Ambulatory Growth Is Raising the Bar for Operational Efficiency – and Driving the Need for Smarter Approaches

Last month, we explored the dawn of operational intelligence in ambulatory care. In this piece, we’ll take a deeper dive into how the expansion of ambulatory networks has left health systems struggling to efficiently manage complex patient flows and ensure timely access to care – and what they can do to keep pace.

Ambulatory care has become the new front door of the health system. Over the past decade, outpatient settings – from primary care and specialty practices to imaging, infusion, surgery, and behavioral health centers – have seen steady growth. Today, roughly 60% of care occurs in these environments. But as more care shifts beyond the hospital walls, organizations face increasing strain in how ambulatory care is accessed, coordinated, and delivered.

While a larger ambulatory footprint means more local access points for patients (and care closer to home), organizations often lack the visibility needed to keep operations running smoothly within these settings. Referral queues, specialty waitlists, and provider schedules are typically tracked across disconnected systems, making it difficult to spot emerging backlogs, rising wait times, or appointment availability.

The consequences are twofold: patients face delays in receiving care, while health systems lose revenue when referrals leave the network. Specialty appointments frequently take 30–60 days or longer to schedule, and referral leakage across organizations can reach 20–30%. Just like in other industries, expectations for timely, on-demand service are rising – and in healthcare, when patients cannot be seen promptly in ambulatory locations, they often seek treatment elsewhere.

In many cases, that means turning to the emergency department. Even popular shows like The Pitt capture this dynamic, depicting EDs overcrowded with patients who had nowhere else to turn for immediate care.

As ambulatory care becomes a broader part of care delivery, the ability to apply AI and analytics to anticipate slowdowns and guide next steps will emerge as the defining operational capability for health systems – and a strategic advantage for those that can do it effectively.

As Ambulatory Care Grows, Operational Challenges Rise

Health systems have expanded their outpatient footprint significantly in recent years, often through physician practice acquisitions or service line growth. Large organizations now operate hundreds of ambulatory locations and thousands of providers across their networks, with patient volumes projected to grow roughly 18% over the next decade.

Yet the infrastructure used to manage this activity has not evolved at the same pace. Many organizations still rely on processes originally designed for individual clinics rather than large ambulatory networks.

Because critical information is siloed, staff often have to assemble the full picture of demand and capacity manually. It can take five or six people reviewing schedules, reconciling referrals, or pulling reports from different systems just to determine where a patient should be directed. Without a clear view across the organization, teams often find themselves reacting to problems after they occur rather than identifying issues early enough to prevent delays.

As a former trauma and critical care nurse, I’ve seen firsthand how this dynamic impacts both clinician and patient experience. Clinical staff are pulled into time-consuming coordination work that contributes to burnout and takes focus away from care delivery, while some key steps – like confirming appointments, tracking next steps, or conveying key clinical information to referred providers – often fall to patients themselves, which is not any health system’s intention.

Extending Operational Intelligence to Ambulatory Care

In the early 2010s, many organizations adopted transfer centers and command centers to streamline patient throughput, bed placement, and staffing across inpatient operations. These capabilities helped health systems move from reactive management to real-time visibility across the enterprise.

Now, health systems need to apply that same operational discipline to ambulatory care.

Emerging advances in AI and data integration have the potential to make that shift possible. By consolidating data from multiple systems into a single framework, organizations can identify emerging bottlenecks, determine the appropriate actions, and intervene before delays escalate. Rather than relying on fragmented reports, teams can work from a unified, system-wide view of demand and capacity, ultimately improving access.

The Next Era of Healthcare Operations

Healthcare organizations are entering a period of significant structural change – something that surfaced repeatedly at this year’s JPM Healthcare Conference. Some systems are shedding hospitals or practices they can no longer operate efficiently, while others are expanding rapidly through acquisitions and partnerships.

In both cases, leaders are reassessing the size and composition of their care footprint – and whether they have the infrastructure to support it. As more care moves beyond the hospital, ambulatory environments are becoming an increasingly important part of that equation.

Organizations that can bring greater coordination to these settings will be better positioned to meet demand and remain competitive. AI-driven operational platforms that unify data into a system-wide view and surface predictive insights can provide the clarity needed to run ambulatory services with far greater precision.