Documo, the leader in automating manual document work that slows critical workflows in healthcare, today released the results of its annual State of Healthcare Operations report. This year’s theme, “The Healthcare Action Gap,” reveals a persistent disconnect between the information healthcare organizations receive and the work that information is supposed to trigger. Across referrals, patient intake, prior authorization, claims and other critical workflows, information frequently arrives outside the EHR, creating manual work before teams can act on it.
The consequences extend well beyond administrative burden. Nearly half (48%) of respondents say document delays often or always negatively affect patient care, while 45% estimate that more than 20% of referrals never become completed appointments — underscoring the operational and financial stakes of work that gets stuck between information arriving and action being taken.
One of the biggest reasons document processing can be so troublesome and time-intensive is that much of it involves the exchange of unstructured documents outside the electronic health record (EHR). EHRs, in theory, are an easily accessible and shareable system of record for a patient’s entire medical history. But 62% of survey respondents reveal that more than a quarter of their document processing work happens outside the EHR; 25% say more than half of document work happens outside the EHR.
When document work lives outside the EHR, patient-care delays rise sharply. While the EHR is a vitally important mechanism for tracking patient history, it does not solve the glaring underlying gap in the operations layer.
Among the survey highlights:
- Fragmented document workflows create a manual-work multiplier outside the EHR. Among organizations with more than half of document-related work outside the EHR, 74% say more than half of incoming documents require manual review.
- Referral leakage exposes the financial side of the action gap. 76% estimate that more than 10% of referrals never become completed appointments, while 45% estimate leakage above 20% — despite referrals ranking among the workflows organizations associate with significant financial impact.
- Document delays are not an edge case—they affect care at many organizations. 48% say document delays always or often negatively affect patient care. 46% say they negatively impact staff productivity. 40% say they impact revenue cycle.
- Manual document review consumes staff capacity — and organizations see significant potential for AI. The organizations doing the most manual review see the biggest opportunity for automation. Among respondents who say more than half of incoming documents require manual review, 60% believe more than half of that work could be automated.
- Healthcare is addressing administrative burden — but underinvesting in document workflow automation. Only 18% of respondents are investing in document workflow automation.
“Healthcare doesn’t have an information problem — it has an action problem,” said Denis Whelan, CEO of Documo. “Critical information arrives every day, but too much of it still has to be manually reviewed, sorted, re-entered, matched, and routed before anyone can act on it. That’s where work stalls, referrals fall through the cracks, care is delayed and staff capacity gets consumed. AI’s real value isn’t just extracting information from a document. It’s removing the unnecessary manual work that stands between information arriving and action happening.”
Key takeaways:
- Patient care: 48% say document delays often or always negatively affect patient care.
- Revenue/capacity: Referral leakage is widespread; delayed claims and referrals have major financial consequences.
- Root cause: 62% say more than 25% of document work occurs outside the EHR; 25% say more than 50% happens outside the EHR.
- Manual work compounds outside the EHR: Among organizations where more than half of document work happens outside the EHR, 74% say more than half of incoming documents require manual review.
- Opportunity: Heavy-manual-review organizations see significant automation potential. Organizations are receptive to AI for moving information forward, but want human control over consequential decisions.
Respondents identified claims, referrals, patient intake and prior authorization among the document types carrying the greatest financial impact for their organizations. Yet only 18% say their organizations are investing in document workflow automation, suggesting a disconnect between the financial importance of these workflows and investment in the infrastructure that supports them.
As with 2025’s State of Healthcare Operations report (themed Stuck in the Fax Lane), Documo’s 2026 survey collected insights from more than 100 administrators, health information management, and IT professionals that work in a mid-size hospital, clinic, ambulatory care center, nursing facility, residential treatment center, healthcare agency or surgical center. These professionals are directly involved with designing workflows, managing intake and routing, or purchasing and auditing compliance.
Healthcare interoperability is essential for both improving patient care and reducing costs. While progress has been made, closing this gap doesn’t require replacing the EHR. It requires automating the document work around it. Documo applies AI and automation after healthcare documents arrive and before teams need to act — automatically classifying documents, extracting key information, and routing them into the appropriate EHR or downstream workflow. Teams spend less time sorting, correcting, analyzing documents for missing information, and chasing that information down, helping critical work move faster while keeping people in control of consequential decisions.
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About Documo
Documo helps healthcare organizations turn information into action by automating the manual document work that slows critical workflows. From referral intake to other document-heavy processes across healthcare operations, Documo reduces administrative burden, improves throughput and creates more capacity for patient care — driving meaningful operational and economic impact. Combining HIPAA-compliant cloud fax, Direct Secure Messaging (DSM), and AI-powered document and workflow automation, Documo helps critical work move forward faster. Learn more at documo.com.
View source version on businesswire.com: https://www.businesswire.com/news/home/20260909012453/en/
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