Patient Care Fragmentation Lives in the Handoffs. Are CIOs Asking the Right Questions?

By Irene Truong, chief product and commercial strategy officer, WestCX.

Imagine a health system’s quarterly technology review, where the numbers appear to tell a promising story. Leaders tout that patient portal adoption is rising, automation is reducing manual scheduling, and a new AI tool is resolving routine patient requests.

Then consider the patient experience.

A patient completes registration through the portal, then has to confirm the same information over the phone. They use an automated scheduling tool and receive an appointment reminder, even though prior authorization is still pending. When they ask for an update on a referral that has moved from primary care to a specialist, the AI assistant can’t tell them whether anyone has reviewed it or what happens next.

Every system involved may be performing well by its own metrics, but the patient’s journey can still feel disconnected.

According to Experian Health, 46% of providers believed patient access had improved over the previous year. Only 18% of patients said the same. That disconnect highlights the persistence of fragmentation in the patient journey, even after years of significant technology investment.

It also shows why CIOs should look beyond measures like adoption or utilization. They must consider outcomes that reflect the patient’s actual experience, such as whether requests are resolved on the first contact, referrals reach the next step, appointments are completed, or patients have to repeat information or reach out again for help.

Health systems have become skilled at digitizing individual functions, but the next challenge is orchestrating the tools.

The patient journey can break down even when individual systems are working

Hospitals can now send, receive, and integrate clinical information across systems more consistently through electronic health records, patient portals, and interoperability tools. In fact, the Office of the National Coordinator for Health Information Technology reports that 96% of U.S. non-federal acute care hospitals electronically send care records, and 65% of patients were offered and accessed their online medical records or patient portal in 2024.

That infrastructure gives healthcare organizations a strong foundation for keeping patient information connected across systems and settings. The operational work begins when information needs to move from one system, team, or channel to the next.

For example, consider a woman who is referred by her primary care physician to a cardiologist. Her physician sends the referral and clinical information electronically, and the specialist’s office receives the record. But the authorization is still being processed in a separate workflow, while scheduling and patient outreach happen through other systems.

She receives a message prompting her to schedule, assumes everything is ready, and calls with a question about next steps. The contact center agent can see the appointment information but can’t see that the authorization is still pending, so the patient has to wait while staff piece together the status across multiple systems. The information exists, but the journey still breaks down between the tools and teams involved.

These gaps are easy to miss when every department measures its own piece of the journey independently.

A 2025 Scottsdale Institute-Deloitte survey illustrates how difficult it can be for health systems to measure the full value of technology beyond cost savings and individual system performance. Eighty percent of surveyed health system executives said that measuring technology value was critical, with 84% regularly tracking cost savings and 88% tracking implementation and operating costs. Yet only 52% assessed consumer-facing metrics, and 44% measured the impact on workforce productivity and satisfaction.

For CIOs, that creates an opportunity to expand the questions they ask when evaluating new technology.

Five questions CIOs should ask before choosing new technology

Healthcare organizations already conduct significant due diligence around security, integration, and performance for new technology. For example, Scottsdale Institute’s analysis of AI intake forms from 16 health systems included assessment areas like model performance, equity, cybersecurity, technical integration, and ongoing monitoring.

Those controls are essential. CIOs can strengthen them by asking the following questions designed specifically to expose fragmentation and ensure that tools reduce friction for patients and support smoother handoffs between teams and systems.

1. What happens before and after this technology is used?

A scheduling tool may successfully book an appointment, but CIOs should also understand where the information comes from, what happens once the appointment is booked, and which other systems or teams rely on that information. Looking one step before and after the interaction can reveal whether the patient journey continues smoothly or requires additional manual work. 

2. What happens when something doesn’t go as planned?

Not every touchpoint in a patient’s journey will go as expected. A referral may arrive without required documentation, or an authorization may still be pending. CIOs should understand who is responsible for resolving those situations, how they’re routed, and whether the patient has to repeat information along the way. 

3. How does the technology handle information that changes or doesn’t match?

Patient information isn’t always static or consistent. CIOs should ask what happens when a phone number changes, two records contain different information, or an outside provider sends incomplete data. They should also understand how corrections are made and shared with the other systems that rely on them. 

4. What will this workflow require from patients and staff?

CIOs should understand how many steps a patient will need to complete and what staff will need to review, approve, or manage. That includes logins, alerts, transfers, forms, authentication steps, and follow-up contacts. 

5. How will we know whether the patient journey is improving?

Alongside adoption and efficiency measures, CIOs should ask how the technology will affect outcomes such as first-contact resolution, completed referrals, repeat contacts, duplicate requests for information, and the time between one care step and the next. These measures can show whether the technology is improving the patient experience beyond the individual system itself.

Start with one journey

Addressing fragmentation does not require redesigning the entire technology stack at once. A health system can start with one high-volume journey, such as a specialist referral or pre-procedure authorization, and look closely at how that patient experience unfolds from beginning to end. That means understanding which systems and teams are involved, where responsibility changes hands, how exceptions are resolved, and where patients and staff are most often asked to step in.

From there, leaders can identify a small set of measures to determine whether patient journeys are becoming more connected over time.

Beyond evaluating whether a platform performs its assigned function, this approach allows leaders to see whether the collection of technologies, workflows, and teams helps the patient continue moving toward a seamless care journey.

Health systems will continue investing in AI, automation, and digital access. The opportunity for CIOs is to make sure those investments work together in a way that makes care easier to navigate, so patients can move from one step to the next without having to repeat information, chase down answers, or manage the gaps between systems themselves.