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The healthcare industry has many ills. The payer-provider disconnect creates confusion, limits access, and exacerbates inefficiencies. Doctor and nurse burnout has led to widespread staffing shortages. This is compounded by aging infrastructure, outdated regulation, fragmented care delivery, and overly-complicated legacy systems. The list goes on. But there is a particular cancer that we could eliminate tomorrow: big consulting firms. Every year, American healthcare systems spend hundreds of millions of dollars on consulting firms that deliver PDFs instead of solutions. While patients suffer and clinicians burn out, these legacy firms collect their checks and move onleaving implementation challenges to healthcare institutions they’ve diagnosed but failed to treat. Proponents of the Big Five consulting model would argue that sclerotic institutions need an untainted outsider to parachute in. Someone who isn’t married to the nuances of an existing system. But theorizing is easy to do when you’re not tethered to the results. In healthcare, it’s not just financial results the consultants are off the hook for, it’s people’s lives. What do providers get with a legacy consulting firm? Well, a sizable stack of documents. With massive fees to match. While a 300-page PDF may impress at first blush, it won’t lead to actionable, sustainable solutions. It certainly won’t allow the health system to rapidly test and refine new models of care delivery, proving which ideas do and dont work in practice. Time pressure and fitting solutions in boxes At Cactus, the design firm I cofounded, one of our clients was let go from a major health system as part of a big consulting cost-cutting round. He had been working to reduce staffing shortages and developed a novel method for care teams to work together more efficiently, freeing up precious time for overworked nurses. Despite having proven results, he was let go because the consultants couldnt fit his already-implemented, already-proven solution into their model. He has now founded a business to sell that same method to health systems as a SaaS business. Traditional consulting firms also worsen a key challenge in healthcare: time pressure. Most health systems plan year-to-year based on government reimbursements. With revenue cycles already complex, consultants often default to short-term cost cuttingan easier sell than long-term change. The result? Innovation stalls, patient experience suffers, and the cycle repeats. If it’s so difficult, why not just leave healthcare alone? Because clearly, patients want better services. And by and large, those closest to the patient aren’t the problem. There is an abundance of clinical excellence in the United States but this doesn’t always translate to the best outcomes or patient experiences. The disconnect lies in how we approach system-level change. While working with a leading cancer center, my team found a big pain point for doctors: low compliancein other words patients werent following instructions. Research revealed that while treatment plans (housed in large binders) were technically sound, they werent tailored to patients. As a result, patients would underperform. We found that clearer communication, organized around actionable items and digestible content, could drive meaningful improvement. This user experiencefirst investigation, which centered on the needs of both doctors (frustrated by low compliance) and patients (overwhelmed by information), is rarely prioritized in traditional consulting models but is core to a more modern, design-led approach. The house renovation problem Imagine you’re renovating a Victorian mansion with a funky layout. The big consulting approach would be to tell the construction team to spend the allotted budget on turning the largest bedroom into two bedrooms, thereby increasing the home value. Maybe they’d advise a fresh coat of light grey paint, chosen to be least likely to offend potential buyers. But what if the person buying the home doesn’t have people to fill those bedrooms? What if they would be happier with a bolder color? What if in the process of splitting the bedroom, the floorboards are found to have mold? Well, the suit-clad consultants are already gone. You’re on your own, kid. Now imagine a design-led approach. In this scenario, the firm leading strategy is also the one implementing the changes. They spend the budget shifting the plumbing, dealing with mold issues as they arise. They don’t add another bedroom because it’s not needed, even if it would theoretically increase value. They try out a few paint swatches and see market appetite for bolder colors. Buyers are happierthey’re willing to pay more! Everyone wins. From slide decks to solutions Apply this rubric to healthcare. A design-led approach can balance strategic and business goals with the realities of user experience and complexities of implementation. Consultants that also build can pilot innovations faster, see results faster, reducing overall risk and cost. This type of team can rapidly experiment and improve in a virtuous cycle like the best startups do. Design-led consulting firms that implement their own changes also have a higher stake in outcomes. They create working prototypes before prescribing final solutions. They iterate based on real-world feedback. This way mistakes are found fast and plans are adjusted before scaling, saving cost and allowing faster and more thorough implementation. A call to healthcare leaders To healthcare leaders, I ask: What could you ship in the next 90 days with a design-led approach? What might still be sitting in a binder three years from now with traditional consulting? If the answer is something that could change people’s lives, and I suspect it is, it might be time to ditch the big guys. Design-led firms offer a fundamentally different relationship: partners who share your risk, commit to real-world results, and aren’t afraid to get their hands dirty implementing solutions. They bring technical talent alongside strategic thinking. They work in weeks, not quarters. Most importantly, they are judged by what they build, not what they recommend. The question isn’t whether you can afford this approach. The question is whether you can afford not to try it. Because while big consulting firms continue collecting their checks for delivering their slide decks, your patients and workforce are waiting for something better. They deserve it. And with the right partners, you can finally deliver it. Noah Waxman is CEO and cofounder at Cactus.
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E-Commerce
America’s behavioral health workforce is in crisis. Burnout is accelerating, waitlists are expanding, and clinicians are transitioning away from the field at alarming ratesnot because their passion has diminished, but because the administrative burden has become overwhelming. These departures represent one of the most significant labor challenges in our industry with its impact felt across communities nationwide. Every week, I talk to leaders running certified behavioral health agencies across the country, and their message is consistent: Leaders aren’t seeking technological disruption. They’re desperate for breathing room to retain staff, serve more clients, and maintain compliance without drowning in documentationa fundamental workforce sustainability issue. When artificial intelligence enters the conversation, many approach it with justified skepticism. This caution stems from two critical concerns: First, behavioral health has endured its share of overhyped technology that promised transformation but delivered frustration; second, and equally important, is the critical issue of regulatory compliance, privacy, and data security in this intensely regulated field. Documentation: The critical foundation for reimbursement and compliance In behavioral health, documentation forms the foundation for intake, clinical interactions, reimbursement, compliance, and broader care accountability. Providers rightfully question whether AI-generated notes (where technology assists in creating clinical documentation) will withstand audits or satisfy complex regulatory requirements. AI technology not only facilitates the creation of clinically relevant documentation but also enhances oversight capabilities and ensures full auditability of all generated content. The daily reality for most providers involves hours of note-taking, repetitive scheduling, and navigating documentation systems never designed for behavioral health’s unique compliance demands. We call this “administrative burden,” but the term fails to capture the resulting exhaustion that drives talented clinicians from the field. According to a recent study by Google Cloud and The Harris Poll, U.S. clinicians spend nearly 28 hours weekly on administrative tasksover half of their work week, with 82% reporting burnout. In behavioral health’s already resource-constrained environment, this burden often becomes the breaking point for dedicated professionals, contributing to a sector-wide labor shortage. Find solutions in thoughtful AI implementation With clinicians overwhelmed with documentation that causes burnout, behavioral health professionals need solutions that work for them. This is where carefully designed AI tools show great promise. Early AI implementations focused on documentation and administrative workflows are demonstrating measurable benefits when developed with clinician input and compliance requirements at the forefront. Organizations deploying these tools thoughtfully see tangible impact: In our current deployments, clinicians are reporting up to 80% reduction in clinical note-taking time as technology listens and drafts notes in the background. Smart assistants help staff locate resources without interrupting care. Intake workflows become more efficient, shortening the gap between a client’s first call and first session. These tools don’t put an end to compliance complexitythey help manage it while creating space for providers to be present. Care gets better when clinicians are supported I remember hearing directly from a patient that during his initial session, his provider never once made eye contact with him. Instead, they were focused on their computer, furiously typing notes and immersed in updating his electronic health record (EHR). Fortunately, thats where we repeatedly see that AI can improve care delivery. By removing needless administrative work, behavioral health clinicians have more time to form connections and spend more time with their clients, achieving better outcomes. According to our customers, 50% say they feel more connected to their clients without increasing hours and 60% say they feel more connected to their patients now that theyre not documenting during sessions. I also hear from clinicians that they see greater consistency in their care plans with fewer missed handoffs. These aren’t merely efficiency gains, but restoration of human capacity essential for building trust, ensuring continuity, and addressing complex behavioral health needsall critical factors in workforce retention. AI won’t fix everything To be clear, AI isn’t a silver bullet. It won’t resolve funding challenges, address workforce shortages, rebuild trust between providers and policymakers, or guarantee that alternative payment models work effectively for behavioral health. What it can do is create breathing room and greater capacity by providing clinicians with the margin needed to practice what they are trained for. In a field where every additional hour with a client, every prevented resignation, and every accelerated intake process can transform a life, that support matters profoundly. 3 critical elements for success For AI to deliver on its promise in behavioral health, its important to focus on three critical elements: clinical expertise driving development, seamless integration into existing workflows, and evaluation against regulatory standards. The most effective AI tools are designed with clinicians informing their development, refined with their feedback, and tested against compliance standards and regulations during audits. Behavioral health needs meaningful innovationtools that honor the work, alleviate friction, and strengthen the relationship between clinician and client. This will help preserve our essential mental health workforce to our social infrastructure Josh Schoeller is CEO of Qualifacts.
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E-Commerce
This morning, the worlds largest telescope revealed its first-ever images of spaceand theyre pretty jaw-dropping. The images come courtesy of the NSFDOE Vera C. Rubin Observatory, a scientific facility funded by the U.S. National Science Foundation and the U.S. Department of Energy’s Office of Science. Located at the summit of Cerro Pachón in Chile, the facility is the product of more than 20 years of work. Its space cameraembedded in the hulking Large Synoptic Survey Telescope (LSST)is about the size of a small car and includes a sensor array of 3 billion pixels, the most sensors ever used in a telescope camera. According to a press release from the Rubin Observatory, its expected to generate an ultrawide, ultra-high-definition time-lapse record of the universe. It will bring the sky to life with a treasure trove of billions of scientific discoveries, the release reads. The images will reveal asteroids and comets, pulsating stars, supernova explosions, far-off galaxies, and perhaps cosmic phenomena that no one has seen before. The most efficient Solar System discovery machine ever built In just its first 10-hour test observation, unveiled today, the LSST managed to capture images that include millions of galaxies and Milky Way stars, as well as more than 2,000 never-before-seen asteroids within our solar system. Taken together, the photos illustrate a technicolor view of space at a mind-boggling scalebut the 10 million galaxies photographed by the LSST represent only 0.05% of the roughly 20 billion galaxies that the camera is expected to record within the next decade. The primary goal of the LSST is to complete a 10-year survey of the Southern Hemisphere sky, capturing hundreds of images and around 20 terabytes of data per night throughout that period. Per the Rubin Observatory, this massive influx of data will make the LSST the most efficient and effective solar system discovery machine ever built. All of the captured data will be made available online, allowing astronomers across the globe to access countless new findings without physical access to the telescope. The LSST is designed to advance four main areas of study: understanding the nature of dark matter and dark energy; creating an inventory of the solar system; mapping the Milky Way; and exploring the transient optical sky (studying objects that move or change in brightness). Experts predict that, given its capacity to identify millions of unseen asteroids, comets, and interstellar objects, the camera could even help protect the planet by spotting objects on a trajectory toward the Earth or moon. NSFDOE Rubin Observatory will capture more information about our universe than all optical telescopes throughout history combined, Brian Stone, chief of staff at the National Science Foundation, said in a press release. Through this remarkable scientific facility, we will explore many cosmic mysteries, including the dark matter and dark energy that permeate the universe.
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E-Commerce
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