Healthcare organizations are managing many challenges at once: consumers expect digital experiences that feel as personalized as other industries, fragmented data in silos slows strategic decision-making, and AI and advanced technologies must integrate seamlessly into existing care models. 

Meeting these demands requires more than incremental change—it calls for digital solutions that unify access to care, trusted data, and advanced technologies to deliver transformative outcomes and operational efficiency. 

IDC Market Glance: Healthcare Ecosystem, 4Q25

We’re proud to share that Perficient has been included in the “IT Services” category in the IDC Market Glance: Healthcare Ecosystem, 4Q25 report (Doc# US54010025, December 2025). This segment includes systems integration organizations providing advisory, consulting, development, and implementation services, as well as products or solutions. 

We believe this inclusion reinforces our expertise in leveraging AI, data, and technology to deliver intelligent tools and intuitive, compliant care experiences that drive measurable value across the health journey.  

We believe this commitment aligns with critical shifts IDC Market Glance highlights in its latest report, which emphasizes how healthcare organizations are activating advanced technology and AI. IDC Market Glance shares, “Health systems and payers are moving more revenue into value-based care and capitated risk, pushing tech buyers to favor solutions that improve quality metrics, lower total cost of care, and help hit incentive thresholds.” 

As the industry evolves, IDC predicts: “Technology buyers will likely favor vendors that align revenue models to customer risk arrangements, plug seamlessly into large platforms, and demonstrate human-centered design that supports clinicians rather than replacing them.” 

To us, this inclusion validates our ability to help healthcare organizations maximize technology and AI to drive transformative outcomes, power enterprise agility, and create seamless, consumer-centric experiences that build lasting trust.

Intelligent Solutions for Transformative Outcomes 

These shifts are actively transforming the healthcare ecosystem, challenging leaders to rethink how they deliver care and create value. Our partnerships with leading organizations show what’s possible: moving AI from pilot to production, building interoperable data foundations that accelerate insights, and designing human-centered solutions that empower care teams and improve the cost, quality, and equity of care. 

Easing Access to Care With a Commerce-Like Experience 

We helped Rochester Regional Health reimagine its digital front door to triage like a clinician, personalize like a concierge, and convert like a commerce platform—creating a seamless experience that improves access, trust, and outcomes. The mobile-first redesign introduced smart search, dynamic filters, and real-time booking, driving a 26% increase in appointment scheduling and saving $79K+ monthly in call center costs. As a result, this transformative work earned three industry awards, recognizing the solution’s innovation in accessibility, engagement, and measurable impact on patient care.

Consumers expect frictionless access to care, personalized experiences, and real-time engagement. Our recent Access to Care Report reveals more than 45% of consumers aged 18–64 have used digital-first care instead of their regular provider—and 92% of them believe the quality is equal or better. To deliver on consumers’ expectations, leaders need a unified digital strategy that connects systems, streamlines workflows, and gives consumers simple, reliable ways to find and schedule care.

Explore how our Access to Care research continues to earn industry awards or learn more about our strategic position on find care experiences. 

Empowering Care Ecosystems Through Interoperable Data Foundations 

We helped a healthcare insurance leader build a single, interoperable source of truth that turns healthcare data into a true strategic asset. Our FHIR‑enabled solution ingests, normalizes, and validates data from internal and external systems and shares a consolidated, reliable dataset through API connectors, gateways, and extracts, grounded in data governance. Ultimately, this interoperable data foundation accelerates time to market, minimizes downtime through EDI and API modernization, and ensures the right data reaches the right hands at the right time to power consumer‑grade experiences, while confidently meeting interoperability standards. 

Discover our platform modernization and data management capabilities.  

Accelerating Member Support With Human-Centered GenAI Innovation 

We helped a leading Blue Cross Blue Shield health insurer transform CSR support by deploying a natural language Generative AI benefits assistant powered by AWS’s AI foundation models and APIs. The intelligent assistant mines a library of ingested documents to deliver tailored, member-specific answers in real time, eliminating cumbersome manual processes and PDF downloads that previously slowed resolution times. Beyond faster answers, this human-centered solution accelerates benefits education, equips agents to provide relevant information with greater speed and accuracy, and demonstrates how generative AI can move from pilots into core infrastructure to support staff rather than replace them.

Read more about our AI expertise or explore our human-centered design services. 

Build Your Scalable, Data-Driven Future 

From insight to impact, our healthcare expertise  equips leaders to modernize, personalize, and scale care. We drive resilient, AI-powered transformation to shape the experiences and engagement of healthcare consumers, streamline operations, and improve the cost, quality, and equity of care.

We have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S., and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

Our strategic partnerships with industry-leading technology innovators—including AWS, Microsoft, Salesforce, Adobe, and  more—accelerate healthcare organizations’ ability to modernize infrastructure, integrate data, and deliver intelligent experiences. Together, we shatter boundaries so you have the AI-native solutions you need to boldly advance business.

Ready to Turn Fragmentation Into Strategic Advantage? 

We’re here to help you move beyond disconnected systems and toward a unified, data-driven future—one that delivers better experiences for patients, caregivers, and communities. Let’s connect  and explore how you can lead with empathy, intelligence, and impact. 

At the Healthcare Interactive Conference (HCIC) last month, I got to talk to marketers who are very focused on results. They are also very focused on what will impact their marketing efforts and why. Every conversation came back to AI.

In my previous HCIC takeaway, I wrote about how AI is not a strategy—it’s a tool to solve real problems. Now I want to dig into a specific problem AI is creating for healthcare marketers: how we get found. We need to be thinking about all aspects of how AI can be used. In general, this breaks down into both impact and opportunity.

Impact: AI Search Is Transforming Healthcare Discovery

Several conference sessions alluded to this shift, but marketing experts Brittany Young and Gina Linville gave some deeper insight.

From a marketing perspective, the largest impact is one of being found. Think about how much time a typical hospital marketer puts into being found. I have had many conversations over the years about Search Engine Optimization (SEO) and the importance of having valuable content that the search engines view as unique and relevant.

AI impacts that in ways that are not at first obvious.

The New Reality of Patient Search

Think of how you typically use ChatGPT or how your search engine has evolved. AI now pulls the data and gives you a brief with information culled from multiple online sources. The good news is that the AI tool will typically reference a website it sources. The bad news is while AI typically credits source websites, patients get their answers without ever clicking through to your site.

The scale of this shift is staggering:

AI provides an overview for up to 84% of search queries when it comes to healthcare questions.

Healthcare leads nearly every sector in AI-powered search results—a trend that’s accelerating:

Strategic Response: Winning at AI Search in Healthcare

This shift demands a fundamental rethinking of content strategy. Two concepts are emerging as critical:

1) Answer Engine Optimization (AEO)

• Answer Engine Optimization (AEO) is the practice of structuring and optimizing content so that AI-powered systems, such as Google’s AI Overviews, ChatGPT, Perplexity AI, and voice assistants, can easily identify, extract, and cite it as a direct answer to user queries.

2) Generative Engine Optimization (GEO)

• Generative Engine Optimization (GEO) is a digital marketing technique designed to improve a brand’s visibility in results produced by generative artificial intelligence (GenAI) platforms. It involves adapting digital content and online presence to ensure that AI systems can accurately interpret, cite, and use the content when generating responses to user queries.

The imperative is clear: Organizations that don’t optimize for AI-powered discovery won’t just lose rankings—they’ll lose visibility entirely.

If you are not already thinking about how to orient your content to this then be aware that you will soon feel an impact.

Opportunity: Agentic AI and Productivity

On the flip side of the coin is the opportunity. While the impact above provides you with an opportunity provided you react appropriately, I want to focus on the productivity part of this. Specifically, think of what Agentic AI can do for your organization.

What Traditional Campaign Development Looks Like

Let me give you a few examples of common tasks and how long they typically take:

• Create a campaign brief: up to two weeks
• Create copy across multiple channels: 8-16 hours
• Create digital assets related to the campaign which fit your brand standards and work in each individual channel. Web site may allow for larger images. Paid search or paid social may have limited space: 40 hours
• Creation of the segment and pushing it to marketing automation tools: several hours

Now imagine specialized AI agents handling each component—not replacing human strategy and judgment, but accelerating execution while maintaining brand standards and compliance. Just getting one campaign going across multiple channels become a multi-person engagement over several weeks. While focused on that, you won’t focus on additional campaign or in honing your craft.

The AI Agent Team Your Marketing Organization Needs

The answer lies with Agentic AI. We believe that AI can cut down on the time necessary to complete these tasks and still keep humans in the loop. Here are a few examples of agents you might need in your organization:

Most importantly, this frees your marketing team to focus on what AI can’t do: strategic thinking, creative problem-solving, and understanding the nuanced needs of your community. 

The Path Forward: Integration, Not Replacement

The organizations winning in this new landscape aren’t choosing between human expertise and AI capabilities. They’re strategically integrating both.

Success requires more than technology. It needs an integrated approach:

1. Rethinking discoverability through AEO and GEO optimization
2. Deploying specialized AI agents for productivity acceleration
3. Maintaining human oversight for strategy, creativity, and judgment
4. Ensuring compliance at every step, particularly in heavily regulated healthcare
5. Measuring impact against business outcomes, not just operational metrics

Enabling Healthcare Organizations To Lead This Shift

HCIC reminded us that success in healthcare marketing isn’t about chasing technology for its own sake. As I shared in my first HCIC takeaway, AI is not a strategy—it’s a tool to solve real challenges that impact your organization’s ability to connect patients to care.

The search revolution is here. The productivity opportunity is real. The organizations that move quickly to optimize for AI-powered discovery while deploying strategic AI agents will gain a competitive advantage that compounds over time.

Start a conversation with our experts today.

Faced with rising patient volumes, care complexity, and financial and labor pressures, healthcare organizations are looking at new ways to deliver better outcomes more efficiently. Intelligent automation (IA) has emerged as a powerful solution for achieving operational excellence and enhancing decision-making.

This is the first installment of our Intelligent Automation in Healthcare blog series, where we’ll explore what IA really means, how it differs from previous automation solutions, and why it’s becoming essential for healthcare transformation.

In this series, we’ll go over 4 key areas of IA and what it means for healthcare organizations:

• This article, Part 1, discusses what IA really means and why it’s essential for healthcare transformation
• Part 2 considers how increasing patient volumes and care complexity are overwhelming healthcare systems, and how IA can help
• Part 3 considers the economic and operational pressures healthcare organizations face, and how IA supports cost control and revenue growth
• Part 4 explores how IA helps healthcare organizations meet regulatory mandates, manage risk, and build future-ready systems

How Intelligent Automation Is Streamlining Healthcare Workflows

The term automation has been around for decades, but its meaning has evolved significantly in recent years. In the 1990s and early 2000s, legacy automation focused on rules-based workflows such as claims routing or basic task automation. These solutions were rigid, code-intensive, and often required traditional process modeling and orchestration using BPMN (Business Process Model and Notation). While they previously offered some efficiency benefits, they currently lack the adaptability and intelligence needed for modern, scalable systems.

That’s where IA comes in. Intelligent Automation offers a more streamlined way of enabling real-time decisioning and dynamic workflows by leveraging different automation technologies together. It’s not accomplished by a single technology working independently, but rather through a combination of insights and technologies acting in concert.

Key Components of Intelligent Automation

It’s common for enterprises to approach automation through a technology lens like robotic process automation (RPA) and then report they are “fully automated.” These organizations sought a specific solution and, in most cases, are stretching the technology beyond its intended purpose.

While partial automation can be achieved through traditional digital process automation (DPA) platforms or process orchestration, IA occurs at the intersection of process mining, DPA, RPA, and artificial intelligence (AI). We are now moving towards an era of agentic frameworks, where automation isn’t limited to executing repetitive manual tasks or following predefined workflows, but also provides recommendations and decisions based on situational context and which actions can be taken.

Key components of Hyperautomation include:

• RPA and APA: Robotic process automation and the new Agentic process automation to not only automate repetitive tasks but also do complex automation with contextual awareness
• GenAI-enabled Process Discovery: Using generative AI to transform legacy business processes and application
• Agentic AI: Autonomous decision making within business workflows
• Case Management: Managing complex business process with defined stages and steps to move a case through it
• Intelligent Document Processing (IDP): Digitizing unstructured data from claims, enrollment forms, and faxes to enable seamless DPA across platforms.
• Low code/No code: Solution development with minimal coding effort

These technologies work together to reduce costs, improve process quality, and increase speed and agility—while also enhancing the experiences of patients, providers, and employees.

Learn More: Engineering Wellness and Efficiency in the Generative AI Era

The Need for Intelligent Automation Is Growing

Digital transformation demands agility and flexible frameworks ​that legacy systems do not support, which is accelerating the adoption of IA in healthcare.

The momentum is undeniable:

• In its 2025 healthcare predictions report, Forrester estimates that half of the top 10 U.S. health insurers will implement AI-powered tools to support contact center employees and care advocates​ in 2025.
• In its FutureScape Worldwide Healthcare Industry 2025 Predictions report, IDC predicts that by 2027, IA is projected to help the healthcare sector save up to $382 billion by enhancing efficiency across clinical, operational, and administrative workflows.

These trends reflect a growing acknowledgement that automation is not only a cost-saving tool, but a strategic enabler of better care delivery, operational resilience, and competitive advantage.

You May Also Enjoy: Reimagining Find Care: How AI is Transforming the Digital Healthcare Experience [Webinar]

How Intelligent Automation Can Transform Healthcare Organizations

IA is already transforming healthcare across a wide range of functions. Here are just a few examples of how it can improve patient, provider, and payer operations:

Conversational AI (using GenAI)

• Context search across multiple documents based on prompts
• Case summary and comparison of content

Document Triage

• Channel intake, classification, data extraction, validation, and entry
• Integration of specialized AI and generative AI for faster, more accurate processing

Patient & Provider Operations

• Patient enrollment, insurance and benefit verification, prior authorization, scheduling
• Provider validation and NPI search
• Provider lifecycle management

Pharmacy & Supply Chain

• Order fulfillment, inventory management, compliance, and patient profiling
• Manage supply chain disruptions with AI

Consultation & Care

• Case management, utilization management, clinical analytics, and value-based care
• Prior Auth modernization

Claims Processing

• End-to-end automation from claim ingestion to quality control and audit
• Member and provider outreach, Medicare coordination, and COB

Enrollment

• End to end automation of enrollment process for requests received from different channels

These use cases go beyond simple task automation by reimaging entire workflows to deliver better outcomes, reduce costs, and improve efficiencies.

Read More: Revolutionizing Clinical Trial Data Management with AI-Powered Collaboration

Empowering Intelligent Healthcare Solutions Through Automation

Perficient combines strategy, industry best practices, and technology expertise to deliver award-winning results for leading healthcare organizations:

• Business Transformation: Activate strategy for transformative outcomes and health experiences.
• Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
• Data Analytics: Power enterprise agility and accelerate healthcare insights.
• Consumer Experience: Connect, ease, and elevate impactful health journeys.

We are trusted by leading technology partners, mentioned by analysts, and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare and automation expertise. Contact us to learn more.

And don’t miss Part 2 of this series, where we’ll be exploring how increasing patient volumes and care complexity are overwhelming healthcare systems, and how IA can help. See you then!

Choosing a provider is one of the most personal decisions in healthcare. Yet, one in five consumers abandon healthcare organizations due to poor digital experiences.

In our recent webinar “Reimagining Find Care: How AI is Transforming the Digital Healthcare Experience,” healthcare leaders explored how AI-powered search, recommendations, and personalization are redefining access to care. Hosts Tara Becker, Perficient principal of healthcare and life sciences, and Mike Raley, Coveo SVP of marketing, detailed why this matters more than ever for health systems seeking to grow, compete, and deliver better outcomes.

Below, we break down the most important takeaways from the session:

1. Find Care Is the New Front Door—and It Must Feel Like Commerce

Healthcare is increasingly judged by the same standards as consumer brands like Door Dash and Expedia. Patients expect to search, compare, and book appointments as easily as they would a hotel or a ride share.

Key Insights:

• Digital access is a revenue driver. A seamless Find Care experience builds trust, drives patient acquisition, and reduces leakage.
• Friction leads to churn. 41% of consumers consider switching providers if the digital experience doesn’t meet expectations.
• Convenience drives action. Patients want to search by criteria that matters to them—location, gender, language, availability—and they want to book instantly.

Perficient’s Access to Care research study quantifies the direct impacts on business and health outcomes due to friction in the care journey.

2. AI-Powered Search and Personalization Are Game-Changers

AI relevance platforms like Coveo are transforming how patients find care. By unifying content, provider data, and real-time intent signals, AI enables hyper-personalized, intuitive experiences.

What AI Enables:

• Smart search that understands intent. Patients can type “family doctor near me” and instantly see relevant, bookable options.
• Dynamic filtering and recommendations. AI surfaces providers based on availability, insurance, and patient preferences.
• Generative answers grounded in trusted content. Patients get accurate, contextual responses—without hallucinations.

3. Strategy First: Align Digital Investments with Business Outcomes

Technology alone isn’t enough. A successful Find Care transformation starts with a clear strategy aligned to organizational goals.

Strategic Best Practices:

• Define your North Star. Establish KPIs that serve as success criteria for your new Find Care experience and prioritize service lines (e.g., cardiology, oncology, primary care) that drive revenue and impact.
• Map patient journeys. Understand your personas (e.g., caregivers, chronic patients), their preferences, expectations, journeys, and friction points. Design a seamless experience that removes obstacles and guides healthcare consumers to conversion.
• Audit and optimize content. Ensure provider profiles are robust and updated. Service line pages need to be relevant, actionable, and conversion-focused.

4. Build a Scalable, Interoperable Tech Stack

Find Care must integrate seamlessly with your existing systems—EHR, CRM, DXP, and more. Flexibility and interoperability are key.

Technical Considerations:

• Platform-agnostic design. Because our AI-powered Find Care solution is DXP-agnostic, it can be tailored for your organization and preferred martech stack, whether that includes Adobe, Sitecore, Acquia, Optimizely, WordPress, etc.
• Unified data layer. Connect provider directories, appointment systems, and content repositories so the most relevant information is delivered to users.
• HIPAA-compliant AI. Ensure patient data is secure while delivering personalized experiences.

5. Measure What Matters: From Clicks to Conversions

Digital success must be measured in business terms—not just traffic. Establish an outcomes dashboard that ties digital engagement to revenue, access, and health outcomes—and report it to the C-suite.

Metrics That Matter:

• Appointment conversions and completions
• Search abandonment and content gaps
• Patient satisfaction and Net Promoter Score (NPS)
• Operational efficiency (e.g., reduced call volume, fewer no-shows)

6. Start Small, Scale Smart

You don’t need to do everything at once. Begin with priority, high-impact experiences and service lines, then iterate.

A Phased Approach:

• Phase 1: Define a patient-centric Find Care blueprint.
• Phase 2: Implement Coveo for a powerfully integrated, unified search experience.
• Phase 3: Launch online appointment scheduling for primary care and urgent care.
• Phase 4: Expand to specialty services and guided journeys.
• Phase 5: Layer in generative AI and conversational experiences.

Final Thought: Find Care Is Not Just a Feature—It’s a Strategic Imperative

In an increasingly competitive and crowded health care marketplace, Find Care is your digital front door, your commerce engine, and your trust builder. AI-powered experiences are no longer optional—they’re expected.

Healthcare leaders who invest in intelligent, patient-centric digital pathways will not only win market share—they’ll improve outcomes, reduce costs, and build lasting loyalty.

Ready to Reimagine Your Find Care Experience?

If you’re exploring how to modernize your digital front door, consider starting with a strategic assessment. Align your goals, audit your content, and evaluate your tech stack. The path to better outcomes starts with a smarter, simpler way to help patients find care.

We combine strategy, industry best practices, and technology expertise to deliver award-winning results for leading healthcare organizations.

• Business Transformation: Activate strategy for transformative outcomes and health experiences.
• Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
• Data + Analytics: Power enterprise agility and accelerate healthcare insights.
• Consumer Experience: Connect, ease, and elevate impactful health journeys.

Our approach to designing and implementing AI and machine learning (ML) solutions promotes secure and responsible adoption and ensures demonstrated and sustainable business value. We are one of a select group of Coveo Platinum partners helping brands design, architect, and implement modern intelligent search solutions that empower users to be more successful and deliver a winning customer experience.

Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S.  Explore our healthcare expertise and contact us to learn more.

Watch the On-Demand Webinar Now

Generative AI (GenAI) is not just a buzzword anymore — it’s rapidly transforming the way we interact with technology. From content creation to design automation and synthetic media, GenAI apps are redefining productivity and creativity across industries. But what exactly are GenAI apps, and how are they impacting our digital landscape?

What Are GenAI Apps?

GenAI apps are applications powered by large-scale AI models that can generate new content. This could be text, images, code, music, or even 3D models. Unlike traditional apps that follow a fixed logic, GenAI apps use deep learning models (like GPT, DALL·E, Stable Diffusion, etc.) to generate output based on patterns learned from massive datasets.

Common Examples of GenAI Apps:

• Chatbots & Assistants: ChatGPT, Gemini, Claude — offering human-like conversational interfaces.
• Image Generation: Midjourney, DALL·E, Canva Magic Design — transforming text prompts into detailed images.
• Code Generators: GitHub Copilot, CodeWhisperer — helping developers write and debug code faster.
• Writing Tools: Jasper, Notion AI — assisting with blog posts, emails, and marketing copy.
• Video & Voice Synthesis: Synthesia, ElevenLabs — enabling AI-generated video avatars and voiceovers.

Key Capabilities

1. Content Creation: Drafting marketing copy, blog posts, emails, social media captions.
2. Design & Visualization: Generating logos, UI mockups, or artwork.
3. Personalization: Tailoring user experiences using real-time data and predictive content.
4. Automation: Streamlining repetitive tasks in writing, data analysis, and software development.

Use Cases by Industry

Benefits of GenAI Apps

• Speed: Instant content and idea generation.
• Scalability: Handle large workloads without human limitations.
• Cost Efficiency: Reduce the need for manual content creation or analysis.
• Creativity Boost: Offer novel ideas and alternatives that humans may overlook.

Challenges & Considerations

• Accuracy: AI can “hallucinate” or produce false content.
• Bias & Ethics: Output can reflect biases in training data.
• Security: Sensitive data must be protected from misuse.
• Regulation: Legal frameworks around AI-generated content are still evolving.

The Future of GenAI Apps

We are at the cusp of a paradigm shift. GenAI apps are evolving from experimental tools to essential productivity companions. As they become more integrated with everyday platforms — from Microsoft Office to Adobe Creative Suite — we can expect more intelligent, context-aware, and multimodal experiences.

Companies are also exploring AI agents: autonomous apps that can plan and execute multi-step tasks, potentially transforming workflows and redefining what software can do independently.

Conclusion

Generative AI apps are more than just cool demos — they’re powerful tools reshaping industries and redefining creativity. As models become more advanced and accessible, the focus will shift toward building responsible, ethical, and highly customized GenAI solutions for real-world needs.

Whether you’re a business leader, developer, or content creator, embracing GenAI apps can offer a competitive edge — the key is to explore, experiment, and evolve.

As technology continues to advance, patients and care teams expect to seamlessly engage with tools that support better health and accelerate progress. These developments demand the rapid, secure, scalable, and compliant sharing of data. 

By aligning enterprise and business goals with digital technology, healthcare organizations (HCOs) can activate strategies for transformative outcomes and improve experiences and efficiencies across the health journey. 

IDC Market Glance: Healthcare Provider Operational IT Solutions, 1Q25 

Perficient is proud to be included in the categories of IT Services and SI services in the IDC Market Glance: Healthcare Provider Operational IT Solutions, 1Q25 report (doc #US52221325, March 2025). We believe our inclusion in this report’s newly introduced “Services” segmentation underscores our expertise to leverage AI-driven automation and advanced analytics, optimize technology investments, and navigate evolving industry challenges. 

IDC states, “This expansion reflects the industry’s shift toward outsourced expertise, scalable service models, and strategic partnerships to manage complex operational IT and infrastructure efficiently.” 

IDC defines IT Services as, “managed IT services, ensuring system reliability, cybersecurity, and infrastructure optimization. These solutions support healthcare provider transformation initiatives, helpdesk management, network monitoring, and compliance with healthcare IT regulations.” The SI Services category is defined by IDC as, “system integration services that help deploy technologies and connect disparate systems, including EHRs, RCM platforms, ERP solutions, and third-party applications to enhance interoperability, efficiency, automation, and compliance with industry standards.”  

Advanced Solutions for Data-Driven Success 

We imagine, engineer, and optimize scalable, reliable technologies and data, partnering with healthcare leaders to better understand consumer expectations and strategically align digital investments with business priorities.  

Our end-to-end professional services include: 

• Digital transformation strategy:  The healthcare industry’s rapid evolution requires attention in several areas – adopting new care models, capitalizing on disruptive technologies, and affecting regulatory, operational, financial, and organizational change. We equip HCOs to recognize and speed past potential hurdles in order to maximize ROI by making the most of technology, operational, and financial resources. 

• Cloud-native environments: Cloud technology is the primary enabler of business transformation and outcomes-focused value. Investing in cloud allows HCOs to overcome limitations of legacy systems, improve stability, and reduce costs. It also leads to better solution quality, faster feature delivery, and encourages a culture of innovation. Our expert consultants tailor cloud solutions to unique business needs, empowering teams and fueling growth, intelligence, and long-term profitability. 

• Hyper-scalable data infrastructures: We equip HCOs to maximize the value of information across the care ecosystem by uncovering the most meaningful, trustworthy data and enriching it with critical context so you can use it to answer difficult questions, power meaningful experiences, and automate smart decisions. Trusting data begins with having trust in the people, processes, and systems that source, move, transform, and manage that data. We partner to build data into a powerful, differentiating asset that can accelerate clinical, marketing, and operational excellence as information is exchanged across organizations, systems, devices, and applications. 

• AI ecosystems: HCO’s face mounting competition, financial pressures, and macro uncertainties. Enhance operations with innovative and intelligent AI and automation solutions that help you overcome complex challenges, streamline processes, and unlock new levels of productivity. Holistic business transformation and advanced analytics are front and center in this industry evolution, and generative AI (GenAI) and agentic AI have fundamentally shifted how organizations approach intelligence within digital systems. According to IDC, “GenAI will continue to redefine workflows, while agentic AI shows promise to drive real-time, responsive, and interpretive orchestration across operations.” Position yourself for success now and in the future with enhanced customer interactions, reduced operational costs, and data-driven decision-making powered by our AI expertise. 

• Digital experiences: Digital-first care options are changing the face of healthcare experiences, bringing commerce-like solutions to consumers who search for and choose care that best fits their personal priorities and needs. We build high-impact experience strategies and put them in motion, so your marketing investments drive results that grow lasting relationships and support healthy communities. As the healthcare landscape continues to evolve – with organizational consolidations and new disruptors reshaping the marketplace – we help you proactively and efficiently attract and nurture prospective patients and caregivers as they make health decisions. 

We don’t just implement solutions; we create intelligent strategies that align technology with your key business priorities and organizational capabilities. Our approach goes beyond traditional data services. We create AI-ready intelligent ecosystems that breathe life into your data strategy and accelerate transformation. By combining technical excellence, global reach, and a client-centric approach, we’re able to drive business transformation, boost operational resilience, and enhance health outcomes. 

Success in Action: Illuminating a Clear Path to Care With AI-Enabled Search 

Empower Healthcare Experiences Through Innovative Technology 

Whether you want to redefine workflows, personalize care pathways, or revolutionize proactive health management, Perficient can help you boost efficiencies and a competitive edge.  

We combine strategy, industry best practices, and technology expertise to deliver award-winning results for leading health systems: 

• Business Transformation: Transform strategy into action: improve operations, lower costs, build operational resilience, and optimize care. 

• Modernization: Provide quality, cost-effective tools and platforms that enable exceptional care. 

• Data Analytics: Enable trusted data access and insight to clinical, operational, and financial teams across the healthcare ecosystem. 

• Consumer Experience: Harness data and technology to drive optimal healthcare outcomes and experiences. 

Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more.

The 2025 National Conference on Artificial Intelligence is an unparalleled opportunity to dive deep into the transformative potential of AI across various sectors. With topics ranging from responsible AI to workforce development, this conference explores the vast possibilities of AI. 

I am thrilled to be leading the AI in Healthcare Industry Panel on April 11 at 2:00 P.M. CT during this year’s conference. As a third-year speaker for this event, I am excited to share why this event is pivotal for the healthcare industry and why you should be a part of it. 

Key Topics in AI 

The following topics are expected to be top-of-mind during the conference; these include: 

1. Generative AI (GenAI) in Healthcare: Explore the latest advancements and applications of GenAI in the healthcare sector. 
2. AI Adoption and Implementation Strategies: Learn about best practices and success stories from industry experts on implementing AI solutions effectively. 
3. Data-Driven Decision Making: With the increasing reliance on data-driven decision making in various industries, understanding how AI can support this process is crucial. 
4. Cybersecurity for AI Systems: As AI becomes more prevalent, cybersecurity concerns are growing. It’s important to learn about measures to protect against potential threats and vulnerabilities. 
5. Ethics and Bias in AI: With the increasing use of AI, there is a growing need to address ethics and bias in AI decision-making processes. 
6. AI for Healthcare Outcomes Improvement: Discover how AI can improve healthcare outcomes, such as patient care, disease diagnosis, and treatment planning. 
7. Emerging Trends in Natural Language Processing (NLP): NLP is a key aspect of GenAI, and staying up to date on the latest developments and applications is essential. 

Perficient’s approach to these topics is grounded in our PACE framework, which provides a holistic approach to responsibly operationalizing AI and GenAI across an organization. The PACE framework empowers organizations to unlock the benefits of AI while proactively addressing risks. 

I find all the sessions at the National Conference on Artificial Intelligence valuable, but I especially enjoy the panel discussions and networking opportunities. I have an abiding commitment to continuous learning and educating new people in AI and healthcare. Clinicians need support and training to take care of patients today and in the future. 

The Importance of Workforce Development in AI 

The future of AI relies heavily on a skilled workforce capable of developing, implementing, and maintaining these cutting-edge technologies. A strong focus on workforce development ensures that we can: 

• Address Skill Gaps: Identify and address skill gaps in NLP and AI development to ensure our clients have access to the expertise they need. 
• Drive Innovation: Foster a culture of innovation by investing in ongoing training and education for our employees, enabling them to stay up to date with the latest advancements in NLP and GenAI. 
• Attract Top Talent: Attract top talent from academia and industry, ensuring that we have access to the best minds in NLP and AI development. 
• Continue to Lead the Nation: Lead the nation in the development and adoption of AI solutions that benefit all of society.  

Did You Know: We’re also advancing STEM education through our award-winning partnership with the Mark Cuban Foundation. Learn more about the free Artificial Intelligence (AI) Bootcamps that we host for high school students across the United States.

Get Ready for the Future of AI 

Let’s connect at the 2025 National Conference on Artificial Intelligence in Houston to explore the future of AI in healthcare. I’m excited to share insights and innovations with you as I lead a panel discussion on AI in healthcare. Connect with me today to schedule time to meet at the conference! 

We are trusted by leading technology partners, mentioned by analysts, and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms. Discover why we have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more.

Introduction
The advent of generative AI (GenAI) marks a pivotal moment in the evolution of healthcare, particularly in the context of acute care settings. As hospitals and health systems grapple with the challenges of increasing complexity, rising costs, and the ever-present need to improve patient outcomes, GenAI emerges as a transformative force, offering unparalleled opportunities to revolutionize healthcare delivery. This blog post delves into the myriad ways in which GenAI can reshape acute care, from enhancing clinical decision-making and optimizing operations to elevating the patient experience and driving innovation.

The Landscape of GenAI in Acute Care
GenAI, a subset of artificial intelligence capable of dynamically generating novel content, insights, and solutions, has the potential to permeate every aspect of acute care delivery. From clinical decision support and real-time intelligence to operational excellence and resource optimization, GenAI can unlock previously unattainable levels of efficiency, accuracy, and personalization. By leveraging vast amounts of data, advanced algorithms, and continuous learning, GenAI systems can augment human expertise, streamline processes, and drive evidence-based practices.

Clinical Decision Support & Real-time Intelligence
One of the most promising applications of GenAI in acute care lies in its ability to revolutionize clinical decision-making. By integrating multimodal data streams, including electronic health records, medical imaging, lab results, and real-time patient monitoring, GenAI systems can provide clinicians with adaptive clinical pathways tailored to individual patient needs. These intelligent systems can dynamically adjust treatment protocols based on a patient’s unique characteristics, comorbidities, and response to interventions, ensuring optimal care delivery.

Moreover, GenAI can serve as a powerful tool for predictive crisis management, leveraging advanced analytics to identify early warning signs of patient deterioration. By continuously monitoring vital signs, lab results, and other critical indicators, GenAI systems can alert clinicians to potential adverse events before they occur, enabling proactive interventions and improved patient safety. Additionally, GenAI can generate intelligent order sets, taking into account patient-specific factors, hospital formularies, and evidence-based guidelines to streamline the ordering process and reduce variability in care.

Operational Excellence & Resource Optimization
Beyond clinical decision support, GenAI holds immense potential for optimizing hospital operations and resource allocation. Through dynamic staff scheduling, GenAI models can predict patient acuity levels and optimize staffing across departments, ensuring that the right personnel are in the right place at the right time. This not only enhances operational efficiency but also reduces burnout and improves staff satisfaction.

GenAI can also revolutionize supply chain management in acute care settings. By leveraging predictive analytics and historical usage patterns, GenAI systems can anticipate supply needs, optimize inventory levels, and prevent stockouts. This intelligent approach to supply chain management can lead to significant cost savings, reduced waste, and improved resource utilization.

Furthermore, GenAI can transform capacity planning and patient flow management. Through real-time bed management and patient flow optimization, GenAI systems can minimize wait times, reduce bottlenecks, and ensure the efficient allocation of resources. By leveraging natural language processing techniques, GenAI can extract insights from unstructured data, such as clinical notes and patient feedback, to identify opportunities for process improvement and enhance the overall patient experience.

Revenue Cycle Optimization & Payer Integration
The complexities of revenue cycle management and payer relations often pose significant challenges for acute care providers. GenAI can streamline these processes, driving efficiency and maximizing reimbursement. Through automated prior authorization, GenAI systems can predict authorization requirements and generate supporting documentation, reducing administrative burden and expediting the approval process.

Moreover, GenAI can revolutionize claims processing by identifying potential denials before submission and suggesting corrective actions. By analyzing historical claims data, GenAI models can detect patterns and anomalies, enabling proactive revenue leakage prevention. Additionally, GenAI can synthesize data from disparate sources to identify missed charges and documentation gaps, ensuring accurate and complete billing.

Enhancing the Patient Experience
At the heart of acute care delivery lies the patient experience. GenAI can play a pivotal role in elevating the patient journey, from personalized care navigation to multilingual communication and smart room technology. By leveraging GenAI-powered assistants, hospitals can guide patients through their stay, providing real-time information, answering questions, and offering support. These intelligent systems can adapt to individual patient preferences, cultural backgrounds, and language requirements, fostering a more inclusive and patient-centric environment.

GenAI can also transform the way patients interact with their physical surroundings. Through voice-enabled environmental controls and smart room technology, patients can effortlessly adjust lighting, temperature, and entertainment options, enhancing comfort and autonomy. Moreover, GenAI-powered patient assistance systems can anticipate patient needs, such as pain management or mobility support, and alert healthcare providers accordingly, ensuring timely and personalized care delivery.

Quality & Safety Enhancement
Ensuring the highest standards of quality and safety is a paramount concern in acute care settings. GenAI can serve as a powerful ally in this pursuit, offering advanced capabilities for adverse event prevention, clinical variation analysis, and infection control. By continuously monitoring patient data and identifying patterns indicative of potential safety risks, GenAI systems can alert clinicians to intervene proactively, mitigating harm and improving patient outcomes.

GenAI can also play a critical role in reducing unwarranted clinical variation, a significant contributor to suboptimal outcomes and increased costs. By analyzing vast amounts of clinical data, GenAI models can identify best practices, detect deviations from evidence-based guidelines, and provide real-time recommendations to standardize care delivery. This data-driven approach to quality improvement can lead to more consistent, high-quality care across the organization.

Furthermore, GenAI can revolutionize infection prevention and control efforts in acute care settings. By leveraging real-time surveillance data, GenAI systems can detect patterns indicative of potential outbreaks, identify high-risk patients, and recommend targeted interventions. This proactive approach to infection control can significantly reduce the incidence of hospital-acquired infections, improve patient safety, and optimize resource utilization.

Knowledge Management & Clinical Research
The exponential growth of medical knowledge presents both challenges and opportunities for acute care providers. GenAI can serve as a powerful tool for knowledge management and clinical research, enabling healthcare organizations to stay at the forefront of evidence-based practices. Through continuous literature synthesis, GenAI systems can analyze vast amounts of research data, identify emerging trends, and update clinical protocols accordingly. This real-time integration of new evidence into clinical decision-making can accelerate the adoption of best practices and improve patient outcomes.

Moreover, GenAI can facilitate real-world evidence generation by automating the analysis of treatment outcomes and identifying patterns across large patient populations. This data-driven approach to clinical research can uncover novel insights, inform quality improvement initiatives, and drive innovation in acute care delivery. Additionally, GenAI can streamline clinical trial matching by identifying eligible patients and predicting trial success, accelerating the development of new therapies and interventions.

Regulatory Compliance & Risk Management
Navigating the complex landscape of regulatory compliance and risk management is a critical challenge for acute care providers. GenAI can serve as a valuable tool in this regard, offering automated compliance monitoring, privacy protection, and audit preparation capabilities. By continuously tracking regulatory requirements and identifying potential violations, GenAI systems can help healthcare organizations maintain compliance and mitigate legal and financial risks.

Moreover, GenAI can play a crucial role in protecting patient privacy and ensuring secure data sharing. Through advanced anonymization techniques and synthetic data generation, GenAI systems can enable the safe and compliant use of patient data for research and quality improvement purposes. Additionally, GenAI can streamline audit preparation by continuously monitoring and documenting compliance activities, reducing the administrative burden on healthcare staff.

Interoperability & Data Integration
The success of GenAI in acute care settings hinges on the ability to seamlessly integrate data from disparate sources and systems. Interoperability and data integration are critical enablers of GenAI adoption, allowing for the free flow of information across the healthcare ecosystem. Through smart data harmonization, GenAI systems can standardize and integrate data from electronic health records, medical devices, and other sources, creating a comprehensive view of the patient journey.

Moreover, GenAI can facilitate the development of intelligent APIs that optimize data exchange between systems, enabling real-time access to critical information at the point of care. These context-aware interfaces can adapt to the specific needs of healthcare providers, presenting relevant data and insights in a user-friendly manner. Additionally, GenAI can play a vital role in modernizing legacy systems, bridging the gap between existing infrastructure and cutting-edge technologies.

Future-ready Infrastructure
As GenAI continues to evolve and mature, it is essential for acute care providers to invest in future-ready infrastructure that can support the growing demands of this transformative technology. This includes the adoption of edge computing, which enables real-time data processing and decision-making at the point of care. By distributing GenAI capabilities across the healthcare network, edge computing can reduce latency, improve responsiveness, and enhance the overall user experience.

Moreover, as quantum computing advances, it is crucial for healthcare organizations to explore quantum-ready algorithms that can leverage the immense computational power of these emerging technologies. By preparing for the next generation of computing capabilities, acute care providers can position themselves at the forefront of innovation and unlock new possibilities for GenAI-driven healthcare delivery.

Sustainable & Responsible Innovation
As the adoption of GenAI in acute care settings accelerates, it is imperative to prioritize sustainable and responsible innovation. This involves considering the environmental impact of GenAI implementations and embracing energy-efficient approaches to minimize the carbon footprint of healthcare delivery. Moreover, responsible innovation requires a strong commitment to ethical principles, ensuring that GenAI systems are transparent, accountable, and free from bias.

To achieve this, healthcare organizations must engage in multidisciplinary collaboration, bringing together clinicians, data scientists, ethicists, and patient advocates to guide the development and deployment of GenAI solutions. By fostering a culture of responsible innovation, acute care providers can harness the power of GenAI while upholding the highest standards of patient care and societal well-being.

Conclusion
The advent of generative AI marks a transformative moment in the evolution of acute care delivery. From enhancing clinical decision-making and optimizing operations to elevating the patient experience and driving innovation, GenAI holds immense potential to revolutionize healthcare. However, realizing this potential requires a strategic and collaborative approach, one that prioritizes data governance, workflow integration, ethical considerations, and continuous evaluation.

As healthcare leaders navigate this exciting new frontier, it is essential to engage proactively with GenAI technologies, shape their development, and harness their power to improve patient outcomes, reduce costs, and drive sustainable innovation. By embracing the transformative potential of GenAI, acute care providers can position themselves at the forefront of a new era in healthcare delivery, one that promises to transform the lives of patients, empower healthcare professionals, and redefine the boundaries of what is possible.

The journey towards unleashing the full potential of GenAI in acute care is just beginning, and the road ahead is filled with both challenges and opportunities. However, with a clear vision, unwavering commitment, and collaborative spirit, healthcare organizations can navigate this uncharted territory and emerge as leaders in the age of generative AI. The future of acute care is here, and it is time to embrace it with open arms, bold vision, and a steadfast dedication to improving the lives of those we serve.

References

1. Francis, N. J., Jones, S., & Smith, D. P. (2025). Generative AI in higher education: Balancing innovation and integrity. British Journal of Biomedical Science, 81, 14048. https://doi.org/10.3389/bjbs.2024.14048
2. Jindal, J. A., Lungren, M. P., & Shah, N. H. (2024). Ensuring useful adoption of generative artificial intelligence in healthcare. Journal of the American Medical Informatics Association, 31(6), 1441-1444. https://doi.org/10.1093/jamia/ocae043
3. Lan, G., Xiao, S., Yang, J., Wen, J., & Xi, M. (2023). Generative AI-based data completeness augmentation algorithm for data-driven smart healthcare. IEEE Journal of Biomedical and Health Informatics. Advance online publication. https://doi.org/10.1109/JBHI.2023.3327485
4. Lee, C. C., & Low, M. Y. H. (2024). Using genAI in education: The case for critical thinking. Frontiers in Artificial Intelligence, 7, 1452131. https://doi.org/10.3389/frai.2024.1452131
5. Malhotra, K., Wiesenfeld, B., Major, V. J., Grover, H., Aphinyanaphongs, Y., Testa, P., & Austrian, J. S. (2025). Health system-wide access to generative artificial intelligence: The New York University Langone Health experience. Journal of the American Medical Informatics Association, 32(2), 268-274. https://doi.org/10.1093/jamia/ocae285
6. Prescott, M. R., Yeager, S., Ham, L., Rivera Saldana, C. D., Serrano, V., Narez, J., Paltin, D., Delgado, J., Moore, D. J., & Montoya, J. (2024). Comparing the efficacy and efficiency of human and generative AI: Qualitative thematic analyses. JMIR AI, 3, e54482. https://doi.org/10.2196/54482
7. Solaiman, B. (2024). Generative artificial intelligence (GenAI) and decision-making: Legal & ethical hurdles for implementation in mental health. International Journal of Law and Psychiatry, 97, 102028. https://doi.org/10.1016/j.ijlp.2024.102028
8. Wachter, R. M., & Brynjolfsson, E. (2024). Will generative artificial intelligence deliver on its promise in health care? JAMA, 331(1), 65-69. https://doi.org/10.1001/jama.2023.25054
9. Yim, D., Khuntia, J., Parameswaran, V., & Meyers, A. (2024a). Preliminary evidence of the use of generative AI in health care clinical services: Systematic narrative review. JMIR Medical Informatics, 12, e52073. https://doi.org/10.2196/52073
10. Yim, D., Khuntia, J., Parameswaran, V., & Meyers, A. (2024b). Preliminary evidence of the use of generative AI in health care clinical services: Systematic narrative review. JMIR Medical Informatics, 12, e52073. https://doi.org/10.2196/52073

The healthcare industry stands at a transformative crossroads with generative AI (GenAI) poised to revolutionize care delivery, operational efficiency, and patient outcomes. Recent MIT Technology Review research indicates that while 88% of organizations are using or experimenting with GenAI, healthcare organizations face unique challenges in implementation.

Let’s explore a comprehensive approach to successful GenAI adoption in healthcare.

Find Your Starting Point: A Strategic Approach to GenAI Implementation

The journey to GenAI adoption requires careful consideration of three key dimensions: organizational readiness, use case prioritization, and infrastructure capabilities.

Organizational Readiness Assessment

Begin by evaluating your organization’s current state across several critical domains:

• Data Infrastructure: Assess your organization’s ability to handle both structured clinical data (EHR records, lab results) and unstructured data (clinical notes, imaging reports). MIT’s research shows that only 22% of organizations consider their data foundations “very ready” for GenAI applications, making this assessment crucial.
• Technical Capabilities: Evaluate your existing technology stack, including cloud infrastructure, data processing capabilities, and integration frameworks. Healthcare organizations with modern data architectures, particularly those utilizing lakehouse architectures, show 74% higher success rates in AI implementation.
• Talent and Skills: Map current capabilities against future needs, considering both technical skills (AI/ML expertise, data engineering) and healthcare-specific domain knowledge.

Use Case Prioritization

Successful healthcare organizations typically begin with use cases that offer clear value while managing risk:

1. Administrative Efficiency

• Clinical documentation improvement and coding
• Prior authorization automation
• Claims processing optimization
• Appointment scheduling and management

These use cases typically show ROI within 6-12 months while building organizational confidence.

2. Clinical Support Applications

• Clinical decision support enhancement
• Medical image analysis
• Patient risk stratification
• Treatment planning assistance

These applications require more rigorous validation but can deliver significant impact on care quality.

3. Patient Experience Enhancement

• Personalized communication
• Care navigation support
• Remote monitoring integration
• Preventive care engagement

These initiatives often demonstrate immediate patient satisfaction improvements while building toward longer-term health outcomes.

Critical Success Factors for Healthcare GenAI Implementation

Data Foundation Excellence | Establish robust data management practices that address:

• Data quality and standardization
• Integration across clinical and operational systems
• Privacy and security compliance
• Real-time data accessibility

MIT’s research indicates that organizations with strong data foundations are three times more likely to achieve successful AI outcomes.

Governance Framework | Develop comprehensive governance structures that address the following:

• Clinical validation protocols
• Model transparency requirements
• Regulatory compliance (HIPAA, HITECH, FDA)
• Ethical AI use guidelines
• Bias monitoring and mitigation
• Ongoing performance monitoring

Change Management and Culture | Success requires careful attention to:

• Clinician engagement and buy-in
• Workflow integration
• Training and education
• Clear communication of benefits and limitations
• Continuous feedback loops

Overcoming Implementation Barriers

Technical Challenges

• Legacy System Integration: Implement modern data architectures that can bridge old and new systems while maintaining data integrity.
• Data Quality Issues: Establish automated data quality monitoring and improvement processes.
• Security Requirements: Deploy healthcare-specific security frameworks that address both AI and traditional healthcare compliance needs.

Organizational Challenges

• Skill Gaps: Develop a hybrid talent strategy combining internal development with strategic partnerships.
• Resource Constraints: Start with high-ROI use cases to build momentum and justify further investment.
• Change Resistance: Focus on clinician-centered design and clear demonstration of value.

Moving Forward: Building a Sustainable GenAI Program

Long-term success requires:

• Systematic Scaling Approach. Start with pilot programs that demonstrate clear value. Build reusable components and frameworks. Establish centers of excellence to share learning. And create clear metrics for success.
• Innovation Management. Maintain awareness of emerging capabilities. Foster partnerships with technology providers. Engage in healthcare-specific AI research. Build internal innovation capabilities.
• Continuous Improvement. Regularly assess model performance. Capture stakeholder feedback on an ongoing basis. Continuously train and educate your teams. Uphold ongoing governance reviews and updates.

The Path Forward

Healthcare organizations have a unique opportunity to leverage GenAI to transform care delivery while improving operational efficiency. Success requires a balanced approach that combines innovation with the industry’s traditional emphasis on safety and quality.

MIT’s research shows that organizations taking a systematic approach to GenAI implementation, focusing on strong data foundations and clear governance frameworks, achieve 53% better outcomes than those pursuing ad hoc implementation strategies.

For healthcare executives, the message is clear. While the journey to GenAI adoption presents significant challenges, the potential benefits make it an essential strategic priority.

The key is to start with well-defined use cases, ensure robust data foundations, and maintain unwavering focus on patient safety and care quality.

By following this comprehensive approach, healthcare organizations can build sustainable GenAI programs that deliver meaningful value to all stakeholders while maintaining the high standards of care that the industry demands.

Combining technical expertise with deep healthcare knowledge, we guide healthcare leaders through the complexities of AI implementation, delivering measurable outcomes.

We are trusted by leading technology partners, mentioned by analysts, and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

Discover why we have been trusted by the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more.

References

1. Hex Technologies. (2024). The multi-modal revolution for data teams [White paper]. https://hex.tech
2. MIT Technology Review Insights. (2021). Building a high-performance data and AI organization. https://www.technologyreview.com/insights
3. MIT Technology Review Insights. (2023). Laying the foundation for data- and AI-led growth: A global study of C-suite executives, chief architects, and data scientists. MIT Technology Review.
4. MIT Technology Review Insights. (2024a). The CTO’s guide to building AI agents. https://www.technologyreview.com/insights
5. MIT Technology Review Insights. (2024b). Data strategies for AI leaders. https://www.technologyreview.com/insights
6. MIT xPRO. (2024). AI strategy and leadership program: Reimagine leadership with AI and data strategy [Program brochure]. Massachusetts Institute of Technology.

The U.S. healthcare insurance industry stands at a pivotal moment. Amid rising costs, regulatory pressures, and an increasing demand for personalized care, healthcare payers must reinvent themselves. Generative AI (GenAI) offers a transformative pathway, enabling payers to transition from reactive cost management to proactive health enablement and strategic value creation.

A new era of opportunity for health insurers GenAI

The stakes have never been higher. According to recent insights, 81% of executives expect AI to drive industry-wide efficiency gains of over 25% in the next two years. For healthcare payers, this represents a seismic opportunity.

As the healthcare AI segment is poised to reach $187 billion by 2030, organizations must act swiftly to secure a competitive edge or risk being left behind.

GenAI promises to revolutionize the healthcare payer ecosystem by addressing long-standing challenges while unlocking unprecedented potential. Imagine a world where health plans are dynamically tailored, predictive analytics forecast crises before they occur, and personalized member engagement becomes the norm.

Success In Action: Accelerating CSR Support of Benefits Questions Using GenAI

GenAI reshapes healthcare payers across three critical dimensions

1. Revolutionizing Member Experience. GenAI empowers payers to deliver hyper-personalized communication, real-time support, and proactive health recommendations. It transforms traditionally cumbersome processes like claims processing into seamless experiences, enhancing member trust and satisfaction.

2. Achieving Operational Excellence. Payers can significantly cut costs while boosting efficiency by automating administrative tasks and utilizing predictive analytics for risk management and fraud detection. Streamlined network management ensures optimal resource utilization, enhancing the payer-provider relationship.

3. Strategic Value Creation. With AI as a driving force, payers can evolve from cost-focused entities to proactive health partners. By fostering innovation, they can develop personalized insurance products, improve population health management, and drive data-informed decisions that redefine their role in the healthcare ecosystem.

The imperative: a foundation for GenAI success

To realize the full potential of GenAI, healthcare payers must first lay a strong foundation, which includes:

• Modern Data Architecture: Transitioning to robust frameworks like the lakehouse model integrates the capabilities of data lakes and warehouses while ensuring compliance with healthcare’s stringent security standards.
• Comprehensive Governance: A unified governance model is key to safeguarding sensitive health information and maintaining trust with members and providers.
• Cultural Evolution: Organizations must embrace AI as a catalyst for cultural transformation, fostering innovation, upskilling employees, and promoting cross-functional collaboration.

The next 24 months are critical for healthcare payers to seize GenAI’s transformative power. Those who act decisively will emerge as leaders, setting new standards in efficiency, member engagement, and innovation. The imperative is clear: the time to act is now.

An Expert Partner: Imagine, Create, Engineer, Run

Combining technical expertise with deep healthcare knowledge, we guide payers through the complexities of AI implementation, delivering measurable outcomes.

We are trusted by leading technology partners, mentioned by analysts, and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.

Discover why we have been trusted by the 10 largest health insurers in the U.S. Explore our healthcare expertise and contact us to learn more.

Our experts are closely monitoring eight healthcare trends that are shaping industry leaders’ strategies in 2025.

And this year is especially interesting, as 2024’s U.S. election results could significantly shift healthcare policy and impact healthcare access, affordability, regulation, and innovation.

As such, forward-looking healthcare organizations (HCOs) that are on-track to differentiate their brand in the modern marketplace demonstrate some key characteristics:

• Pragmatically progressive strategies
• Strong partnerships to see those strategies through

Let’s dive into the eight healthcare trends and pragmatic innovations that our experts are helping HCOs navigate in 2025.

Healthcare Trend #1: AI Disruption and Enablement

Healthcare has seen a surge of interest in AI, with the market set to soar to $187.95 billion by 2030. But the industry faces unique challenges that other sectors don’t encounter. Strict regulations around HIPAA, PHI, and PII create significant barriers, making it difficult to adopt off-the-shelf AI solutions from fields like commerce or digital experience. These regulations demand that healthcare AI be specifically tailored to ensure data privacy, security, and compliance, limiting the utility of plug-and-play approaches seen in other industries.

Recommended Approach: AI should not be viewed as a standalone strategy but rather as a powerful enabler of broader business objectives. A well-formed strategy aligns key business priorities with organizational capabilities – people, technology, and processes – to create a cohesive framework. AI’s transformative potential can then be harnessed to address high-impact use cases for HCOs that are defined by clear KPIs and measurable outcomes. However, this potential can only be fully realized if AI is implemented with careful consideration of ethical, security and privacy, and oversight issues. This approach ensures that AI drives tangible value, tailored to the unique needs and strengths of the organization.

Success In Action: Accelerating CSR Support of Benefits Questions Using GenAI

Healthcare Trend #2: Cost Management Without Sacrificing Agility

HCOs continue to face substantial challenges in maintaining margins. While there are many macro and operational factors at play, cost management will play a key part in C-suite planning for the foreseeable future. Against this background, leaders are still under intense competitive pressure to improve many aspects of the digital experience. This tension is driving renewed interest in automation, including AI, and an emphasis on MVP+ and Agile delivery of everything from data modernization to websites and search.

Recommended Approach: Strategic cohesion is vital to ensure initiatives are supported by extremely clear goals and KPIs, and ultimately deliver business value and better health outcomes. A rigorous yet practical business transformation mindset has therefore never been more important. Leaders must prioritize technology investments that balance shorter-term wins and longer-range viability. Cost containment will require compromises. Thus, organizational alignment and change management become even more vital as teams competing for technology development dollars evolve their focus from departmental goals to enterprise sustainability.

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Healthcare Trend #3: Clinician Burnout and Patient Impacts

Approximately 63% of physicians report burnout at least once a week. Clinician burnout not only exacerbates staffing challenges and jeopardizes the health and well-being of frontline healthcare workers, it also poses critical risks to patient safety, care quality, and the long-term sustainability of HCOs. Burnout can lead to increased medical errors, compromised decision-making, and diminished patient-provider relationships, directly impacting the experience and outcomes for patients and potentially increasing insurance premiums and out-of-pocket expenses for members. Every departing nurse or physician deepens the cycle, as budget freezes and shortages in the workforce make it difficult, if not impossible, to replace these key personnel. As the pressure mounts, remaining staff and healthcare consumers all suffer – with longer wait times, reduced continuity of care, and overall diminished access to services, threatening the very stability of healthcare delivery systems.

Recommended Approach: Ease the burden on clinicians by first understanding teams’ day-to-day friction points. Engaging directly with end-users ensures their voices inform your modernization efforts, fostering a culture of collaboration that can drive meaningful change. This open dialogue cultivates powerful change advocates who will champion the adoption of digital investments, such as smart automation, trusted data, advanced analytics, and integrated consumer experiences. Furthermore, organizations must strategically engage and resonate with providers who are contemplating career transitions, ensuring that their needs and aspirations are addressed. These efforts not only contribute to your HCO’s bottom line but also enhance the overall experience for everyone—providers, patients, and caregivers alike. In both the short- and long-term, these initiatives will build trust within your consumer base, positioning your organization as a desirable destination for care and ultimately fostering a healthier, more engaged community.

See Also: Perficient Mentioned in Two Forrester Reports on Tech-Enabled Clinician Experiences

Healthcare Trend #4: Experiences That Build Trust

Research from Gallup showed consumers, in 2023, had some of the lowest levels of trust ever recorded in the healthcare industry. Although we are seeing levels of trust in HCOs begin to improve, they still have a long way to go. 2025 will see the continued push to meet healthcare consumers’ demand for convenience and personalized digital experiences.

Recommended Approach: From everyday commerce to the 2024 presidential election, we continue to see one clear fact: It’s imperative to know your audience. There is no “typical” healthcare consumer, and if you don’t treat people as individuals with unique, personal needs, you risk losing them to another HCO that does. Your organization must incorporate comprehensive healthcare personas and journeys to fully understand the people you serve, how they want you to communicate with them, and how they access your care or services — or risk losing them. Consider potential areas of mistrust for your organization and address them now to build consumers’ confidence. Key areas where we often help HCOs do just that are through digital front door strategies, implementation of intelligent search, and reimagining information architecture (IA).

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Healthcare Trend #5: Competition From Disruptive Healthcare Models

We’ve seen upheaval in the realm of healthcare disruptors — as Walmart has pulled out and Walgreens has pulled back, Best Buy has jumped in. Healthcare disruptors are finding out something traditional healthcare organizations (HCOs) have known for some time: Success in the healthcare industry is a complicated. But we are seeing disruptors to the traditional healthcare model find that success. Companies like Hims, Hers, and Henry Meds combine the best of empathetic, consumer-friendly language with convenient, powerful commerce experiences designed to help users way find and convert quickly.

Recommended Approach: Traditional HCOs that want to compete against successful disruptors require thoughtful, thorough business transformation. Take stock of your organization’s KPIs and how you are measuring success. Are you driving toward growth? If so, is it the right kind of growth to stand out? Next, determine whether you’re meeting the evolving expectations of today’s healthcare consumers. Be mindful of considerations around health equity and social determinants of health (SDOH) and align your strategies to match. Ultimately, we’re seeing powerful outcomes from organizations that shift from a project-focused model to a product-driven approach. Product-driven healthcare enables greater agility to respond to market shifts and fluctuations, as well as industry trends, the uncertainty of changes in healthcare regulation, and the demands of today’s consumers.

Read More: Is Your Healthcare Organization Really Product-Driven?

Healthcare Trend #6: Better Health Outcomes Through Shared Health Data

Efforts to reduce costs and improve health outcomes are driving collaboration among HCOs as health plans and integrated systems aim to more-holistically support consumer health, ease the care journey, and reduce the cost of care. Clinical data spanning an individual’s various provider relationships is crucial for a comprehensive patient view. Meanwhile, leaders continue to explore ways AI and automation can illuminate a 360-degree consumer view to power personalization, boost retention, and increase business resilience. These discussions are forcing focus toward data quality, consistency, governance, and bias.

Recommended Approach: Cloud services’ importance has surged to meet the growing need for real-time, accessible data. We recommend that HCOs continue building a scalable foundation to connect and integrate consumer data across health systems, providers, and insurers. This requires focus in several key areas, including data integration, data management. and data consistency and quality. Only then can data be richly woven into a reliable 360-degree view of the consumer that spans and supports better care management, marketing engagement, and support services. To optimize costs, we anticipate increasing adoption of data virtualization (a.k.a., Data as a Service, or DaaS). This unified data access layer approach bypasses the need to replicate data across various patient and member data management systems (e.g., data warehouses, MarTech, contact center, etc.), and offers a single view of enriched and transformed data from multiple data sources.

Explore More: Data-Driven Companies Move Faster and Smarter

Healthcare Trend #7: Care For the Aging and Underserved

An aging consumer base and a growing emphasis on health equity are reshaping patient engagement and business models for HCOs. According to the National Institute on Aging, approximately 85% of older adults have at least one chronic health condition, and 60% have at least two chronic conditions. In response, health insurers intensified focus on Medicare Advantage and Medicaid managed care plans to effectively serve a more diverse and underserved member population. Concurrently, providers are expanding into digitally connected services, such as telemedicine, remote patient monitoring, and personalized care plans, enabling patients to manage their health in more convenient and accessible settings. These shifts not only enhance patient experience and satisfaction but also foster a more inclusive healthcare system that addresses the unique needs of various demographic groups.

Recommended Approach: Deeply understand your patients’ and members’ journeys so you can deliver differentiated digital experiences in an increasingly crowded marketplace. Improve brand affinity with intuitive, personalized, accessible care moments that build trust (and bolster Star ratings). Intelligently automate systems and processes to optimize costs and build margin that can buffer potential shifts in reimbursement models. The integration of Social Determinants of Health (SDOH) data adds value by addressing factors like transportation, housing, and food security that impact health outcomes. Through a surround-care approach, powered with important health insights and intuitive tools, HCOs can strengthen community and individual health. This comprehensive strategy enhances engagement and trust while promoting better health outcomes and equity across diverse populations.

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Healthcare Trend #8: Mandate-Driven Transformation

Regulatory mandates continue to drive significant investment and effort from all HCO’s. Leaders strive to meet evolving requirements in CMS interoperability and prior authorization, price transparency, TEFCA, and others. Meanwhile, HHS insight on PHI and legal cases muddy the waters of HIPAA. In general, the effort to understand expectations, implement new functionality, and abide by existing mandates continues to increase. These mandates may seem simple at first, but they have significant implications as insurers work to incorporate patient data using standards common to the provider world. HCOs cannot simply repurpose hastily-constructed solutions from earlier mandates as a foundation for future compliance. Upcoming mandates are meant to build upon those that came before. Without a scalable approach and a thoughtful architecture, HCO’s will find themselves with an ever-increasing debt burden.

Recommended Approach: We encourage leaders to identify mandates’ silver lining opportunities. After all, to remain competitive and compliant, HCOs must innovate in ways that add business value, meet consumers’ evolving expectations, build trust, and deliver equitable care and services. Achieving transformative outcomes and health experiences requires a digital strategy that not only satisfies mandates but also aligns the enterprise around a shared vision and actionable KPIs, ultimately keeping patients, members, and care teams at the heart of progress.

Therefore, we recommend that HCOs approach mandates as a set of iterations, using a strategy-first approach that holistically considers the broader mandate and regulatory landscape. Keep a pulse on what other healthcare organizations – especially new market entrants and disruptors – are doing. Adapt digital best practices from outside of the healthcare industry. And deeply understand the nuance of interoperability standards, patient data modeling, API gateways, and SMART on FHIR applications.

The most successful organizations will build a proper foundation that scales and supports successive mandates. Composable architecture offers a powerful, flexible approach that balances “best in breed,” fit-for-purpose solutions while bypassing unneeded, costly features or services. Tactically, organizations can accelerate value, privacy, and data quality with secure, compliant, and modern technology platforms and data architectures. It’s also vital to build trust in data and with consumers, paving the way for ubiquitous, fact-based decision making that supports health and enables relationships across the care continuum.

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In this next decade, advances in digital health, growing consumerism, and mounting financial constraints will propel how HCOs shape experiences and deliver equitable, high-quality, cost-effective care.

Perficient combines strategy, industry best practices, and technology expertise to deliver award-winning results for leading health plans and providers:

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• Consumer Experience: Connect, ease, and elevate impactful health journeys.

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Healthcare leaders are engaging us in a variety of discussions to explore intelligent automation’s role for complex business challenges, ranging from efforts to enhance consumer trust and use artificial intelligence (AI) in effective ways, to navigating change that comes with prior authorization mandates. This series shares key insights coming from those discussions.  

As the saying goes, diamonds are made under pressure, and the most impactful opportunities are often those that challenge leaders the most. 

Prior Authorization, In a Nutshell

The CMS Prior Authorization mandate, which goes into effect on January 1, 2026, aims to reduce guesswork for healthcare consumers and the administrative burden on care teams, and to improve patient/member care by streamlining processes and enhancing the exchange of health information. 

Enabling prior authorization through API development is a good start; however, APIs are not a comprehensive solution. Rather, the introduction of multiple third-party APIs creates new processes and steps, often prompting manual follow-ups to track and connect data gathered from multiple sources. In addition, these new data points require new data models and methods to handle patient data.  

To address these inherent challenges, healthcare leaders are prioritizing investments in interoperability and automation technologies. 

Intelligent Automation Supports Prior Authorization and Business Efficiencies

True trust-enhancing transparency can be unlocked through intelligent automation. This is especially true as low-code, more-approachable AI, machine learning (ML) and Generative AI (GenAI) capabilities enter the mix. 

Intelligent automation connects digital process automation (DPA), robotic process automation (RPA), and artificial intelligence (AI) to deliver efficient and intelligent processes and align all aspects of your organization with the vision of constant process improvement, technological integration, and increasing consumer value. 

Although DPA, RPA and AI don’t make final decisions, they can streamline and leverage information, so the right decision gets made. Health insurers are always seeking access to actionable information about their members while adhering to data privacy laws and regulations. 

Getting to that actionable data requires multiple considerations: 

• Using best practices to assemble and curate the right data fields for any given use case 

• A continuous process of identifying and resolving issues in core systems 

• Appropriate environments in which to store data to maintain its integrity, security, and accessibility 

• Only then can you effectively enable specific sub-functions (i.e. functions that ingest the data then act or recommend actions) to happen accurately and on time 

Streamline and Optimize Prior Auth Processes

Every step in the prior authorization process has potential for improvement using intelligent automation. It can support, enhance, and accelerate based on rules engines, event logs, decision rules, and simple automations of high-volume processes. 

These intelligent tools streamline information sharing between payers and providers, reducing the need for repeated exchanges and guesswork, enhancing clinical review, and ensuring timely, accurate decisions. 

Intelligent automation rapidly optimizes the prior authorization workflows that occur at the edge of what can conveniently and cost-effectively be managed through APIs. AI and machine learning (ML) can assist required communications, reporting, and decision flows in many ways, including: 

• Orchestration: Automate the coordination of tasks and data flow between disparate systems and stakeholders. 

• Monitoring: Continuously track the status of prior authorization requests and flag any issues or delays. 

• Standardization: Ensure consistent repeatable workflows and processes across all systems to facilitate smoother information exchange. 

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Best Practices to Transform Prior Authorization Experiences

Intelligent automation enhances and overlays existing systems, helping to accelerate the prior authorization process with greater efficiency and generating insights into any recurring root causes in process breakdowns. 

As you’re approaching your prior authorization initiatives, we recommend the following transformation best practices: 

Transformation Tip #1: Cross-Functional Feedback

Maintaining cross-functional feedback is essential to identify and address pain points effectively. Automation allows for healthcare providers to quickly identify and communicate common pain points, such as inaccurate or incomplete record keeping, avoiding common pitfalls in the prior authorization process. 

Transformation Tip #2: Measurement and Tracking

Automated processes provide valuable insights for contracting, reporting requirements, and more. By measuring and tracking these processes, efficiency, effectiveness, and consumer experience are greatly impacted. This information can be used to improve upstream messaging to patients and members about prior authorizations.  

The overlay of technology not only increases operational efficiencies, but it also provides valuable insights that can be used to improve communication and support for consumers. 

Empowering Solutions for Healthcare

We partner with healthcare leaders to optimize prior authorization experiences and drive transparent, consistent engagement with consumers.  

Interested in learning more? In a recent webinar, our experts explored how better prior authorization experiences could enhance consumer trust in healthcare. 

Discover why we’ve been trusted by the 10 largest healthcare systems and 10 largest health insurers and are consistently recognized by Modern Healthcare as a leading healthcare consulting firm. Contact us today to explore how we can help you forge better experiences and improve outcomes.