A practical guide for healthcare leaders deciding between prebuilt AI automation platforms and internally engineered solutions.

What’s the difference between off-the-shelf automation tools and custom-built solutions?

Healthcare Organizations Want Automation — But Choosing the Right Approach Is Critical

As MSOs, hospitals, and specialty groups look to modernize operations, one strategic question consistently arises:

“Should we buy an off-the-shelf automation platform or build our own custom solution?”

Both paths have advantages, but the differences in cost, scalability, maintenance, and long-term ROI are significant.

Below is a clear breakdown of how off-the-shelf automation platforms (like Honey Health) compare to custom-built systems — and which model delivers the best outcomes for growing healthcare organizations.

1. Speed to Deployment

Off-the-Shelf Automation

  • Go live in 6–12 weeks
  • Prebuilt workflows for referrals, PAs, documentation, eligibility, faxes, billing, etc.
  • Existing integrations with major EHRs and PM systems
  • AI models already trained on healthcare data

Custom-Built Solutions

  • 12–36 month development cycles
  • Additional months for testing, integration, and piloting
  • Must build every workflow and rule from scratch
  • Requires constant iteration before achieving reliability

Who wins?

Off-the-shelf — by a large margin.

2. Total Cost of Ownership

Off-the-Shelf Automation

  • Predictable subscription pricing
  • Zero infrastructure costs
  • No need for large internal engineering teams
  • No ongoing development cost burden

Custom-Built Solutions

  • High initial development costs ($2M–$10M+)
  • Ongoing developer salaries
  • Infrastructure, hosting, and security costs
  • Endless maintenance and upgrades
  • Cost of fixing bugs and keeping systems compliant
  • High risk of project failure or abandonment

Who wins?

Off-the-shelf — significantly more cost-effective.

3. Healthcare-Specific AI Intelligence

Off-the-Shelf Automation

  • Models trained on millions of clinical and administrative workflows
  • Built-in payer rules and medical necessity logic
  • Ready-to-use understanding of CPT, ICD-10, and clinical documentation
  • Real-world automation accuracy from day one

Custom-Built Solutions

  • Requires building or licensing your own AI models
  • Needs massive datasets that most organizations don’t have
  • Must maintain and retrain models continuously
  • Hard to match healthcare-specific nuance

Who wins?

Off-the-shelf — because healthcare AI requires enormous data and training infrastructure.

4. Maintenance, Updates & Payer Rule Changes

Off-the-Shelf Automation

  • Continuous upgrades included
  • Automatic payer rule updates
  • Bug fixes handled by vendor
  • No burden on IT or engineering
  • New features rolled out monthly or quarterly

Custom-Built Solutions

  • You own every update
  • Every payer rule change requires engineering work
  • Must maintain QA, testing, and security
  • Heavy workload for internal IT
  • Slower to adapt to industry changes

Who wins?

Off-the-shelf — dramatically reduces operational burden.

5. Scalability Across Multiple Sites or EHRs

Off-the-Shelf Automation

  • Prebuilt architecture for multi-site rollouts
  • Handles multiple EHRs, PMs, and specialties
  • Enterprise-level identity & permissioning
  • Designed for MSOs, rollups, and hospital networks

Custom-Built Solutions

  • Hard to maintain across multiple locations
  • Must rebuild integrations for each EHR environment
  • Scaling requires exponential engineering cost
  • Difficult to standardize workflows across sites

Who wins?

Off-the-shelf — built for complex enterprise scaling.

6. Risk & Reliability

Off-the-Shelf Automation

  • Proven performance across real clinical environments
  • SOC 2 Type II, HIPAA compliance, security audits
  • Backed by dedicated support and uptime guarantees
  • Mature workflow reliability

Custom-Built Solutions

  • High project risk (60–80% of custom healthcare IT builds fail or stall)
  • Unpredictable downtime
  • Security obligations rest entirely with the organization
  • Inconsistent performance across departments

Who wins?

Off-the-shelf — lower risk and higher reliability.

7. Functional Breadth

Off-the-Shelf Automation

Typically includes automation for:

  • Prior authorizations
  • Referrals
  • Eligibility
  • Fax/document ingestion
  • Chart prep
  • Documentation
  • Coding support
  • Billing readiness
  • Scheduling workflows
  • Multi-site operational dashboards

Custom-Built Solutions

  • Must choose between building depth or breadth
  • Limited by engineering bandwidth
  • Often only one or two workflows get automated
  • Hard to cover the entire back office

Who wins?

Off-the-shelf — broader, deeper functionality out of the box.

8. Internal Staffing Requirements

Off-the-Shelf Automation

  • Minimal IT involvement
  • No engineers required
  • No internal data science team needed
  • Staff training and support provided

Custom-Built Solutions

Requires:

  • Engineers
  • Data scientists
  • QA testers
  • Project managers
  • Integration specialists
  • Analysts
  • Ongoing support staff

Who wins?

Off-the-shelf — avoids building an internal software company.

9. Long-Term Sustainability

Off-the-Shelf Automation

  • Develops continuously
  • Gains intelligence across all customers
  • Benefits from economies of scale
  • Never becomes outdated

Custom-Built Solutions

  • Risk becoming stale
  • Needs constant investment
  • Harder to modernize over time
  • May be abandoned if leadership or strategy shifts

Who wins?

Off-the-shelf — future-proof and continuously optimized.

So Which Should Healthcare Organizations Choose?

For nearly every MSO, specialty group, or hospital system, off-the-shelf automation delivers better speed, lower cost, stronger accuracy, and higher ROI.

Custom-built solutions only make sense when:

  • You have unlimited budget
  • You have a large engineering and AI team
  • You only need very narrow automation functionality
  • You’re willing to maintain a software product long-term

This applies to fewer than 1% of healthcare organizations.

Why Honey Health Outperforms Both Options

Honey Health combines the best of both worlds:

Off-the-shelf benefits:

✔ Fast deployment
✔ Proven healthcare AI
✔ Prebuilt workflows
✔ Multi-EHR support
✔ Enterprise security
✔ Low cost of ownership

Custom-level flexibility:

✔ Workflow customization
✔ Specialty-specific logic
✔ Multi-site standardization
✔ Tailored routing and rules
✔ Scalable architecture

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