For the past decade, health systems have been told to invest in digital front door (DFD) technologies to solve access challenges. Many did so, modernizing websites, rolling out online scheduling, and beefing up their patient portals. But now, the promised digital front door often serves as a welcome mat to a dead end. The industry convinced itself that a prettier entry point would somehow fix access.
It didn’t.
It created the illusion of progress, but the real work of getting a patient to the right appointment, at the right time, with the right provider, stayed stuck in the same fragmented workflows. Even health systems that invested early in digital communication and AI tools still face:
- Patients leaking out of the funnel.
- Referrals sitting untouched.
- Capacity mismatched and schedules underutilized.
- Staff trapped in inboxes.
We’ve spoken with over a thousand healthcare delivery organizations and continue to see firsthand where digital front doors succeed, and where they fail. The digital front door is dead. It’s time for more than a better interface over the same manual workflows.
The digital front door hasn’t fixed access
Health systems proudly promote online scheduling and digital tools. But real patient behavior is a harsh reality check:
- 40% of highly-digital health systems don’t allow new patient scheduling online.
- Nearly 20% of these same health systems rely on the consumer to jump through multiple hoops to find an appointment.
- Over 60% of all healthcare appointments are still booked on the phone.
Meanwhile, consumers might never even find your digital front door, using tools like ChatGPT and internet searches instead to find providers directly. And, if they do find it, consumers have much higher expectations.
Data shows that when DFDs create friction, patients lose patience. Half say a poor digital experience “ruins the entire experience with that provider,” and one in five say they have switched providers, looking for a better digital experience.
This is not a consumer expectation problem. It is a workflow problem.
Where digital front doors consistently fail
- Scheduling is challenging. If a patient can’t reschedule after hours – for example, your health system doesn’t allow new patient scheduling or they can’t find an appointment that works – they’re stuck leaving a portal message or voicemail. But by the time they receive outreach, they’ve likely already scheduled elsewhere, and that revenue is gone.
Luma’s operational AI replaces this after-hours breakdown with real-time action. At one academic medical center using Epic, more than 650 inbound patient calls were handled in the first week, and more than 8,000 cancellations and confirmations were completed in the following months without staff involvement. Teams reclaimed hours. Patients found answers quickly. Revenue stopped disappearing.
- AI chatbots are lipstick on broken workflows. Many health systems have tried to modernize the DFD with AI tools, but most sit on top of the same fragmented workflows. They can answer questions, but not do things like schedule complex appointments, which requires a complete staff-like view of appointment inventory. Savvy patients know when AI can’t help them, which only further erodes trust.
For operational AI to work, it needs to function as a full-stack engine that sees the same rules, schedules, and pathways as your staff and executes them immediately.
- Referral workflows remain stuck in the fax era. Referrals continue to leak out of health systems at high rates. Patients wait to be scheduled with no updates, while staff are buried in faxes to process manually.
With Luma’s AI-powered referral processing, some large specialty groups now process fifteen times more faxes per day and schedule patients weeks sooner by digitizing and routing referrals automatically.
- Patients search for care everywhere except your website. Consumers begin their care journey with Google, ChatGPT, Siri, and Gemini. They’re looking for what’s most convenient, not for a specific health system, and they’ll book with whoever can respond immediately.
Why the digital front door failed
The digital front door assumed patients needed more information. What they needed was a completed outcome. Healthcare has been applying modern UI to legacy operational processes that still rely on manual queues, callbacks, and scheduling rules buried in the EHR. The front entrance looks new, but the hallway is cluttered and blocked off.
AI hype has only widened and further complicated this gap. Patients expect tools that can replicate the service they expect from a staff member – tools that take action and deliver a completed outcome. Yet most AI solutions don’t have the visibility that a staff member has. They still hit the same limitations the digital front door did: handling easy requests, but ultimately hitting a dead end.
If not the digital front door, then what?
The future is not another clever interface. It is operational AI that delivers action and impact. It is an AI transaction engine that understands patient intent, applies the health system’s rules, and completes workflows instantly across voice, text, chat, search, and portal.
Operational AI has three defining traits:
- It meets patients where they already are, whether through AI search, your website, your phone line, or Google.
- It eliminates friction for both patients and staff by actually completing the task at hand.
- It has access to the same rules, slots, appointment openings, etc. that a human agent does.
The digital front door, as a redesigned informational layer that a patient still needs to navigate, is dead. The next era belongs to health systems that build AI-driven operational workflows that are simple and get patients to a completed outcome.
