For most of my career we bought healthcare software and bent the practice of medicine around it. Now we build the software — alongside AI agents — and deliver care better, faster, and cheaper at the same time. This is how.
I am an interventional radiologist. I have spent thirty years at the intersection of medicine and the systems built to support it — and for most of those years, the systems won. Brilliant clinicians spent their days navigating screens, rekeying data, and chasing claims across software that was never designed to work together. We bought the tools the market sold us, and then we contorted the practice of medicine to fit them.
At CIMSS Innovative Solutions, we stopped doing that. We built an operating system for healthcare that puts the patient — not the electronic health record — at the center. We call it IHOS, the Intelligent Healthcare Operating System, productized as our PhoenixAP3M program. It runs in production today across the RCG Federation: MIMIT Health, Arogya Medical, and Advanced Clinical Imaging. It is not a concept on a whiteboard. It is how we operate.
What made it possible is a real shift in what a small, focused team can build. I want to be honest about that shift, because it is the actual story.
What Changed: We Build With Agents Now
Humans and agents, on one team
The new generation of AI — Claude, Salesforce Agentforce, Box AI — did not just hand us coding assistants. It changed the physics of building.
The leverage is not only in writing code faster, although it does that. It is in finding the real problem quickly, working with agents to design the solution, and shipping it — better, faster, and cheaper than any of us could before. I can do things I simply could not do before. I can do them faster. I need fewer people to do them. I can stand up a software solution in days that used to take a quarter and a budget.
And the obstacles that used to stop a project cold — the integration nobody could untangle, the data nobody could reconcile — we now break through by putting a human and an agent on the problem together.
“This is not automation replacing judgment. It is humans and agents working as one team — and the human stays the point.”
The clinician’s expertise and the agent’s tireless execution, combined. The agent does the navigating. The human does the caring. That is the whole design philosophy, and it is why the result feels less like new software and more like a new operating speed.
One Operating System, Not a Pile of Tools
A core, an ecosystem, and one conductor
The agentic enterprise is not a feature you switch on. It is an architecture you commit to.
IHOS is built on the Salesforce platform as its core — Health Cloud, Agentforce, Data Cloud (Data 360), Marketing Cloud, and MuleSoft — with the EHR connected at the edge through FHIR, never at the center. Around that core we have assembled the best of the wider ecosystem, and we did it as a genuine partner to each company:
Salesforce
Platform & agentic partner. Health Cloud design and implementation partner. The operating layer and the agentic runtime that conducts everything else.
AWS
Cloud partner. The infrastructure beneath the platform — and beneath Amazon Connect, which powers our 24/7 omnichannel contact center.
Box
Content partner. Box with Advanced Box AI is the intelligent content layer over everything unstructured in healthcare.
Snowflake
Data partner. Zero-copy sharing into Salesforce Data Cloud is live in production — analytics and AI ground in the same truth without ever moving the data.
Anthropic
AI partner. Claude is the primary cognitive layer we build with, reason with, and deploy alongside Agentforce every day.
Combining these is the entire point. Any one of them is a product. Orchestrated together under one operating model, with Agentforce as the conductor, they become an enterprise that thinks. PhoenixAP3M is the repeatable blueprint we use to deploy that enterprise — the same pattern, proven once and delivered many times.
The 360° Patient, Inside the Secure Boundary
Care fails when the data is fragmented
The single most valuable thing IHOS does is assemble one complete, trustworthy picture of each patient — inside the secure, compliant boundary of the health record, never outside it.
Data 360 unifies all of it: the clinical record from the EHR, the engagement and communication history, the revenue-cycle and financial data, external data brought into the ecosystem, and the unstructured content that healthcare still runs on — the documents, the reports, the records that arrive by fax. Box, with Advanced Box AI, reads and understands that unstructured content. Working with Agentforce and Claude, it turns a stack of faxed pages into structured, governed knowledge.
The result is a true 360-degree view — of the patient, the provider, the payer, and the condition. Care plans and care programs run on top of that single source of truth. And because every agent inherits the same profile, the system gets smarter as the patient moves through it. Care becomes better, faster, and cheaper — not as a trade-off, but at the same time.
The Whole Enterprise on One Engine
Not only clinical — everything
The breakthrough is not confined to the exam room. The same operating system runs the rest of the business.
Marketing, patient acquisition, the omnichannel contact center, revenue cycle management, finance, and accounting all live on the same Salesforce-native platform — sharing the same data and addressable by the same agents. An autonomous revenue-cycle pipeline reconciles claims end to end. An AI extraction agent turns a fifteen-minute document task into fifteen seconds. The deal-to-cash spine and the care-to-cash spine run on one substrate.
Running an entire healthcare organization — clinical and commercial, front office and back office — on a single intelligent operating system is, candidly, unprecedented. It is what lets a focused team operate at the scale and speed of one many times its size.
Exceeding the Quintuple Aim
Better outcomes · better experience · lower cost · clinician well-being · equity — all at once
459%
ROI in 90 days with Agentforce Health
Lower Cost
40%
more patients per provider — no added hours
Access & Throughput
<10 min
to fully onboard a new patient
Patient Experience
55%
drop in cancellations — from 40% to 18%
Equity of Access
Single digits
physician burnout, where ~half the field reports it
Care-Team Well-Being
$2M
annual cost reduction
annual cost reduction
2×
Net Promoter Score — doubled
Better Experience
+30%
patient satisfaction (CSAT)
Better Experience
4.9–5.0
average review rating, out of 5.0
Better Outcomes
Results documented and published by Salesforce — MIMIT Health customer story, salesforce.com/customer-stories/mimit-health
For a decade, healthcare has chased the Quintuple Aim: better outcomes, a better patient experience, lower cost, the well-being of the care team, and health equity. Most organizations treat these as competing goals that must be traded off against one another. IHOS treats them as one outcome of a better-built system. Better health, a better experience, lower cost, healthier clinicians, and broader access — together. That is what it means to exceed the aim rather than negotiate with it.
The Proof Is the Point
A living laboratory, not a pilot
We did not ask the market to take any of this on faith. MIMIT Health is our living laboratory: every capability is proven on our own patients before it is ever offered to a client. That makes IHOS a proof point, not a prospect — and it makes CIMSS a different kind of partner.
When CIMSS engages a health system, I speak with their clinical leadership as a physician who has run this system himself, and our architects speak with their engineers as people who have built it. We are not selling billable hours or a slide deck. We are offering a working blueprint and the partner ecosystem — Salesforce, AWS, Box, Snowflake, and Anthropic — to deploy it.
