That's rarely because of a lack of technology, though. Entrenched business processes, human bias, "old boy networks", fear of losing jobs, etc. are far bigger factors in things outside of SV often sucking. You can build the perfect solution for a problem at an amazing price and Accenture would still win because the people making the decisions want Accenture, not the actual best solution.

> So much time is waiting executing rote processes by hand across industries

I've personally seen many times how companies prefer doing those hand processes, even after having paid me for developing a solution to solves that. Humans are strange creatures.

The big problems that most people want solved and can indeed be solved have already been solved. For the most part we're now in the phase of solving small problems, refining current solutions, and maybe creating new problems with its own set of solutions.

Of course there are many big problems that haven't been solved because those are extremely difficult and expensive to solve which falls outside of the realm of startups. For example an HIV vaccine, super efficient solar cells, cold fusion, efficient energy storage, brain computer interface, dark energy, dark matter, etc.