Build vs. Buy Agentic AI: A Strategic Healthcare Decision

Healthcare organizations are rapidly embracing AI, but many are asking the wrong question: Should we build AI or buy it? The better question is: Which capabilities should we own, and which should we outsource? The answer can determine whether AI becomes a competitive advantage or simply another technology investment. 

The New Reality: Buy the Foundation, Build the Differentiation 

The traditional build-versus-buy debate is no longer relevant. Leading health systems are adopting a hybrid approach: buy foundational, compliance-heavy capabilities and build the intelligence that differentiates their organization. 

Industry data supports this shift. According to Deloitte’s 2025 survey of healthcare executives, 40% of leaders no longer view technical talent as a major barrier to AI adoption. Yet only 31% of AI initiatives have reached production, indicating that strategy not technology is now the primary challenge. 

When Buying Makes Sense 

Buying AI is often the fastest and lowest-risk path to value. Commercial solutions offer: 

• Faster deployment and time-to-value 

• Lower upfront investment 

• Built-in compliance and governance 

• Continuous product innovation

A strong example is Nuance DAX Copilot, which has been deployed across more than 500 health systems and has reduced clinical documentation time by 50% per encounter while increasing clinician satisfaction by 22 percentage points. 

Similarly, Epic reported at HIMSS 2026 that 85% of its customers are actively using Epic AI, demonstrating the growing demand for AI capabilities embedded directly into clinical workflows. 

The challenge, however, is that every competitor can purchase the same technology. Buying AI often delivers efficiency but rarely creates lasting differentiation. 

When Building AI Creates Competitive Advantage 

Building AI becomes valuable when it is tightly linked to an organization’s unique care model, patient population, or operational strategy. 

Examples include: 

• Readmission prevention programs 

• Population health management 

• Personalized patient engagement 

• Clinical decision support 

• Surgical workflow optimization

These capabilities often rely on proprietary data, clinical expertise, and workflows that cannot be replicated through off-the-shelf software. 

Organizations that own their data and intelligence can create significant long-term value. Tempus, for example, built its own analytics platform and now manages 45+ million de-identified patient records and over 7 billion clinical notes, helping drive annual revenues exceeding $1.2 billion. 

Compliance Must Be Part of the Decision 

Whether organizations build or buy, compliance remains a critical factor. Agentic AI systems can access patient records, trigger workflows, and make decisions that directly impact operations and care delivery. 

Healthcare leaders should evaluate: 

• HIPAA compliance and minimum necessary access 

• HITRUST and SOC 2 certifications 

• Data governance and auditability 

• Third-party risk exposure 

According to the Ponemon Institute and Imprivata 2025 Report, nearly 50% of health IT leaders experienced a cyberattack or breach involving third-party access within the previous year. This highlights the importance of governance regardless of deployment strategy. 

The Emerging Middle Path 

Healthcare organizations no longer need to choose between fully building or fully buying. Companies like Nallas Corporation allow organizations to build custom AI agents within existing healthcare ecosystems while leveraging established security and governance controls. 

This approach offers a balance between customization and speed, though organizations must carefully consider platform dependency and portability requirements. 

The Strategic Takeaway 

The future of healthcare AI is not Build vs. Buy—it is Build and Buy. 

• Buy capabilities that are standardized, compliance-intensive, and operational. 

• Build capabilities that create differentiation and improve patient outcomes. 

• Leverage platforms when customization is needed without the cost of building from scratch.

The healthcare organizations that succeed over the next decade will be those that strategically determine what intelligence to rent and what intelligence to own. AI adoption is no longer a technology decision—it is a business strategy decision. 

Sources: Deloitte Center for Health Solutions Agentic AI Survey (2025), Deloitte Global Health Care Outlook (2026), State of Enterprise AI Adoption Report (2026), Ponemon Institute & Imprivata Third-Party Risk Report (2025), HIMSS 2026 Coverage, Becker’s Hospital Review.