Mission Viejo is big enough that most of its businesses already bought software. Medical and dental practices, physical therapy and imaging, tutoring centers, family service companies and the retail around the mall each run on a system somebody chose three or four years ago. The systems work. They do not talk to each other, and the front desk is what fills the space between them.
That space has a price, and it is paid in people. A patient calls to reschedule, so a staff member opens the calendar, the billing system and the reminder tool in turn. A new client fills out a paper form that somebody retypes. A referral arrives by fax and sits until a person notices it. Reminder calls go out one at a time because nobody switched on the automatic ones. Each of those is a trained employee doing work a system was already paid to do.
We drive up from San Diego for this, about an hour and fifteen minutes, and we do it in person because this problem is invisible on a video call. We sit with the front desk for a morning and trace one patient from the first phone call to the paid claim, count the handoffs, then rank the fixes with build costs written next to each. Some of what we find is a setting in software you own, and that still counts.