Healthcare’s Human Edge: What Must Never Be Outsourced

Healthcare organizations face unprecedented pressure to do more with less. Labor shortages, rising costs, shrinking reimbursements and increasing patient expectations are forcing leaders to examine every operational process through the lens of efficiency. Automation, artificial intelligence and outsourcing have become critical tools for preserving margins while maintaining access to care.

Yet amid the drive toward optimization, healthcare leaders must answer a fundamental question: What should never be outsourced or automated?

Members of the Senior Executive Healthcare Think Tank—a group of experts specializing in patient experience, workforce strategy, healthcare technology, quality, policy and innovation—largely converge on a common answer. While administrative functions, repetitive workflows and operational processes may benefit from automation, the human judgment and relationships at the center of care must remain protected.

Their perspectives align with a growing body of research showing that trust, continuity of care and clinician oversight remain critical determinants of patient outcomes even as technology becomes more sophisticated. The challenge for healthcare leaders is not deciding whether to automate, but determining where automation should stop. Think Tank members share their perspectives on the functions that should remain in-house, the risks of removing human oversight from care delivery and the practical steps organizations can take to improve efficiency without compromising patient trust, clinician engagement or quality outcomes.

Protect the Capabilities That Define Your Organization

Rajani Kumar Sindavalam, Systems Engineering Leader at HCL America Inc., approaches the question from a strategic perspective shaped by nearly two decades of leadership across the global medical device industry.

Sindavalam says healthcare organizations must first identify what makes them uniquely valuable before making outsourcing decisions.

“Every healthcare system must deeply understand its unique strengths and weaknesses,” he says. “The golden rule is to always keep your core technical differentiator in-house.”

According to Sindavalam, organizations often attempt to build expertise across every operational domain, only to discover that doing so dilutes focus and resources. Instead, healthcare systems should preserve ownership of the capabilities that directly create value, innovation and competitive advantage.

“The proprietary technology or specialized platform is exactly what makes your system stand out,” he says.

His view touches on a broader reality facing healthcare leaders: Efficiency gains are most sustainable when organizations protect the capabilities that define their mission while leveraging external expertise for supporting functions.

Never Outsource the Patient Relationship

Jordan Henry, Founder and Chief AI Ethicist at Veritas AI Consulting, believes the answer is straightforward: The patient-facing care relationship should never be outsourced or automated.

“Never outsource or automate the patient-facing care relationship, especially bedside nursing, care coordination and goals-of-care conversations,” Henry says.

Drawing on experience spanning healthcare administration, emergency management and ethical AI governance, Henry argues that these interactions represent far more than workflow steps.

“That work builds trust, catches subtle changes and adapts care to a person’s values, not just a protocol,” he says.

Technology may improve efficiency, but it cannot fully replicate the human awareness required to recognize unspoken concerns, emotional distress or emerging clinical issues.

“If preserved in-house, professionals keep clinical judgment and purpose,” Henry says. “Patients feel seen and safer, and quality improves through continuity, empathy and faster escalation when something is off.”

“Healthcare systems must understand where their differentiation exists and maintain this skill set as a core, protected asset.”

– Mark Francis, Founder and CEO of CaregiverZone, Inc.

SHARE IT

Focus Resources on What Makes You Different

Mark Francis, Founder and CEO of CaregiverZone, Inc., sees the issue through the lens of competitive strategy and innovation.

“Healthcare systems must understand where their differentiation exists and maintain this skill set as a core, protected asset,” Francis says.

Having led ventures across digital health, aging services and healthcare technology, Francis notes that organizations naturally accumulate responsibilities that may no longer align with their core mission.

“Organizations often expand into adjacent areas or take on workflows which are not core but can add revenue and scale,” he says.

However, today’s environment rewards agility.

“Leading organizations are shedding these ancillary businesses and tasks,” Francis says. “More and more companies are following the model of AWS, which is to automate or outsource the undifferentiated heavy lifting.”

The ultimate goal, he says, is freeing resources to focus on innovation and the capabilities that create meaningful value for patients and stakeholders.

Protect the Last Mile of Clinical Judgment

Sriharsha Chavali, Enterprise Technology Leader at The Aspen Group, has spent years building large-scale healthcare platforms and clinical surveillance systems. His experience reinforces a principle he summarizes succinctly: “Outsource the work, not the responsibility.”

Chavali says automation can significantly improve clinical operations when deployed appropriately.

“We created real-time alerts, drug-bug mismatch detection and de-escalation workflows to reduce noise and focus attention,” he says.

But technology alone is not enough.

“Every alert still needs a clinician who understands what is not documented, listens to the bedside and applies judgment,” Chavali says.

He warns that organizations risk unintended consequences when automated systems begin driving decisions instead of supporting them.

“When systems start driving decisions, critical thinking erodes and edge cases get missed,” he says.

For Chavali, the ideal model is augmentation rather than replacement.

“Technology scales insight, but people bring context, equity and meaning,” he says. “Clinical judgment connects data to the human story and must be preserved.”

“Patients are not just data points; their symptoms, fears, social context and subtle changes matter.””

– Tirumala Ashish Kumar Manne, Principal Cloud Architect at Optum

SHARE IT

Accountability Must Remain at the Point of Care

Tirumala Ashish Kumar Manne, Principal Cloud Architect at Optum, believes clinical judgment is the one function healthcare systems should never fully outsource or automate.

“I would never fully outsource or automate clinical judgment at the point of care,” Manne says.

Technology can effectively support many administrative functions, including scheduling, documentation and eligibility verification. However, healthcare decisions involve variables that often cannot be fully captured in structured data.

“Patients are not just data points,” he says. “Their symptoms, fears, social context and subtle changes matter.”

Manne argues that distancing accountability from care teams creates risks for both professionals and patients.

“When that responsibility moves too far away from the care team, professionals lose ownership, patients lose trust and quality can suffer,” he says.

The most effective role for automation, he says, is removing burdens that prevent clinicians from focusing on what matters most.

“The best use of automation is to remove the burden around care so clinicians have more time for the human decisions that truly affect outcomes.”

Empathy Cannot Be Replicated by Software

Dr. Dmitriy Schwarzburg, Founder and Medical Director of Skinly Aesthetics, argues that direct patient communication belongs firmly on the list of functions that should remain human-led.

“Clinical judgment and direct patient communication should never be fully outsourced or automated,” Schwarzburg says.

Although technology can improve responsiveness and efficiency, healthcare interactions often require empathy, interpretation and emotional intelligence.

“Healthcare decisions often require experience, empathy and context that technology alone cannot provide,” he says.

The risks become especially apparent during moments of frustration or uncertainty.

“When patients feel unheard or frustrated, automated responses only increase the frustration,” Schwarzburg says.

He believes automation works best when it serves as a support mechanism rather than a replacement for clinician expertise.

“Replacing human clinical decision-making risks weaker outcomes, lower patient confidence and a more transactional healthcare experience.”

Healthcare Exists for Human Connection

Harikrishnan Muthukrishnan, Principal IT Developer at BCBS Florida, believes healthcare leaders should resist the temptation to view every interaction through an efficiency lens.

“The one function that should never be outsourced or automated is the human relationship at the heart of care,” he says.

Muthukrishnan points to some of the most difficult moments in healthcare delivery as examples.

“When a clinician delivers a difficult diagnosis or sits with a family deciding whether to withdraw life support, no algorithm or call center can replicate what that moment demands,” he says.

Those moments require moral reasoning, emotional attunement and genuine presence.

“These aren’t inefficient processes waiting to be optimized,” he says. “They are why healthcare exists.”

He warns that over-automation can damage both patient trust and clinician fulfillment.

“For professionals, it turns purposeful work into a list of mechanical tasks,” he says. “For patients, it creates abandonment when connection matters most.”

Keep Clinical Workflow Design Close to Care

Mahendran Chinnaiah, Digital Healthcare Architect for a major U.S. healthcare and pharmacy services firm, identifies clinical workflow design as the function that should remain under direct organizational control.

“Clinical workflow design should never be outsourced or automated,” Chinnaiah says.

While technology can streamline documentation and data capture, he argues that workflow architecture determines how care is actually delivered.

“You can automate data entry, but you can’t outsource the operational architecture of how care actually happens,” he says.

When workflow decisions are delegated to outside vendors, healthcare organizations often receive generic solutions that fail to reflect real-world clinical complexity.

“You get rigid, cookie-cutter templates that don’t fit the messy reality of a hospital floor,” he says.

The consequences extend beyond efficiency metrics.

“For healthcare professionals, this leads to burnout as they fight tools that slow them down,” Chinnaiah says. “For patients, it creates dangerous friction and delays care.”

“Dignity is not inefficiency; it is the ethical center that keeps care human when incentives push otherwise.”

– Donna P. Mitchell, CEO of Mitchell Universal Network LLC

SHARE IT

Dignity Is Not an Inefficiency

Donna P. Mitchell, CEO of Mitchell Universal Network LLC and widely known as The Transformation Authority™, believes the healthcare industry’s technology transformation challenge ultimately comes down to preserving human dignity.

“Outsource scheduling, operations, workflows, triage and repeatable processes,” Mitchell says. “You can even automate some guardrails for scale and consistency.”

The danger emerges when organizations remove human oversight in pursuit of efficiency.

“If human oversight and compliance are not built in, you are in a downward spiral,” she says.

Drawing on decades of experience leading large-scale technology adoption efforts, Mitchell argues that healthcare differs from other industries because its outcomes directly affect human well-being.

“The people side of technology adoption keeps diagnostics, treatment and follow-up anchored in the dignity of the person,” she says.

Mitchell believes organizations that lose sight of this principle risk undermining both quality and value.

“Dignity is not inefficiency,” she says. “It is the ethical center that keeps care human when incentives push otherwise.”

Nine Principles for Balancing Efficiency and Care

• Protect your organization’s core differentiator. Identify the capabilities that create unique value and preserve ownership of them.
• Keep patient-facing relationships human. Bedside care, care coordination and goals-of-care conversations require trust and empathy.
• Outsource undifferentiated work. Free resources by automating or delegating non-core activities.
• Use automation to augment judgment. Technology should support decisions, not make them.
• Maintain accountability at the point of care. Ensure clinicians retain ownership of patient outcomes.
• Preserve direct patient communication. Human interaction remains essential for trust and confidence.
• Prioritize the therapeutic alliance. Connection and presence matter most during life’s most difficult healthcare decisions.
• Keep workflow design close to clinicians. Build systems around real-world care delivery rather than vendor templates.
• Embed human oversight into every transformation. Efficiency gains should never come at the expense of dignity and ethics.

The Human Core of Healthcare

Healthcare has always been a business of decisions, but its most important decisions rarely happen in spreadsheets, dashboards or algorithms. They happen in exam rooms, at bedsides and during conversations patients remember for the rest of their lives.

The experts in this discussion disagree on where organizations should draw operational boundaries, but they share a common conviction: Efficiency should create more room for humanity, not less. The healthcare organizations that thrive in the years ahead won’t be the ones that automate the most. They’ll be the ones that know exactly which parts of care should never be automated at all.