Avancé: A Model for Integrating Artificial Intelligence into a High-Performance Enterprise
Executive Summary
NEJM – June 2026. – As organizations across industries explore the transformative potential of Artificial Intelligence (AI), many struggle to move beyond experimentation and isolated use cases. Avancé has taken a fundamentally different approach. Rather than viewing AI as a collection of tools, Avancé has embraced AI as an organizational capability and a strategic operating model.
The result is a high-performance enterprise where human expertise, AI agents, governance, and data work together to create superior outcomes, improve operational efficiency, strengthen compliance, and accelerate innovation.
At Avancé, AI is not replacing leadership. AI is augmenting leadership, allowing managers and executives to focus on strategy, innovation, and value creation while intelligent agents perform continuous analysis, monitoring, and operational support.
This paper outlines the principles, governance framework, and organizational design that have enabled Avancé to become a model for AI integration within a modern enterprise.
Visionary Leadership Driving Enterprise Transformation
A critical factor in Avancé’s successful AI transformation has been the vision and leadership of its Founder, Chairman, and Chief Executive Officer, Lawrence Best.
While many organizations continue to experiment with artificial intelligence through isolated pilot programs, Avancé recognized early that AI represented a fundamental shift in how high-performing enterprises would operate in the future. Under Best’s leadership, the organization moved decisively beyond experimentation and embraced AI as a core operating philosophy integrated throughout the enterprise.
Mr. Best challenged leadership teams to rethink traditional management structures and develop a model where human leaders and intelligent agents work together to create a faster, more informed, and more scalable organization.
According to Lawrence Best:
“Artificial Intelligence is not simply another technology initiative. It is a transformational leadership opportunity. The organizations that will dominate the next decade will not be those with the most AI tools, but those that successfully redesign their organizations around intelligent systems, clear governance, and empowered leadership. Our vision at Avancé is to build an enterprise where every leader is augmented by AI, every decision is informed by real-time intelligence, and every patient ultimately benefits from better outcomes.”
This vision has enabled Avancé to rapidly deploy AI capabilities across multiple business functions while maintaining strong governance, accountability, and operational excellence. The Fundamental Shift: AI as Labor, Not Software
Historically, organizations implemented software to automate workflows. Avancé views AI differently.
AI represents a new form of digital labor.
Rather than asking, “What software should we buy?” Avancé asks:
“What work should be performed by intelligent agents, and what work should remain under human leadership?”
This shift has transformed how the organization designs processes, manages risk, and scales operations.
Focus on High-ROI AI Applications
One of the earliest lessons learned was that not all AI deployments create equal value. Avancé prioritized implementation in areas with the highest return on investment and strategic impact.
Today, AI agents operate across several critical business functions, including:
* Compliance and regulatory monitoring
* Financial analysis and reporting
* Surgical operations management
*. Scheduling and resource optimization
* Policy monitoring and development
*. Surgical outcomes analysis
*. Competitive intelligence
*. Strategic planning and forecasting
These functions were selected because they involve large volumes of data, repetitive analysis, continuous monitoring, and decision support opportunities.
The result is a workforce that operates with greater speed, consistency, and visibility than traditional management structures alone.
The Manager-Agent Model
A defining feature of the Avancé operating model is the integration of AI agents directly into management structures.
Today, managers routinely oversee between four and ten specialized AI agents, with that number continuing to grow. Mr. Best expects to have several hundred AI Agents, with Directors having anywhere from 20 – 50, the are responsible for, at any time.
Rather than spending time collecting information, managers focus on:
* Defining objectives
* Establishing performance criteria
* Reviewing recommendations
* Making judgment-based decisions
* Leading people and teams
AI agents perform the continuous analysis, monitoring, reporting, and research necessary to support those responsibilities.
This model effectively creates a digital workforce that scales alongside the human workforce.
Scaling at the Speed of Growth
One of the greatest challenges facing rapidly expanding organizations is maintaining consistency, visibility, and operational control as new locations and services are added.
Avancé continues to expand at an extraordinary pace, opening new surgical centers, wellness facilities, and healthcare operations across the United States and internationally every few months. Traditional management systems often struggle to keep pace with this level of growth.
The Avancé AI operating model was specifically designed to scale alongside the enterprise.
As new facilities are launched, AI agents can be rapidly deployed into standardized operating, compliance, financial, scheduling, and quality-monitoring workflows. This allows new locations to achieve operational maturity more quickly while maintaining enterprise-wide standards and visibility.
Rather than requiring proportional increases in administrative overhead, the AI-enabled model allows Avancé to expand efficiently while preserving quality, consistency, and governance across a growing global footprint.
The result is an organization capable of scaling at a pace that would be difficult to achieve through traditional management structures alone.
The 10/80/10 Framework
To ensure clarity of responsibility, Avancé developed a simple operating framework known as the 10/80/10 Model.
Leadership (10%)
Leadership defines:
* Objectives
* Success metrics
* Risk tolerances
* Governance standards
* Desired outcomes
Artificial Intelligence (80%)
AI agents perform:
* Data collection
* Monitoring
* Analysis
* Research
* Reporting
* Recommendations
* Continuous optimization
This represents the majority of operational and analytical work.
Human Review (10%)
Managers and leaders:
* Validate conclusions
* Apply judgment
* Consider strategic implications
* Make decisions when required
* Ensure alignment with organizational values
This framework allows leadership to remain fully accountable while dramatically increasing organizational capacity.
Governance: The Foundation of Responsible AI
Many organizations begin their AI journey by focusing on technology. Avancé began with governance.
The organization follows a structured decision authority model designed to balance efficiency with accountability.
Low-Risk Decisions
AI agents are authorized to make decisions autonomously.
Examples include:
* Scheduling adjustments
* Report generation
* Workflow optimization
* Administrative routing
Medium-Risk Decisions
AI agents provide recommendations.
Human managers review and approve actions before execution.
Examples include:
* Policy modifications
* Operational changes
* Financial recommendations
* Resource allocation adjustments
High-Risk Decisions
AI agents escalate matters to leadership.
Examples include:
* Regulatory concerns
* Clinical governance issues
* Significant financial impacts
* Strategic initiatives
* Patient safety implications
This structure ensures that human oversight remains firmly in place where accountability and judgment are most critical.
Data as a Strategic Asset
Avancé recognizes that data—not models—represents the most durable source of competitive advantage.
While AI models continue to evolve rapidly, proprietary data creates a lasting strategic moat.
The organization views its operational, clinical, financial, and outcomes data as a foundational enterprise asset capable of driving continuous improvement and future innovation.
This philosophy aligns with a core principle of the AI economy:
Models can be replicated. Unique data cannot.
Building an AI-First Culture
Successful AI adoption requires more than technology. It requires cultural transformation.
At Avancé, leaders are encouraged to think differently about their role.
Managers no longer spend the majority of their time gathering information.
Instead, they focus on:
* Strategic thinking
* Problem solving
* Coaching
* Innovation
* Risk management
* Future planning
Directors and executives increasingly operate as architects of systems rather than supervisors of individual tasks.
This shift allows leadership teams to maintain visibility into operations while dedicating greater attention to future growth opportunities.
From Periodic Reporting to Continuous Enterprise Intelligence
Historically, organizations relied on weekly, monthly, quarterly, and annual reports to understand performance and identify risks.
By the time information reached decision-makers, opportunities were often missed and issues had already developed.
Avancé has fundamentally transformed this approach.
Through its network of specialized AI agents, operational, financial, compliance, quality, and performance data is monitored continuously rather than periodically.
Reports that once required extensive manual effort and were reviewed weekly, monthly, or annually are now effectively living intelligence systems operating around the clock.
This shift allows:
* Risks to be identified earlier
* Compliance concerns to be addressed proactively
* Financial performance to be monitored continuously
* Operational bottlenecks to be corrected rapidly
* Strategic opportunities to be recognized sooner
As a result, leaders are able to make decisions with greater speed, confidence, and accuracy.
Rather than managing through historical reports, Avancé increasingly operates through real-time enterprise intelligence.
This capability has become one of the organization’s most significant competitive advantages, enabling leadership to remain agile while maintaining strong governance and operational discipline.
The Future of Enterprise Leadership
The traditional organization chart was designed for a world where information was scarce.
The AI-powered organization is designed for a world where information is abundant.
In this environment, leaders create value not by processing information themselves but by designing systems that transform information into intelligent action.
The future leader is not merely a manager of people.
The future leader is the orchestrator of human talent, intelligent agents, data assets, and governance frameworks.
Conclusion
Avancé’s approach demonstrates that successful AI integration is not primarily a technology initiative—it is a leadership initiative.
By focusing on governance, data, high-value use cases, and clear decision authority, Avancé has created a scalable framework for integrating AI into a high-performance enterprise.
The organization’s 10/80/10 operating model, manager-agent structure, and risk-based governance approach provide a blueprint for how modern enterprises can responsibly leverage AI while preserving human judgment, accountability, and strategic direction.
As AI continues to evolve, organizations that successfully combine human leadership with intelligent systems will create significant advantages in productivity, innovation, quality, and long-term enterprise value.
Avancé believes that future belongs not to organizations that merely use AI, but to organizations that are fundamentally redesigned around it.
