iKang Healthcare Group, serving nearly 10 million patients annually, built a centralized healthcare data hub powered by Apache Airflow to support its large-scale, real-time clinical operations. The platform integrates batch and streaming data in a lakehouse architecture, orchestrating complex workflows from data ingestion (HL7/FHIR) to clinical decision support. Healthcare data’s inherent complexity—spanning structured lab results to unstructured clinical notes—requires dynamic, reliable orchestration. iKang uses Airflow’s DAGs, extensibility, and workflow-as-code capabilities to address challenges like multi-system coordination, semantic data linking, and fault-tolerant automation. iKang extended Airflow with cross-DAG event triggers, task priority weights, LLM-driven clinical text processing, and a visual drag-and-drop DAG builder for medical teams. These innovations improved diagnostic turnaround, patient safety, and cross-system workflow visibility. iKang’s work demonstrates Airflow’s power in transforming healthcare data infrastructure and advancing intelligent, scalable patient care.