The Great Healthcare Tech Conundrum : Build, Buy, or Integrate?
The Death of SaaS, the Rise of AI-Built Platforms, and the Looming Interoperability Crisis
For far too long, healthcare has been a patchwork of niche solutions—each solving a very specific problem in isolation. Need prior authorization automation? There’s a product for that. Want to streamline remote patient monitoring? Another vendor has you covered. Looking for AI-powered claims adjudication? Yet another company is pitching a standalone solution.
The explosion of point solutions has been a necessary evil, driven by an industry that moves at a glacial pace, weighed down by regulation, legacy systems, and deeply entrenched incumbents. But now, the rise of AI-powered agents is forcing a reckoning. These intelligent systems aren’t just automating tasks; they are beginning to orchestrate entire workflows across multiple disconnected platforms. The question is no longer whether these niche solutions will integrate—it’s whether they will even be relevant when the sum of the parts becomes more expensive than the whole.
The High Cost of a Fractured Ecosystem
Healthcare has always struggled with interoperability. Every new point solution introduced into the mix adds another integration headache, another API contract, and yet another vendor to manage. The result? Skyrocketing costs, operational inefficiencies, and an IT department drowning in middleware and support tickets.
Even when vendors claim to “play well with others,” the reality is far messier. Healthcare data is notoriously complex, and interoperability standards are still far from seamless. In many cases, the cost of integrating a set of niche solutions (both in dollars and engineering effort) ends up exceeding the cost of building something in-house from the ground up.
The harsh truth? Many niche solutions aren’t actually solving a problem—they are monetizing friction.
The Death of SaaS: When AI Kills the Subscription Model
Tech moguls have been warning us: “SaaS as we know it is dying.”
For years, enterprises have been locked into expensive contracts for bloated software they barely use. The SaaS pricing model—per-seat licenses, API usage fees, and endless upsells—has made software procurement a financial sinkhole. The rise of AI is about to change all of that.
When a single developer can use AI to build an alternative to DocuSign in a weekend, what does that mean for an industry flooded with overbuilt, overpriced software?
Healthcare, in particular, has been held hostage by SaaS vendors promising seamless solutions—only for IT teams to discover that they are now managing 20+ vendor contracts, each with its own data silos and integration headaches. AI isn’t just automating tasks anymore; it’s enabling companies to build their own “good enough” systems without relying on traditional software vendors.
For years, the argument against in-house development has been cost and complexity. But AI changes the equation. Instead of hiring an entire engineering team, companies can now:
• Use AI-powered development tools to spin up internal applications in weeks instead of months.
• Automate integrations instead of paying vendors to do it.
• Build lightweight, purpose-built solutions instead of adopting monolithic SaaS platforms.
This isn’t just about cost-cutting—it’s about control. Why rent when you can own?
The Future: What Happens When Every Company Becomes a Platform?
Fast-forward ten years. AI-powered development has matured to the point where companies no longer look to external vendors for every software need. Instead, they build what they need, when they need it.
Every major healthcare company now has its own internal platform, built and maintained with AI, tailored specifically for their workflows. AI agents orchestrate tasks, data moves seamlessly across systems, and vendor lock-in is a relic of the past.
At first glance, this seems like a utopia:
• Lower costs: No more paying SaaS vendors just to connect disparate systems.
• Faster innovation: Companies iterate on their own platforms instead of waiting for a vendor roadmap.
• More control: Custom-built solutions perfectly align with business needs.
But here’s the risk: we’ve been here before.
Instead of a fragmented vendor ecosystem, we may end up with a fragmented enterprise ecosystem.
Without standards-based protocols, every company’s internal platform could become yet another walled garden.
The irony? We’d just be replacing vendor-driven silos with company-driven silos—undoing decades of work toward interoperability.
How Mergers & Acquisitions Will Be Impacted
Historically, M&A in healthcare and healthtech has been driven by three key factors:
1. Acquiring technology – Companies buy startups to integrate new capabilities into their ecosystem.
2. Expanding customer base – Larger companies acquire smaller ones to gain market share.
3. Achieving economies of scale – Consolidation leads to cost efficiencies.
But in a future where every enterprise has built its own AI-powered platform, acquisitions get far more complicated.
• Technology buys become less attractive – If every company already has an AI-driven tech stack, why buy another company just for its software?
• Integration challenges will be worse than ever – Instead of merging systems, acquiring companies might have to completely rebuild everything from scratch.
• The focus will shift to data, not software – If software can be built in-house at low cost, then the real asset in M&A is data and distribution.
M&A won’t stop, but it will shift from technology-driven acquisitions to ecosystem-driven acquisitions. Instead of buying companies for their software, firms will acquire data assets, partnerships, and distribution channels.
How Standards-Based Protocols Can Save the Future
If we don’t want to repeat the mistakes of the past, the shift away from SaaS can’t just be about building more software in-house—it has to be about building on open standards.
A future-proof healthcare ecosystem must include:
1. AI-driven systems that are interoperable by design – not just within an organization but across the industry.
2. Common APIs and open protocols – ensuring that even if companies build their own platforms, they can still “speak” the same language.
3. A governance model for AI-driven automation – preventing a scenario where every company’s AI model behaves differently, creating chaos in claims, reimbursements, and patient care coordination.
If we blindly rush into an era where every company builds their own “platform,” without a shared framework, we risk undoing all the progress we’ve made toward connectivity.
Final Thought: The Inevitable Shift
The question isn’t whether AI will change how healthcare technology is built—it already is.
The question is:
• Will we learn from the past and build open, connected systems?
• Or will we create a future where every company has its own AI-powered ecosystem, but none of them work together?
SaaS may be dying, but if we don’t embrace standards and interoperability, we’ll just be trading one problem for another.
The companies that recognize this shift early—those that build with openness in mind—will define the next era of healthcare technology. The rest? They’ll just be walled gardens waiting to be torn down.
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