Clinical care is a small part of the health equation. Could AI make up the difference?

Nasim Afsar, M.D., M.H.M., MBA, is enthusiastic about the opportunities that can emerge from digital health technology. Yet when she shares her vision with healthcare technology executives, not everyone is equally receptive.

“It depends on if people are thinking really short term,” she says, “or if they are willing to be leaders in the intermediate term.”

In a world of rapid change and technological advancement, Afsar is all in on artificial intelligence (AI). However, she also rejects the notion that healthcare leaders can simply plug AI into the existing healthcare system.

“In the really short term, there is a lot of money that could be made with solutions that are not optimal for the longer term,” she says. “But I think for those who want to lead in the longer term, people are very excited to have these conversations. They know that this is where things are going, and they need to align.”

Afsar is well positioned to make such claims. She is the former senior vice president and chief health officer at Oracle, where she helped develop tools that leverage AI to assist clinicians. She previously was chief operating officer at the University of California, Irvine’s UCI Health, leading the organization’s launch of new telehealth and hospital-at-home programs, as well as large-scale population health and healthcare quality initiatives. Along the way, she served as the president of the board of directors of the Society of Hospital Medicine.

Her latest venture is a book, “Intelligent Health: The Movement to Unify Data, Harness AI, and Empower People to Thrive.” The book, published in March 2026, is a call to action, arguing for a holistic reimagining and realignment of the healthcare industry. In it, she calls on leaders to turn away from the heavily siloed, transaction-based status quo and instead embrace a more holistic, preventive and data-driven approach.

Her premise is that healthcare leaders can build a system that optimizes human health by using AI to make sense of disparate healthcare data, leveraging AI while also giving patients clear control over their data. She notes that although many healthcare organizations have expressed a willingness to integrate AI into their operations, the new technology has largely served to fill existing gaps. That’s why Afsar’s case is not only about championing technology but also about championing a holistic mindset.

“This is such a large and complicated problem that you’re going to need multiple stakeholders at the table to try and figure out how we do this better,” she says.

Dealing with the 80%

Underlying Afsar’s message is the notion that clinical care makes up only a fraction of a patient’s overall health picture. Likewise, the data typically recorded in patients’ electronic health records capture only a fraction of the insights needed to holistically address a patient’s health.

“The clinic or hospital data is about 20% of what determines our health,” Afsar says. “All this other stuff is the 80% of what determines our health. Those data streams need to be brought together, and intelligence needs to be applied to that entire data set.”

Afsar’s 80-20 split is consistent with a landmark 2016 study published in the American Journal of Preventive Medicine that analyzed county-by-county health rankings. The results showed that patient behavior, socioeconomic factors and the physical environment have much more to do with determining a patient’s health than clinical care.

Technology could presumably bring more useful data into healthcare conversations via wearable devices, smartphone apps and other technology. Afsar says that such data usually get left by the wayside, even if the patient brings the data with them to the clinic.

“The clinician doesn’t need data,” she says. “They need the interpretation of the data.”

It’s not feasible for a physician to spend valuable patient-care time trying to interpret a data set. “Honestly,” she says, “nor should they.”

It would be better to use software to interpret such data and generate meaningful insights, she explains. “And then you’ll be able to say, ‘Now that I have the signal out of the noise, what am I going to do about the signal?’”

AI and equity concerns

Insofar as this new healthcare future is built on intelligent use of data, it also carries the risk of exacerbating existing inequalities within the healthcare system. Although AI can make meaning out of disparate data sets, the type and quality of data available for a given patient may vary significantly depending on, for example, whether they can afford, say, an Apple Watch. Afsar says the new healthcare system needs to be designed to deal with such barriers.

“You have to build [the new ecosystem] understanding the different groups that are going to use it,” she says. “The technology has to be seamless and easily accessible like it is on our phones.”

She notes that a smartphone can be a valuable tool in an AI-driven healthcare system. For instance, a patient might not have a smart ring that performs biometric monitoring, “but they do have an ability with their phone to take a picture of what they eat, or there is geolocation that can let them know about air quality or safe walking paths,” she says.

Moreover, an intelligent health system would use behavioral economics to make well-informed suggestions to patients, for instance, when they are shopping for groceries. It could nudge the patient to buy the baked potato chips instead of the deep-fried chips.

“Even if one out of every five times they are choosing something different, the addition of that over a lifetime could really add up,” she says.

A unique moment in time

Though Afsar is calling for a transformation of a change-averse industry, she is optimistic that the current moment is favorable not just from a technology standpoint but also from a business standpoint.

“Part of what makes this a unique time is that the economics are working out,” she says. “From the standpoint of payers for healthcare — the insurance companies, as well as employers — the current cost of healthcare isn’t sustainable.”

That’s why payers have increasingly turned their attention to wellness initiatives. For instance, many insurers and employers are partnering with grocery store chains to incentivize the purchase of healthy foods. Such programs, she says, demonstrate that the industry is finding ways to make an economic case for prevention.

In addition, Afsar notes that consumers spend hundreds of billions of dollars each year on consumer healthcare products, a category that increasingly includes digital tools. “So I feel like the consumer is there and ready to spend,” she says.

The path may not be so easy on the provider side. “I think this is where we could have some challenges,” she says. “If you are on a traditional fee-for-service model, this could potentially hurt your bottom line.”

She says organizations that have an innovative, prevention-focused mindset can be leaders in the healthcare transformation, and she believes evolution in other parts of the healthcare sector will eventually make the economics work, even for fee-for-service die-hards.

“I do think we’re at this unique point where the economics of this are aligned between multiple stakeholders that wouldn’t have otherwise come together,” she says.

Ultimately, Afsar says she doesn’t begrudge those who are slow to embrace change. She says a clear-eyed approach is warranted to ensure the healthcare system can take full advantage of synergies without further entrenching inefficiencies. What’s needed, she says, is a nuanced understanding of a complex — but critically important — problem.

“The reality is that there’s tremendous potential,” she says, “but we have to be very intentional about that, and we have to proceed with responsibility and accountability.”