The Missing Ingredient in Healthcare AI Adoption: Accountability

Dreamforce always offers a glimpse into where enterprise technology is heading. This year, the message is especially clear: AI is moving from experimentation into the systems, workflows, and decisions that power everyday business. Here are five developments the Kona Kai team is watching closely: 1. AI agents are taking on more meaningful work Agentforce continues to evolve beyond simple tasks. Salesforce’s newest agents are designed to pursue longer-term goals, learn new skills, collaborate with other agents, and handle more complex work across sales, service, commerce, and workforce operations. 2. Salesforce is building AI specifically for CRM reasoning One of the biggest announcements is Koa, Salesforce’s first CRM reasoning model, developed with NVIDIA. Koa is purpose-built to help agents reason through complex, multistep enterprise workflows using nearly three decades of Salesforce CRM intelligence. 3. AIforce is taking Salesforce beyond the traditional CRM interface Salesforce introduced AIforce , a new live interface layer that essentially makes Salesforce’s data, workflows, business logic, permissions, security, and governance available within the AI tools where people are already working. That means employees and AI agents can interact with Salesforce capabilities through experiences like Claude, Slack, and custom AI interfaces without always having to work directly inside the traditional Salesforce UI. AIforce is launching with Claudeforce, Slackforce, and Agentforce Coworker. For enterprises, that could fundamentally change how employees interact with CRM while making strong data architecture, permissions, and governance even more important. 4. Slack is becoming a true AI workspace Salesforce continues to position Slack as a place where people, agents, enterprise data, and workflows come together. Instead of AI existing as a separate tool, the goal is to bring intelligence and actions directly into the conversations where work is already happening. 5. Governance is becoming part of the AI infrastructure As agents become more autonomous and Salesforce capabilities become available across more interfaces, trust and governance have to evolve with them. It reinforces something we talk about often at Kona Kai: successful AI adoption depends on more than deploying the technology. Organizations need the right governance, people, data, and processes around it. Our biggest takeaway The conversation is shifting from “What can AI do?” to “How do we operationalize it responsibly across the enterprise?” The announcements coming out of Dreamforce show just how quickly the technology is evolving. For organizations, the opportunity now is to make sure their strategy, systems, data, and people are ready to evolve with it.

AI is changing workforce training from a one-time project into a continuous business capability. For decades, enterprise technology transformations have followed a predictable pattern. A new system is implemented, then employees learn how to use it. Productivity dips for a while, then recovers as the organization adapts. Whether it was a CRM implementation, ERP modernization, a claims platform replacement, or a core banking upgrade, the skills gap eventually disappeared because the technology itself stopped changing. AI is different. Unlike traditional enterprise software, AI capabilities continue to evolve after implementation. New models are released, AI agents become more capable, and workflows change faster than most organizations can retrain employees. The result is a workforce that isn't simply learning a new system, but continuously adapting to one. That fundamentally changes how organizations should think about workforce readiness. Recent research from the World Economic Forum and Microsoft's Work Trend Index suggests many organizations already recognize the challenge. Are enterprises doing enough to prepare for a skills gap that may never close? AI Changes the Rules for Workforce Training Traditional enterprise software had a finish line. Once employees learned the new system, their knowledge remained valuable for years. Training programs could be planned, measured, completed, and archived because the technology itself remained relatively stable. AI doesn't offer that stability. Employees who learned effective prompting techniques six months ago may now be using AI agents. Teams that started with document generation may now be automating entire workflows. Capabilities continue to expand, changing what effective work looks like almost as quickly as organizations can document it. That means workforce readiness can no longer be viewed as a milestone that follows implementation, as it needs to become part of day-to-day operations. The AI Skills Gap Doesn't End After Go-Live The challenge isn't simply that AI is changing jobs. It's that AI itself keeps changing. Foundation models continue to improve. New copilots are released. AI agents take on increasingly sophisticated tasks. Features that didn't exist six months ago become standard workflow tomorrow. Employees aren’t learning one “system” because they need to continuously adapt to new capabilities. Someone who learned the most effective way to use AI six months ago may already be working differently today. Traditional training models weren't designed for that pace of change. AI Is Reshaping the Workforce Faster Than Organizations Can Respond The World Economic Forum's Future of Jobs Report 2025 highlights just how significant this challenge has become.

PwC's April 2026 AI Performance Study surveyed 1,217 senior executives across 25 sectors and found something that should reframe how every regulated organization talks about AI investment: nearly three quarters of AI's economic value is being captured by just one fifth of organizations. Not because that top fifth has better models. PwC is specific about the differentiator: those organizations are 1.7 times more likely to have a Responsible AI framework and 1.5 times more likely to have a cross functional AI governance board. Their employees trust AI outputs at twice the rate of everyone else's. The value gap is structural, not a matter of who bought the better tool. That finding lands differently once you connect it to where trust actually comes from. It doesn't come from a more sophisticated model. It comes from knowing where your data originated, who touched it along the way, and what controls sat around it the entire time.  McKinsey's June 2026 research on AI data readiness makes the case that most organizations manage data like a storage problem when they should be managing it like a supply chain. A single PDF can expand into extracted text, tables, images, metadata, sensitivity tags, and quality scores, each one an intermediate artifact that AI systems reuse and recombine downstream. A small error introduced upstream doesn't stay small. It propagates. This matters more in regulated industries than almost anywhere else, because the data causing the most exposure is usually the data getting the least attention. Structured fields get governed. Clinical notes, claim narratives, loan officer comments, and audit trails, the unstructured stuff, usually don't, even though AI systems depend on it heavily. Gartner and IDC both put the share of enterprise data that is unstructured at somewhere around 80 to 90 percent. McKinsey's own research doesn't cite that specific figure, but makes the same underlying point: unstructured content is where AI systems draw the most context, and where governance attention is thinnest. None of this is an argument for waiting until your data is perfect before you deploy anything. PwC's 2026 Digital Trends in Operations Survey argues directly against that instinct: AI can help bridge data gaps, particularly through agents that reason using whatever data is actually available. The real mandate isn't clean data as a prerequisite. It's disciplined governance and iterative improvement running in parallel with deployment, calibrated to how much risk a given use case actually carries. So what does that look like in practice for a CIO or CDO sitting inside a regulated organization right now? A few diagnostic questions worth asking before your next AI initiative launches: Where does data quality actually break down in your pipeline, and does anyone own fixing it? Is lineage visible for the data feeding your highest risk AI use cases, or is it assumed? Where do unstructured assets, like clinical notes, policy documents, and loan files, enter your systems without any governance attached? Have you defined what "good enough" data quality means for each use case, calibrated to its actual risk profile, rather than applying one standard everywhere? Answering those honestly is uncomfortable in most organizations, because the answer is usually "we don't fully know." That's the point. You cannot govern what you cannot see, and you cannot trust an AI output built on a data foundation nobody has actually traced. The organizations in PwC's top 20 percent didn't get there by waiting for perfect data or by buying a better model. They got there by treating governance as a financial performance variable, not a compliance checkbox, and by building the lineage and controls that make trust possible at scale. Kona Kai's data supply chain assessment is built to answer exactly these questions before tool selection, not after. If you're not certain where your organization would land on that list, that uncertainty is worth resolving now. Get in touch to talk through what the assessment covers. Sources: PwC 2026 AI Performance Study, April 13, 2026 (74%/20% figure and 1.7x/1.5x/2x multipliers confirmed directly at pwc.com); McKinsey, AI Data Readiness: The Key to Scaling Impact, June 2026; Gartner and IDC estimates for the 80-90% unstructured data share; PwC 2026 Digital Trends in Operations Survey.

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