Healthcare · Agentic Operations Layer

The AI operations layer
for your hospital.

Put a team of agents on yourintake.

Rach.Dev runs intake, triage, clinical documentation, scheduling, CPT/ICD-10-CM coding and ICU monitoring across the systems you already use — with a clinician in the loop on every clinical decision, and a full audit trail on every action.

HIPAA-aligned by designWorks with your existing EHRClinician-in-the-loopEnglish & Spanish
The operating picture

What an agent team takes off your floor

Most of a hospital's load isn't clinical judgement — it's coordination, paperwork and chasing. Here's where agents own the busywork, mapped to how your hospital actually runs.

In demo

The Front Door

Every inquiry captured, qualified and routed — 24/7, in English or Spanish.

  • Multi-channel intake (walk-in, phone, SMS, patient portal)
  • Identity match & EHR record linkage
  • Insurance eligibility & benefits verification
In demo

Triage & Safety

Severity scoring with explicit red-flag detection and instant escalation.

  • Routes to ER, clinic or specialist by acuity
  • Red-flag alerts page the on-call clinician
  • Matches to the right available provider
In demo

Clinical Encounter

Pre-charting, ambient notes and cited references — the clinician decides.

  • Charts pre-filled with history & meds
  • Ambient note + e-prescription draft
  • Drug-interaction checks on every order
In demo

Diagnostics

The full loop, with critical results escalated the moment they land.

  • Order → collection → result → routing
  • Critical-value alerts to the ordering provider
  • Imaging via cleared partner systems
In demo

Care Coordination

Beds, referrals, discharge and the follow-up patients never get.

  • Scheduling, bed / OR & referral orchestration
  • Auto discharge summary + med reconciliation
  • Reminders & adherence nudges (EN / ES)
In demo

Revenue & Coding

The fastest ROI for a CFO: catch every charge, clean every claim.

  • CPT + ICD-10-CM coding from the note
  • Charge capture & claim generation
  • Prior-auth & denial-risk flags before submission
In your build

Back-Office & Workforce

Rosters, credentialing and the compliance paperwork no one wants to do.

  • Schedules, rosters & PTO (HR self-serve)
  • Joint Commission / incident / reportable-condition filing
  • Patient feedback & complaint handling
In demo

Knowledge Layer

A role-aware assistant grounded only in your approved sources.

  • Separate views for patient, clinician, staff
  • Every answer cites its source
  • Hard guardrails — never a diagnosis

Watch the team run a case

Pick a case and press play. Watch the agent team run it end to end — a clinician approves every clinical action.

Control Tower
Robert Daniels · 58 / MChest pain, diaphoretic — walk-in
Walk-in · ER
Front Door
Triage
Encounter
Diagnostics
Decision
Coordination
Follow-up
Agents
AvaFront Desk · Intake
Idle
MarcusTriage & Safety
Idle
NoraClinical Scribe
Idle
OwenCare Coordination
Idle
RileyRevenue & Coding
Idle
IrisKnowledge Assistant
Idle
HopeICU Sentinel
Idle
Decision trace0/7

Press Run the journey — or scroll in and watch it play automatically. Every clinical action waits for a clinician.

Every clinical action waits for a clinician. Rach.Dev drafts, stages and routes — a human approves.

Seven specialists, one conductor

Each agent owns one job and hands the next a complete, structured context. Atlas routes the work, enforces the human-in-the-loop gates, and writes every action to an audit log.

Atlas

Atlas is the orchestrator. It routes each case to the right specialist, carries shared patient context between them, pauses for clinician approval on every clinical action, and records a complete, timestamped audit trail.

Live handoff pipeline
AvaIntake
MarcusTriage
NoraScribe
OwenCoord
RileyBilling
IrisKnowledge
HopeICU

Click Ava below — the full intake-to-billing workflow plays out automatically.

MarcusTriage & Safety

Triage & safety. Scores acuity, watches for red flags, and escalates straight to the on-call clinician — never sitting on a dangerous symptom.

Context from Ava
Karen Mitchell, 45 / FT2DM follow-upStable vitals
Acuity scored — routine follow-up, no same-day risk
Red-flag scan clear (no chest pain, no hypoglycemia)
Escalation path armed if anything changes at check-in
Acuity scoringRed-flag detectionEscalation
NoraClinical Scribe

Clinical scribe. Pre-charts the visit, drafts the ambient note and orders, and checks every prescription for interactions — leaving the clinician to decide, not type.

Context from Marcus
Routine follow-upLast A1c 8.1%Meds: metformin, lisinopril
Chart pre-filled with history, meds and overdue screenings
Metformin refill drafted from the note
Interaction check clean — flagged for physician e-signature

Draft only. The prescription is sent solely after a clinician signs.

Pre-chartingAmbient notesDrug-interaction checks
OwenCare Coordination

Care coordination. Books visits, orders labs ahead, routes referrals and prescriptions, and keeps patients on track with reminders and adherence nudges.

Context from Nora
A1c + lipid panele-Rx → pharmacyCare gap: eye exam
Standing labs queued so results are ready at the visit
e-Rx routed to the patient's pharmacy after sign-off
Visit + lab reminders scheduled; eye-exam referral opened
SchedulingReferrals & labsReminders
RileyRevenue & Coding

Revenue & coding. Codes the encounter from the note in CPT and ICD-10-CM, captures every charge, and clears prior-auth and denial risk before the claim ever goes out.

Context from Owen
99214 follow-upE11.9 · I10Labs: 83036, 80061
Encounter coded from the note — CPT + ICD-10-CM
Charges captured; payer rules checked for this plan
Prior-auth not required; denial-risk scan clean → claim staged
CPT / ICD-10-CMCharge captureDenial & prior-auth
IrisKnowledge Assistant

The role-aware knowledge assistant. Answers patients, clinicians and staff from your approved sources only — every answer cited, and never a diagnosis.

Context from Riley
Patient viewApproved sources onlyEN / ES
Answered the patient's questions from approved materials
Every answer carried its source citation
Clinical-advice request → handed to a clinician, not answered

Iris informs. It never diagnoses, prescribes or overrides a clinician.

Role-awareCited answersNever a diagnosis
HopeICU Sentinel

The ICU Sentinel. Always on, reading the live signal stream for every monitored patient — flagging silent deterioration hours before it becomes a code, and staging the response for the care team.

Context from the care team
Post-admit telemetrySepsis risk: elevatedRenal: watch
How Hope calibrates for this patient
Baselines vitals, labs and meds for this specific patient
Tightens thresholds for known cardiac + renal risk
Suppresses nuisance alarms to cut alert fatigue
What Hope reads in real time
HR / rhythmBP / MAPSpO₂ / RRTempUrine outputLabs
Silent ischemia — ST-segment drift with no symptoms
Sepsis — rising lactate with MAP trending down
Respiratory — falling SpO₂ as respiratory rate climbs
Acute kidney injury — urine output below threshold
Arrhythmia — new-onset AFib or runs of VT
Neuro — trending change in responsiveness

Hope is advisory. It alerts and stages — a clinician decides and acts. Every alert is logged with the signal that triggered it.

Live · ICUAlways-on monitorEarly-warningAdvisory only

Ava captures patient intake by voice, then hands a structured summary to 6 downstream agents — triage, documentation, coordination, billing, knowledge and ICU monitoring — each acting on the shared context, with Atlas orchestrating and a clinician approving every clinical action.

Ava starts the workflow.

One layer over the systems you already run

Rach.Dev sits on top of your EHR and existing tools — orchestrating agents, enforcing governance, and keeping a clinician in the loop. No rip-and-replace.

Layer 4Human-in-the-loop

Every clinical action — orders, prescriptions, admissions — pauses for a clinician to approve. Agents draft and stage; people decide.

Approval gatesClinician sign-offRole-based access
Layer 3Governance & audit

HIPAA-aligned controls, minimum-necessary access, and a complete, timestamped audit trail on every action and every data touch.

HIPAA-alignedFull audit logPHI minimizationSource citations
Layer 2Agent orchestration

Atlas routes each case to the right specialist, carries shared context between agents, and coordinates hand-offs end to end.

Routing & hand-offShared contextEscalation paths
Layer 1Integration

Bidirectional connectors to your EHR, telephony, clearinghouse and labs over the standards your systems already speak.

HL7 / FHIRSMART on FHIRWebhooks & APIs
Works with the systems you already run
EpicOracle Health (Cerner)athenahealtheClinicalWorksMEDITECHTwilioAvailityChange HealthcareLabCorpQuest Diagnostics

A knowledge layer that knows its limits

Iris answers patients, clinicians and staff from your approved sources only. Every answer is cited — and a clinical question is always handed to a clinician, never diagnosed.

Try a question

IrisPatient view

Hi, I'm Iris. Ask me about appointments, billing or your care instructions — I'll always cite my source.

Iris provides information only — never a diagnosis, prescription or medical advice. Anything clinical is routed to a licensed clinician.

A knowledge layer that knows its limits — questions and answers

When is my next appointment?
Your next visit is a diabetes follow-up with Dr. Priya Shah on Tuesday, June 17 at 9:40 AM. Please arrive 15 minutes early and bring your current medications. You can reschedule anytime from your patient portal or by replying here.
¿Cuánto voy a pagar por la visita?
Según su plan, esta visita de seguimiento tiene un copago de $25, que se cobra al registrarse. Los análisis de laboratorio se facturan por separado a su seguro. Si necesita un estimado detallado, puedo conectarla con facturación.
Is it safe to take my metformin with the new medication?
That's a clinical question, so I won't advise on it myself. I've flagged your medication list and routed your question to a pharmacist and your care team, who will follow up. If you feel unwell, call 911 or go to the nearest ER.

Governance, not just guardrails

The controls that let a hospital actually deploy agents — enforced in the system, not promised on a slide.

Clinician in the loopEvery order, prescription and admission waits for a licensed clinician to approve. No agent takes a clinical action on its own.
Complete audit trailEvery action, hand-off and data access is logged with a timestamp, the agent, the source and the approver — exportable on demand.
HIPAA-aligned by designMinimum-necessary PHI access, encryption in transit and at rest, role-based permissions, and a signed BAA — privacy built in, not bolted on.
Grounded with sourcesAnswers come only from your approved knowledge sources and cite them. No open-web guessing, no ungrounded claims.
No vendor lock-inStandards-based connectors (HL7 / FHIR) and your data stays yours. Turn an agent off and your systems keep running.

Live audit log

A sample of what every action looks like on the record.

23:41:02Inbound SMS (es) received & answered — patient #4821Logged
09:12:55Insurance eligibility verified — copay $25Verified
09:13:20PHI accessed: chart pre-load (minimum necessary)PHI
09:15:08e-Rx drafted — metformin 1000mg, awaiting sign-offPending
09:15:47Prescription approved by Dr. Priya Shah, PCPApproved
14:02:31Red-flag (possible ACS) — on-call physician pagedEscalated

What changes when agents own the busywork

Directional outcomes our pilots target — validated on your own data, never assumed.

24/7
Coverage, every channel
Phone, SMS and portal answered around the clock, in English and Spanish — no after-hours voicemail.
Minutes
From intake to chart
Registration, eligibility and pre-charting done before the patient is in the room.
Cleaner
Claims out the door
Coding, charge capture and denial checks before submission — fewer reworks, faster cash.
Hours back
For clinicians
Less typing and chasing, more time on the care that needs human judgment.

The problem, in numbers

  • Physicians and their staff report prior authorization is a high or extremely high burden, completing dozens of authorizations per physician each week. AMA, 2023 Prior Authorization Physician Survey
  • For every hour of direct patient care, physicians spend roughly two additional hours on EHR and desk work during the clinic day. Sinsky et al., Annals of Internal Medicine, 2016
  • Administrative transactions cost the US healthcare system tens of billions a year, with large savings available from automating eligibility, prior auth and claims. CAQH Index, 2023

Figures above are external benchmarks and pilot targets, not guarantees — we validate every number on your own data before you rely on it. Monitoring agents are advisory: they alert and stage, a clinician acts.

Start with one service line. Prove it. Then scale.

We stand up a single workflow on your existing EHR, show the audit trail and the outcomes, and expand only once your team trusts it.

01
Scope one workflow

Pick the highest-pain workflow — intake, prior auth or ICU monitoring — and we map it to your systems.

02
Pilot in your environment

Agents run on your EHR with a clinician in the loop and a full audit trail, in weeks not quarters.

03
Measure, then expand

Review the outcomes on your own data, then roll the agent team out service line by service line.