The U.S. healthcare system is under immense pressure. Costs are rising, clinicians are burning out, disparities are widening, and patients are frustrated. The Triple Aim focused on patient experience, population health, and per capita cost is no longer sufficient. We’ve evolved to the Quintuple Aim, adding two essential pillars: provider well-being and health equity.
This expanded vision isn’t just aspirational, it’s urgent. And artificial intelligence (AI), paired with intelligent automation, offers a practical path forward.
As someone with hands-on experience delivering AI-first transformation across payers and providers, I’ve seen the potential and the pitfalls of technology in healthcare. Done well, AI doesn’t replace clinicians; it empowers them.
AI Can Accelerate the Quintuple Aim
AI is already helping organizations tackle foundational gaps. A 2023 McKinsey report estimated that healthcare AI could create over $360 billion in annual value by 2027, primarily through administrative efficiencies and clinical decision support. But it’s not just about cost savings - it’s about enabling better care, faster.
Reduce clinical burden: Generative AI tools can auto-summarize multi-year chart histories, extract structured insights from clinical notes, and reduce documentation time by over 30%. As one Mayo Clinic executive noted in a recent JAMA Health Forum discussion, “We need AI to give clinicians the gift of time.”
Streamline prior authorization: With over 90% of providers reporting delays due to manual prior auth (AMA, 2023), AI can help standardize and automate approvals using structured and contextual data.
Auto-code from doctors’ notes: NLP and machine learning models can extract billable codes directly from narrative notes, increasing claim accuracy and speeding up reimbursement cycles.
Elevate the patient experience: AI-enabled scheduling, voice bots, and digital front doors reduce friction and enhance access. When paired with proactive outreach and personalized follow-ups, these tools create deeper engagement and better outcomes.
Support home health and Social Determinants of Health (SDoH): AI-driven remote monitoring, predictive risk modeling, and community resource mapping are helping close the loop for vulnerable populations, especially seniors and underserved communities.
Orchestrating Intelligence Across the Ecosystem
The real unlock lies in an omni-channel analytics layer that integrates data across clinical, financial, and operational systems to power real-time, actionable insights. When this intelligence sits atop core platforms such as EHRs and others, it bridges silos across departments creating a unified view of the patient journey, provider effectiveness, and system-wide performance. Health equity is not a parallel initiative; it’s the outcome of operational excellence designed with inclusion at the core.
From Pilots to Platforms
The moment to act is now. Generative AI and large language models are maturing. Infrastructure is in place. Talent exists. The risk is not in moving too fast but in waiting too long. As Dr. Vindell Washington, former National Coordinator for Health IT, said: “AI can’t fix what was never designed to work. But it can help us redesign it better, together.”
At Tysons Advisory, we believe transformation must be both responsible and bold. We’re committed to helping organizations build intelligent systems that improve access, reduce friction, and deliver care with both precision and humanity. The future is here. Let’s build it with purpose.