the thing correctly, why is the first person doing the thing manually?
These questions sound almost ridiculous.
That's the point.
Sometimes absurdity becomes visible only when we stop
accepting the process as normal.
What We Should Stop Doing
Stop measuring administrative activity as though it
automatically represents value.
Stop assuming the department where a problem appears is the
department responsible for creating it.
Stop adding technology before understanding the process.
Stop celebrating automation that merely transfers work from
one employee to another.
Stop calling every workflow “optimized” because it has a
dashboard.
Stop treating patients as inputs moving through a system.
And stop assuming that more healthcare automatically means
better healthcare.
Sometimes better healthcare means less healthcare
administration surrounding the care that actually matters.
What We Should Start Doing
Start measuring rework.
Start tracing problems upstream.
Start designing around the patient's actual journey.
Start asking where information originated.
Start reducing unnecessary handoffs.
Start structuring data at the point of capture.
Start measuring time returned to clinicians and patients.
Start using AI to prevent work, not simply accelerate it.
And start treating administrative simplicity as a clinical
experience issue.
Because it is.
Technology Should Give People Their Time Back
Dr. Toyin Ajayi's recent point about technology being
potentially deflationary in healthcare is worth taking seriously.
But there is another kind of deflation we rarely discuss.
Deflation of administrative burden.
Fewer clicks.
Fewer calls.
Fewer faxes.
Fewer duplicate entries.
Fewer status checks.
Fewer corrections.
Fewer “just following up” messages.
Fewer tasks whose only purpose is to repair another task.
Imagine what happens when those minutes disappear.
The physician gets more attention for the patient.
The nurse gets more time for the patient.
The staff member gets more time for meaningful work.
The caregiver gets more time with the child.
And the child gets to be a child.
That is a much better definition of innovation.
The Point Isn't to Remove Humans
There is an easy mistake to make here.
If administrative work is wasteful, perhaps we should
automate everything.
No.
That is the wrong lesson.
Healthcare is deeply human.
Judgment matters.
Empathy matters.
Trust matters.
Context matters.
A physician recognizing that something is wrong before a
test confirms it matters.
A nurse noticing that a patient is frightened matters.
A caregiver knowing that a child is having an unusually
difficult day matters.
Technology should not eliminate those moments.
It should protect them.
The best automation may be the automation that nobody
notices.
The claim that submits correctly.
The authorization that never becomes a crisis.
The missing information caught before it becomes a denial.
The referral that arrives without someone calling to ask
where it went.
The patient who never knows there was a problem because the
system solved it before they encountered it.
That is the kind of invisible infrastructure healthcare
needs.
And Then There Is Luca
Luca will turn five on October 7.
His parents cannot predict everything his future will bring.
But they can control some things.
They can take him outside.
They can create experiences.
They can celebrate small victories.
They can advocate.
They can build community.
They can laugh.
They can give him a childhood.
Mariah also founded The SPATA Foundation after realizing how
little research and support existed around SPATA-related disorders.
She turned uncertainty into action.
That may be the most important part of the story.
She did not wait for the system to become perfect.
She asked:
What can we do with what we have?
Healthcare leaders should ask the same question.
Not:
“Can we fix the entire healthcare system?”
We probably cannot.
Instead:
What piece of unnecessary friction can we eliminate?
One form.
One handoff.
One duplicate entry.
One avoidable denial.
One unnecessary phone call.
One broken workflow.
One repeated question.
One hour of pajama time.
That is how systems change.
Not always through giant transformations.
Sometimes through subtraction.
The Future of Healthcare May Be Smaller Than We Think
We often describe the future as more.
More AI.
More data.
More automation.
More devices.
More monitoring.
More personalization.
More intelligence.
But perhaps the future should also be defined by less.
Less waiting.
Less repetition.
Less chasing.
Less rework.
Less paperwork.
Less uncertainty.
Less fragmentation.
Less administrative noise.
Less time spent proving that something was done.
Because the ultimate measure of technology may not be how
much it can produce.
It may be how much unnecessary work it allows us to stop
producing.
The Uncomfortable Question
Luca's story forces a question that has nothing to do with
rare disease.
It is a question for every physician.
Every clinic owner.
Every healthcare executive.
Every technology founder.
Every person building the next healthcare workflow.
Are we building technology that helps healthcare
organizations do more work?
Or are we building technology that makes unnecessary work
disappear?
Those sound similar.
They are not.
One creates productivity.
The other creates capacity.
One gives the system more things to do.
The other gives people their time back.
And ultimately, that is what Luca's story reminds us
healthcare is supposed to protect.
Not the workflow.
Not the dashboard.
Not the task queue.
Not the claim.
Not the authorization.
Not the revenue cycle.
The life on the other side of all of it.
But I Could Be Wrong
Maybe healthcare really does need another dashboard.
Maybe another notification will finally solve everything.
Maybe the 47th workflow will be the one that works.
Maybe the answer really is to add one more person to the
queue.
I am skeptical.
Because if the same problem keeps returning, the question
should not simply be:
“How do we handle it faster?”
It should be:
“Why does it keep happening?”
That question moves us upstream.
And upstream is where some of the biggest opportunities in
healthcare may still be hiding.
A Different Definition of Healthcare Innovation
We have spent years asking whether technology can make
healthcare more efficient.
I think the better question is:
Can technology make healthcare less burdensome?
For physicians.
For staff.
For caregivers.
For patients.
For families like the Georges.
That changes the design brief.
The objective is no longer maximum automation.
It is maximum human attention where human attention
actually matters.
The objective is no longer more activity.
It is more completion.
The objective is no longer more data.
It is better data at the point where it enters the
system.
The objective is no longer more workflows.
It is fewer problems that require workflows.
And the objective is no longer making healthcare
organizations better at processing patients.
It is helping patients spend more time living their lives.
Luca's parents understand that instinctively.
Maybe healthcare needs to learn it technologically.
Final Thought
Luca's diagnosis is part of his story.
It is not who he is.
That distinction should stay with us.
Because patients are not diagnoses.
Physicians are not productivity units.
Nurses are not task processors.
Caregivers are not administrative coordinators.
And healthcare workers should not have to spend their best
hours compensating for information problems that could have been prevented
upstream.
We do not need a healthcare system that simply moves faster.
We need one that makes fewer people carry the weight of its
broken parts.
Maybe the future of healthcare isn't about doing more.
Maybe it is finally about giving people more life.
The Conversation
What is one piece of healthcare administration that your
organization has become so accustomed to that nobody questions why it exists
anymore?
A denial?
A fax?
A duplicate form?
A referral chase?
A prior authorization?
A spreadsheet?
A handoff?
Something else?
Tell me in the comments.
And if this made you rethink what “efficiency” actually
means in healthcare, repost it for a physician, clinic owner, healthcare
operator or founder who should be part of this conversation.
I also share a free practice-improvement resource in my LinkedIn
Featured section — no signup needed.
About the Author
Dr. Daniel Cham is a physician, entrepreneur and
medical consultant focused on healthcare technology, healthcare management and
medical billing.
His work explores a simple question:
How can technology remove unnecessary friction from
healthcare without removing the humanity from it?
Connect with Dr. Cham on LinkedIn to
learn more.
Disclaimer
This article is for educational and informational
purposes only. It does not constitute medical, legal, financial or professional
advice. Individual healthcare organizations should evaluate their own clinical,
operational, compliance and technology requirements with appropriate
professionals.
Continue the Conversation
Follow Dr. Daniel Cham for perspectives on healthcare,
medical technology, physician entrepreneurship, medical billing and the future
of healthcare delivery.
The goal isn't more healthcare technology.
The goal is better healthcare with less unnecessary work.
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References
- Shkurtaj,
Tereza. “Parents of 4-Year-Old with Ultra-Rare Genetic Disorder Are
Determined to Give Him as ‘Normal a Childhood as Possible’ (Exclusive).” PEOPLE,
October 3, 2026. The primary source for Luca George, Mariah George,
Nicholas “Nick” George, SPATA5L1-related disorder, and the family’s effort
to give Luca a normal childhood.
Read the PEOPLE story - Ajayi,
Toyin, MD. “AI Has More to Offer Health Care.” The Commonwealth
Fund — The Dose, October 2, 2026. Source for the quote about
technology being a potential “deflationary force” in healthcare and for
the discussion of AI, outcomes, access, data, and closing care loops.
Read the Commonwealth Fund interview - Gabriel,
Meghan; Patel, Vaishali; Richwine, Chelsea. “Less Pajama Time, More
Patient Time: How Better Interoperability Can Reduce Physician Burden.” Office
of the National Coordinator for Health Information Technology (ONC),
September 30, 2026. Source for the 2024–2026 physician
administrative-burden data, including prior authorization,
external-information retrieval, and after-hours documentation.
Read the ONC analysis
#Healthcare #HealthTech #MedicalBilling #HealthcareAI
#PhysicianEntrepreneur #RevenueCycleManagement #HealthcareInnovation #MedicalPractice
#AdministrativeBurden #PatientExperience #DigitalHealth #HealthcareLeadership
#AIinHealthcare #PhysicianBurnout #HealthIT
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