A Measured Prescription for AI-Driven CX in Healthcare

Authors: Beth Schultz, VP of Research and Principal Analyst As patients navigate today’s healthcare systems, they have high expectations, as consumers, that responses to their outreach will be prompt, accurate, and personalized—no matter whether they’ve placed a call or engaged via a digital channel. The jury is still out on how healthcare providers are meeting these expectations. Among the 503 consumers in North America that participated in our Customer Experience Optimization: 2025-26 – Consumer Views study, conducted in late 2025, 12.5% rated their healthcare interactions as among the top three best customer service experiences they’ve had within the past year. But 7.4% said that healthcare interactions were the worst experiences they’ve had. While the delta between best and worst is positive, at 5.1%, there’s certainly room for improvement. For healthcare providers, the onus is to improve patient experience such as to ensure that interactions are among the best. Artificial intelligence (AI) represents a critical technology for achieving this goal. At this point, the necessity of establishing a strong AI-based CX strategy and technology underpinning is all but a given—not just for healthcare, of course, but across all industries. In turn, the knowledge management (KM) strategy and infrastructure must be ready, or AI-based CX initiatives will be for naught. In preparing for AI, healthcare organizations must balance the drive for technological innovation with the unforgiving realities of clinical accuracy, stringent regulatory compliance, and the protection of highly sensitive protected health information (PHI). There’s no misdiagnosing the criticality of having pristine knowledge for healthcare providers. In this environment, after all, a hallucinated AI response regarding a billing dispute, recommended treatment, or medical policy is not merely an inconvenience but rather represents a critical operational and legal liability—not to mention putting a patient’s wellbeing at stake. Because of these high stakes, the healthcare industry is forging a distinct path in establishing a knowledge foundation for CX. Based on Metrigy’s global Data Stores & Knowledge Management: 2025-26 research study with 393 companies, this issue paper examines the strategic realities, operational challenges, and financial planning defining the healthcare sector's CX knowledge journey.

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Table of Contents

• Introduction
• The New Baseline: How Knowledge Strategies are Evolving for AI
• Centralized Knowledge
• Agent Assist, Customer/Patient Self-Service
• Maintenance Pain Point
• Strategic Leadership and Rigorous Vendor Preparation
• Reality Check: Bot Containment, Modest Gains, and Agent Experience
• Success with Bot Containment
• The 2026 Financial Strategy: Targeted Budgets Driven by AI Search
• Conclusion
• Working With Metrigy