For practice administrators, billing managers, and providers running their organizations on eClinicalWorks: a working recap of the 2026 eClinicalWorks and healow National Conference in Nashville (October 23–25), what was actually announced, what it costs, when it ships, and what it means for your workflows and your revenue cycle.
eClinicalWorks used Nashville to reposition the EHR from a “system of record” to a “system of intelligence.” The practical center of gravity is V12.04 and its Canvas for Care (Smart Canvas) redesign, which eCW described as 43% faster in its own keynote time study and which is scheduled to begin rolling out to existing customers on January 15, 2027, at no added license cost. Around it sit healowIQ (evidence inside the note), a materially upgraded Sunoh.ai, a multichannel healow Genie, and an AI Workbench with a token-metered agent builder and an Agent Store. The company also opened two new business units, inpatient hospital EHR and pharmacy, and projected $1.3 billion in 2026 revenue.
More than 3,000 attendees gathered at the Gaylord Opryland Resort for three days built around a single keynote, more than 100 breakout sessions, an exhibit hall with live demos, staffed support and training rooms, a hands-on AI Workbench Build-A-Thon, and a Sunday half-day of 24 breakouts and roundtables covering eBO, AI Workbench, and value-based care. Breakout presentations are posted to my.eclinicalworks.com a few weeks after the event, so if you missed a session you can still retrieve the deck.
CEO and cofounder Girish Navani framed the keynote around “Crossing the Chasm” and the shift from a system of record to a system of intelligence, software that performs work rather than only documenting it. He described the “documentation tax” of the Meaningful Use, MIPS, and value-based care eras as the reason EHR efficiency gains stalled, and positioned AI and the Canvas redesign as the systemic answer to “click, click, click.” The keynote organized every announcement under five commitments:
The company update matters for anyone evaluating vendor stability: 27 years in business, roughly 6,500 employees, more than 2,000 new customers and 51 health centers added in the past year, 17,800 customers cited by Navani, and projected 2026 revenue above $1.3 billion with roughly 12% annual growth and no acquisitions. A CMS keynote by Amy Gleason, Deputy Administrator and Chief Product Officer in the CMS Office of Health Technology and Products, anchored the regulatory context (covered below). The 2027 National Conference is already set for October 8–10, 2027, in Orlando.
Takeaway: V12.04 is a UI-architecture change, not a feature drop. Canvas for Care (eCW uses “Smart Canvas” and “Canvas Design” interchangeably) replaces pop-ups, OK/Cancel dialogs, and tab-switching with a single AI-native workspace that combines patient context, task queues, AI-generated summaries, recommendations, and one-click actions. Providers can choose Canvas or the legacy Windows-style design screen by screen, which lowers change-management risk because you can stage adoption by role and by workflow rather than flipping the whole practice at once.
The performance claim was specific. In a keynote time study comparing the same visit and documentation in 12.04 against the prior version, eCW reported the new interface was 43% faster, with 19% fewer clicks, 31% less mouse movement, and about 32% fewer pop-ups. Chief Medical Officer Dr. Raj Dharampuriya demonstrated “Smart Chips,” contextual shortcuts that guide common actions such as renewing medications, booking appointments, sending letters, and completing forms directly from the canvas. Healthcare IT Today’s John Lynn, attending for the fourth consecutive year, described Smart Canvas as the moment eCW finally packaged years of separate AI and UI projects into one place.
The practice-management side of 12.04 is where billing leaders should look first: a redesigned referral inbox, a new claims screen, Smart Scheduling (recommendation-driven slot finding), Form Hub (an AI-powered form builder you can prompt in plain language), and RCM Insights, which flags revenue cycle issues inside the EHR. None of these were headline items on stage, but they touch the front desk and the billing office every day.
| Component | What it does | Cost model (as stated by eCW) | Timing |
|---|---|---|---|
| Canvas for Care / Smart Canvas | Single AI-native workspace; Smart Chips; AI summaries; screen-by-screen opt-in | Included in standard V12.04 upgrade; eCW absorbs the AI cost | Announced: new technology deployment from Nov. 1, 2026; existing-customer upgrades scheduled from Jan. 15, 2027 |
| Smart Scheduling | Recommendation-driven scheduling interface | Included (uses tokens, but free to customers) | With V12.04 |
| Form Hub / Form Builder | Prompt-to-build electronic forms | Included (uses tokens, but free to customers) | With V12.04 |
| healowIQ | Conversational clinical intelligence with EBSCO DynaMed, chart data, PRISMANet records, 700+ calculators | Included at no added cost for eligible Sunoh.ai and AI-bundle customers; confirm other licensing options with eCW | Rolling out to customers now |
| RCM Insights, new claims screen, redesigned referral inbox | Flags revenue cycle issues; modernized claim and referral workflows | Part of V12.04 practice management | With V12.04 |
| AI Workbench / Agent Store | Build, customize, deploy, and govern AI agents; prebuilt agents and flows | Token-based consumption pricing; initial experimentation credits | Available now via demo and implementation review |
| Sunoh.ai | Ambient documentation with Smart Commands, Smart Edit, Synthesis, 10 languages | Separately licensed per user | Updates demoed at keynote |
| healow Genie | AI contact center: voice, text, WhatsApp, email, outbound campaigns, Genie Chat | Separately licensed | Multichannel expansion announced |
Strategic context: why “free” is a deliberate business decision
Navani told Newsweek that the AI inside 12.04 “is going to cost a lot of money, but it’s free” to customers, and that eCW calculated predictable token usage for Canvas, Form Builder, and Smart Scheduling and chose to absorb it. The stated rationale is privately held status (no shareholders to answer to) and a strategy of making AI affordable “to even the solo practice.” For independent practices that have watched competitors price ambient AI and agent tooling as add-ons, this is the single most important commercial fact from the conference. Included licensing removes one barrier, but the value you realize will still depend on how the product performs in your workflows, your configuration and training, and the internal cost of the transition.
What this means for your practice: Three things should happen before January 15. First, baseline your metrics now (time-per-note, charge lag, claim creation lag, clean-claim rate, front-desk call abandonment) so the 30% projection becomes a measurement rather than a slogan. Second, decide which roles and screens move to Canvas first; Navani told Newsweek he expects cautious early uptake before volume ramps to roughly 500–600 upgrades per day (a company forecast, so confirm your own date with eCW), and Smart University (eCW’s online learning platform) is the stated vehicle for pre-upgrade education. Third, audit your template, order set, and claims-screen customizations, because an interface that removes pop-ups also removes places where practices have historically buried workarounds. If your eClinicalWorks configuration has accumulated years of patches, 12.04 is the natural moment to clean it up rather than carry it forward.
Takeaway: healowIQ places conversational clinical intelligence inside the record. It draws on licensed medical journals and guidelines through EBSCO DynaMed, the patient’s own chart, and outside records retrieved through PRISMANet, and lets clinicians ask natural-language, patient-specific questions without leaving the note. It includes more than 700 clinical calculators that populate from chart data and a clinical-trial matching enhancement that surfaces relevant research. It is available in the EHR, eClinicalMobile, and eClinicalTouch, and eCW says the provider reviews the evidence and makes the decision; healowIQ does not act on its own.
The commercial detail that matters: healowIQ is included at no added cost for Sunoh.ai and AI-bundle customers. For practices considering Sunoh.ai, included access to healowIQ adds another factor to the purchase decision; first confirm whether an existing AI bundle already qualifies and what other licensing options eCW offers. Navani’s own framing in the keynote was that a deeply integrated evidence tool combined with chart data and PRISMANet information is where “the whole game changes.” John Lynn’s read was more measured but still positive: healowIQ is more compelling than standalone generative-AI clinical tools precisely because it has the patient’s clinical data in context.
Specialty note: healowIQ was first previewed to FQHC users at the May 2026 Health Center Summit. Its chart-populated calculators and guideline retrieval have the most immediate value in primary care, internal medicine, and health centers managing chronic-disease panels under value-based contracts, where clinicians can test its usefulness for chronic-care review. It does not change the underlying rules: HCC reporting and quality-measure submissions still depend on diagnoses and interventions supported by the clinician’s own documentation, not on the evidence tool itself.
Takeaway: Sunoh.ai moved from “drafts the note” to “drafts the note, proposes the orders, and reviews the chart.” According to Sunoh’s recap, 67% of the keynote audience said they had already used Sunoh (an attendee figure, not an all-customer adoption rate), and Sunoh’s recap cites more than 25 million ambient visits for 2026, though its wording (“averaging”) leaves the calculation and reporting basis unclear. The updates demonstrated in Nashville:
Opportunity: the revenue cycle angle on Smart Commands
Order capture at the point of documentation is a charge-capture opportunity, not just a convenience. Suggested orders that the provider confirms inside the visit workflow could reduce missed or late orders, and the assessment-to-findings linkage could make medical-necessity support easier to see in the note. Neither outcome has been published yet, so measure it: track missed orders, charge lag, coding queries, and documentation corrections before and after go-live, and keep provider confirmation of every order. If you outsource clinical coding, ask your coding partner to report query volume across the transition.
Specialty notes: The on-stage and press proof points were deliberately clinical and varied. A rural Tennessee pediatric practice (Kidzcare Pediatrics, Athens, TN) reports providers saving at least two hours daily with Sunoh inside eCW, and eCW published a dedicated pediatric AI-scribe piece the week before the conference emphasizing multi-voice visits. An eCW announcement dated November 5 described Conway OB-GYN’s move from late-night charting to same-day documentation with Sunoh. Provider testimonials in the Sunoh update came from neurology, dermatology, and a general practice. The multi-language expansion is the most important Sunoh change for FQHCs, CHCs, and any practice with a large LEP patient base; it may reduce documentation work in visits conducted in other languages. Validate accuracy in the languages you serve and keep qualified interpreters where they are needed: an English draft note does not show that the patient and clinician understood each other.
Important note: validate ambient AI before you scale it
Before a broad rollout, have a clinician review a sample of drafts for speaker attribution in multi-party visits, negation (“denies chest pain”), medication names and doses, chart-derived calculator inputs, and the appropriateness of suggested orders. The “annual physical labs” set is an example of product behavior, not a clinical standard. Confirm your patient-notification and recording-consent approach under your state’s recording laws, and get written answers on where audio and transcripts are stored, how long they are retained, which subprocessors handle them, and whether they are used for model training. Programs that handle substance use disorder records should also confirm 42 CFR Part 2 handling.
Takeaway: AI Workbench is the platform that makes the “system of intelligence” claim operational. Users describe an agent in plain language, review the proposed plan, and approve it before it is built. Agents can be triggered manually or automatically, and the platform supports REST and FHIR APIs plus, newly, Model Context Protocol (MCP) endpoint support so organizations can connect their own applications. eCW says Workbench can reach across the EHR, payer portals, documents, labs, Microsoft 365, Salesforce, HubSpot, and other business applications, depending on configured access. An Agent Store will host agents published by eCW and agents customers build and share.
eCW named its first-party agents on its product page: Profy (autonomous revenue cycle: claim status checks, payer follow-up, denial investigation and resolution, with billing staff pulled in when judgment is needed), Clara (prior authorization: gathers documentation, prepares requests, navigates payer requirements, tracks submissions, flags items for review), Scouty (value-based care: care gaps, outreach, follow-up coordination), Cleo (email and scheduling: organizes inbound requests, coordinates scheduling, drafts follow-ups), and Sparky (urgent telephone encounters: reviews phone encounters against routing criteria and escalates time-sensitive requests). On stage, an email agent read a provider’s out-of-office message, cleared the day, canceled nine appointments, and began rebooking patients; a prior-authorization agent prepared a morning summary and submitted requests through a payer portal; and agents for value-based care outreach and health center UDS reporting were shown. Navani distinguished chatbots, which answer one question and wait, from agents, which take a goal, plan steps, gather data, act, and report back, and described the future as “people plus agents.” eCW’s stated guardrails are human-in-the-loop review, a full audit trail, and a kill switch.
The economics are different from the rest of the release. Navani was explicit with Newsweek: “Workbench is not free. Workbench software, but you pay for tokens.” Customers receive initial credits to experiment, and eCW says it cannot absorb unpredictable usage because “people will build agents that will just go do 500 things.” Internally, eCW reported building roughly 60 agents in about 2.5 weeks. Newsweek’s reporter watched attendees at the Build-A-Thon and noted that the questions they asked Varun Navani, a Workbench project lead, centered on integration with existing systems and whether agents could be trusted to run reliably. Workbench also includes an evaluation suite that tests agents against defined criteria before deployment and alerts when technical failures need human intervention.
Risk: token budgets and unbounded automation
Healthcare IT News summarized the governance problem in one line: organizations will need to architect how they monitor the AI agents they use to balance trust and token budgets. An agent that polls a payer portal every hour for every open claim is both a cost center and a compliance exposure if no one owns the output. Before enabling any agent in production, assign an owner, define the approval checkpoint, set a monthly token ceiling, and decide what “failure” looks like for that workflow. Health API Guy, an interoperability analyst, also cautioned that Workbench remains “cloaked in mystique”: eCW’s use of the word “portals” rather than “APIs” suggests agents may operate payer websites the way a human would, which is powerful but brittle whenever a portal changes. Get the commercial terms in writing as well: token rates, overage handling, whether spending caps are technically enforced or only reported, integration charges, support commitments, and who is responsible when an agent takes an erroneous action. Before production, test each agent’s permissions and how it handles instructions embedded in emails, documents, or payer-portal content, and ask for the vendor’s technical documentation and security-review findings rather than assuming safeguards exist.
Takeaway: eCW is now selling agentic revenue cycle automation as a named capability, and the headline number is aggressive. The company says autonomous RCM agents can automate up to 98% of manual revenue cycle work, monitoring activity, flagging denials, finding reimbursement opportunities, and reducing manual follow-up. On stage, eCW separately showed a seven-day run in which agents handled 359 transactions across claims, payment posting, statements, and appeals; the published recap does not say whether that run produced the 98% figure. Navani also cited an early internal revenue cycle improvement figure of 50% without defining the metric, and separately told Newsweek, “I could do double the work with the same number of people.” Those two statements should not be read as the same measurement. Autonomous value-based care, built on the Scouty agent, identifies cost drivers and high-risk patients, notifies care teams, determines needed follow-ups, and automates manual outreach. eCW also described RPM agents that detect defective devices and notify patients to protect monitoring continuity.
Here is the honest read for billing leaders. The 98% automation claim and the undefined 50% internal figure are both vendor-reported; Newsweek explicitly noted that the company’s figures do not establish that practices will achieve similar results. Claims from creation through completion is also a workflow where payer behavior, not software, sets the ceiling: timely filing rules, appeal windows, and payer denial behavior (Kodiak Solutions’ platform data, covering more than 2,100 hospitals and 300,000 physicians, put the 2024 initial denial rate at 11.81%, alongside the under-5% denial-rate benchmark cited in a 2023 Conifer-sponsored article published by HFMA; the two use different measurement bases, so confirm definitions before comparing them) are the variables that determine whether automation produces cash or simply produces faster-moving rework. The practical question is not “does Profy work” but “which transaction types do we hand it first, and who reviews the exceptions.”
| Phase | Hand to agents | Keep with staff | Control metric |
|---|---|---|---|
| 1. Observe (30–60 days) | Claim status checks; eligibility re-verification; statement batching | All submissions, appeals, and adjustments | Agent accuracy vs. staff audit sample; token spend per 100 claims |
| 2. Assist (60–120 days) | Denial categorization and routing; prior-auth document assembly (Clara); payer follow-up drafts | Appeal decisions; write-offs; coding corrections | Days in AR; first-pass resolution; denial overturn rate |
| 3. Automate (120+ days) | Low-dollar, high-volume rework; routine payment posting; scheduled resubmissions | High-dollar appeals; payer escalations; contract disputes | Net collection rate; cost to collect; exceptions per 1,000 transactions |
The timeframes above are planning examples, not vendor guidance. Advance a phase only after validating accuracy, permissions, exception handling, and financial controls.
If your organization lacks a denial-management function mature enough to audit an agent’s decisions, build that first. Revele’s AR and denial management services and eClinicalWorks medical billing services are designed to run inside the eCW environment these agents will operate in, which is precisely the oversight layer agentic RCM assumes exists. For a primer on the end-to-end process the agents are being pointed at, see What Is Revenue Cycle Management.
Takeaway: The front office got as much as the exam room, it just got less stage time. healow Genie, the AI contact center that began with inbound voice, now supports text, WhatsApp, and email, and eCW says it resolves up to 80% of common service issues across practices using it. The Genie breakout previewed AI-powered outbound campaigns, Genie Chat, multilingual voice, and enhanced analytics. Vendor-published case studies offer examples rather than expected results: Goodtime Family Care (family medicine, Maryland) reported Genie handling 77% of calls received during business hours and 100% of after-hours calls; Maryland Endocrine reached 80–90% of inbound calls and voicemails within weeks; Estrella ENT reached 70% automation; Capital Area Health Network eliminated 45-minute hold times. John Lynn noted Genie received less keynote focus than expected but drew consistent praise from users on the floor, and that it is now being used for chronic care management conversations, potential workflow support for practices running APCM, CCM, and RPM programs. AI activity alone does not establish billing eligibility; each program’s service elements, clinical-staff and supervision rules, consent, and documentation requirements still apply. CCM codes require qualifying practitioner or clinical-staff time, while APCM is billed as a monthly bundle rather than by the minute, so automated conversation time is not billable staff time; review any RPM workflow separately (see CMS guidance on APCM and CCM). Before go-live, ask for the documented escalation workflow (how patients reach a person, how urgent symptoms are routed, and how language, disability, digital-literacy, and authentication barriers are handled) and test it yourself rather than relying on automation percentages.
The healow patient portal was redesigned to cover booking, check-in, visits, payments, and follow-up under each practice’s own branding. The Day 2 customer story is a useful benchmark for anyone weighing digital check-in: Medical Associates of Rhode Island, roughly three months after rolling out healow CHECK-IN, reported more than 2,700 patients checking in electronically, participation rising from 37% to 73%, an estimated 230 staff hours saved according to the practice, and 5–10 minutes per patient reclaimed for face-to-face care. Family Nurse Practitioner Tara Panciotti’s caution is the one worth repeating to your own team: implementation does not end at go-live, and the workflow needs continued monitoring and troubleshooting.
Important note: patient-pay is a natural place to measure portal and Genie returns
A branded portal that handles payments and a contact center that answers balance questions at any hour are patient-pay infrastructure. Patient responsibility is rising, and Medicaid eligibility is about to become less stable for many adults: Public Law 119-21 requires six-month renewals for most expansion adults beginning with renewals scheduled on or after January 1, 2027 (CMS SMD #26-001), and states must implement the separate community-engagement (work) requirement by January 1, 2027, subject to exemptions and any good-faith extensions (CMS-2454-IFC). That makes real-time eligibility checks, renewal assistance, and accurate patient-balance workflows, including self-service resolution and card-on-file where appropriate, collection controls rather than conveniences. Before charging a stored card, confirm what the patient actually owes after coverage, contractual and QMB billing restrictions, and any sliding-fee or financial-assistance policy, and that you hold valid payment authorization. If you are redesigning intake around 12.04 anyway, fold patient-pay workflow into the same project.
Takeaway: Interoperability was positioned as both a product feature and a regulatory alignment play. PRISMA AI pre-visit planning now presents problems, outside visits, pertinent labs, referral information, care gaps, and AI recommendations in one view before the provider enters the room, and eCW describes PRISMA and Sunoh working together to surface inferences from the patient’s history during the visit and suggest real-time care plan updates. PRISMANet, eCW’s Qualified Health Information Network, exchanges 26.5 million patient documents daily and pledged on stage to become a CMS Aligned Network.
That pledge is the bridge to the CMS keynote. Amy Gleason opened with “We have normalized the absurd,” citing clipboards, MRIs on CDs, and fax machines still embedded in routine care. She reported that the CMS Health Technology Ecosystem launched at the White House in July 2025 grew from 60 to more than 900 participants in its first year and that the share of patients able to assemble their records in one app rose from 5% to 60%. The initiatives she named, Kill the Clipboard at check-in, CMS Aligned Networks for data connectivity, and the Medicare App Library for trusted patient apps, map directly onto healow CHECK-IN, PRISMANet, and the redesigned portal. Her closing line, “Speed is a moral variable,” is the policy frame eCW wants customers to adopt. For practices, the operational translation is that CMS is promoting voluntary commitments around digital intake and network-level exchange, and eCW is positioning its products around those goals. Confirm any specific program requirements or payment opportunities separately.
Takeaway: eCW is leaving its ambulatory-only identity. The new AI-native inpatient EHR targets smaller community and critical access hospitals, a segment Navani estimates at 2,000 or more U.S. facilities. Four hospitals have signed, with go-lives starting as early as year-end: American Specialty Hospital (Plano, TX), Cleveland General Hospital (Cleveland, TX), Lakeland Community Hospital (Haleyville, AL), and Riceland Medical Center (Winnie, TX), and at least 25 more prospects are in discussions. eCW notes it already runs in more than 600 hospitals worldwide. The inpatient system automates routine processes and connects to the ambulatory EHR and the pharmacy system, which is the real pitch: one record across clinic, hospital, and pharmacy.
eClinicalWorks Pharmacy is a pharmacy management system built directly into the EHR, developed over two years with East Georgia Healthcare Center, an FQHC whose CEO, Jennie Wren Denmark, was recognized on stage. It supports real-time inventory visibility, claims adjudication, electronic prior authorizations, tools to support 340B compliance, and patient prescription notifications, with healow Genie already handling refill and prescription-status calls. It is live in Georgia and available nationwide, and Navani’s goal is 100 pharmacies on the system in 2027.
Who this is really for: FQHCs with in-house pharmacies and rural provider-based networks
eCW says the pharmacy platform supports 340B compliance workflows inside the dispensing record, and it was co-developed with an FQHC. Responsibility for compliance stays with the covered entity, including preventing diversion and duplicate discounts and keeping auditable records (HRSA 340B Program requirements), so validate the platform’s controls against your own dispensing and billing arrangements. Health centers running 340B contract pharmacy programs or in-house dispensaries should evaluate this against their current pharmacy system’s split-billing and inventory reconciliation. For rural health systems, the combination of an eCW inpatient EHR for a critical access hospital, eCW ambulatory for provider-based RHCs, and PRISMANet exchange is a credible single-vendor story for the first time. These announcements do not change Medicare RHC payment rules: the standard per-visit payment limit is $165 for 2026 and $178 for 2027, and qualifying grandfathered provider-based RHCs have separate limits (CMS). Whether a single-vendor network lowers your integration cost is a question for a practice-specific implementation proposal.
Most announcements were platform-wide, but the examples, proof points, and co-development partners eCW chose tell you where each capability lands first.
| Specialty / setting | Most relevant announcements | Why it matters |
|---|---|---|
| FQHCs, CHCs, look-alikes | eClinicalWorks Pharmacy with tools to support 340B compliance; UDS reporting agent; multilingual Sunoh (10 languages) and Genie; healowIQ (previewed at Health Center Summit); PRISMANet’s pledge to become a CMS Aligned Network | Highest concentration of health-center-specific value at the conference; the pharmacy unit was co-developed with an FQHC and the first live site is an FQHC |
| RHCs, CAHs, rural networks | AI-native inpatient EHR for community and critical access hospitals; eClinicalTouch offline mode; Genie for after-hours access | Single-vendor clinic-hospital-pharmacy record becomes possible; offline capture addresses rural connectivity gaps |
| Primary care, family medicine, internal medicine | Canvas for Care; healowIQ calculators and guidelines; Sunoh Smart Commands (“annual physical labs” example); Genie for CCM conversations; Scouty for care gaps | Largest user base and the explicit target of the 30% efficiency projection; evaluate agent support for APCM, CCM, and RPM workflows separately from each program’s billing requirements |
| Pediatrics | Sunoh multi-voice visit handling (Kidzcare Pediatrics, rural TN: 2+ hours/day saved); eCW’s pediatric AI-scribe spotlight published Oct. 15 | Parent-plus-child encounters are useful test cases for speaker attribution and note accuracy in a pediatric pilot; eCW chose pediatrics as a flagship proof point |
| OB-GYN and women’s health | Conway OB-GYN Sunoh workflow story (same-day documentation), published Nov. 5; earlier women’s clinic case reporting 2+ hours/day saved | High-volume, high-documentation specialty where same-day note completion may enable earlier charge entry when coding and review workflows are ready |
| Dermatology, neurology, other procedural and cognitive specialties | Sunoh provider testimonials from Skin Solutions Dermatology and Neurology Center of New England; Synthesis for abnormal values and trends | Confirms Sunoh is being tuned beyond primary care; Synthesis supports longitudinal specialties |
| Behavioral health and SUD programs | Reporting tools and electronic forms for quality measures and screenings (Recovery Consultants of Atlanta, quoted by Newsweek at the conference); Form Hub; Sunoh adoption after last year’s event | Small BH organizations cited forms and reporting, not flashy AI, as the workhorse features; portal adoption remains limited by digital literacy |
| Orthopedics, cardiology, surgical specialties | Clara prior-authorization agent; Profy autonomous RCM; redesigned referral inbox; new claims screen | Prior-auth-heavy specialties stand to gain most from Clara; specialists in the mandatory CMS Ambulatory Specialty Model (starting 2027) need cleaner referral and quality data; check whether your physicians appear on CMS’s final 2027 participant list, since eligibility is individual and limited to selected geographic areas (CMS ASM FAQ) |
| Endocrinology, ENT, and other call-volume-heavy specialties | Genie multichannel expansion; published results from Maryland Endocrine (80–90%) and Estrella ENT (70% call automation) | Refill and results calls dominate these front desks; Genie’s pharmacy integration adds refill-status automation |
Attendees' online accounts were largely on LinkedIn and in on-site press interviews; no substantive user-forum threads on the conference had surfaced as of this writing. The themes were consistent.
Enthusiasm centered on Canvas. Todd Thurman Jr., an attendee posting on LinkedIn, listed 12.04 and Smart Canvas first among his highlights, specifically for centralizing patient information and ordering functions in one place, and summarized his takeaway as eCW continuously folding AI and automation into daily operations. John Lynn wrote that Smart Canvas “really pushes against” the too-many-clicks complaint he hears from clinicians on every EHR. Magaly López posted on LinkedIn that she attended representing the Asociación de Salud Primaria de Puerto Rico, highlighting the island’s health centers and three full days of learning across more than 100 sessions, a reminder that the health center contingent is a significant and organized part of this user base.
Practical users valued the unglamorous tools. Angel Jenkins, practice manager at Recovery Consultants of Atlanta, told Newsweek during the conference that reporting tools and electronic forms supporting quality measures and behavioral health screenings are what make her small organization work, that one provider adopted Sunoh after last year’s event, and that Navani’s 30% projection could prove conservative for her team. She also acknowledged that limited digital literacy still restricts portal use among her patients. Lynn made the same point from the analyst side: forms designers, RCM, and document and image AI are “not sexy” but may be the most impactful.
Peer networking was the product no vendor can ship. eCW’s own Day 2 recap captured independent-practice administrators from Virginia and Florida comparing front-desk operations, documentation methods, and call-volume strategies, concluding that no single solution fits every practice, and exchanging contact information.
The skepticism was specific and fair. Newsweek distinguished the two headline numbers: the 30% efficiency figure is a company projection, while the 50% RCM figure is an undefined internal benchmark, and neither establishes results for an individual practice. It also cited broader data showing private practices trail employed and system-affiliated settings in AI adoption (72% of employed physicians using AI versus 64% in private practice, per AMA survey data). Lynn observed that most announcements had been previewed at the Enterprise and Health Center Summits earlier in 2026, that Navani ran out of time on the AI-agent framework he was building on stage, and that Genie got less keynote attention than it deserved. Health API Guy noted that Workbench’s MCP and portal-access claims rest on marketing language rather than technical documentation. Navani himself set expectations candidly: eCW aims to succeed “about nine times out of ten,” and clinician adoption follows a bell curve.
| Action | Owner | Timeframe | Strategic impact |
|---|---|---|---|
| Capture baseline efficiency and revenue cycle KPIs | Practice administrator / RCM lead | November–December 2026 | Makes the 30% projection measurable; supports vendor accountability |
| Schedule V12.04 upgrade and role-based Canvas rollout plan | IT lead / clinical champion | Q1 2027 | Screen-by-screen opt-in enables staged adoption with lower disruption |
| Decide on Sunoh.ai / AI bundle to unlock healowIQ at no added cost | Medical director / CFO | December 2026 | Documentation time, order capture, and evidence at point of care |
| Clean up templates, order sets, and claims-screen workarounds | eCW administrator / optimization partner | Before upgrade | Prevents legacy configuration from undermining Canvas gains |
| Analyze 90 days of inbound call reasons; scope a Genie pilot | Front-office manager | Q1 2027 | Selected vendor-published case studies report 70–90% call automation; results vary by practice |
| Define agent governance: owner, approval checkpoints, token ceiling, kill-switch protocol | Compliance officer / RCM lead | Before any Workbench pilot | Controls cost and compliance exposure of autonomous workflows |
| Pilot one bounded agent (claim status or prior-auth assembly) with experimentation credits | RCM lead | Q1–Q2 2027 | Produces your own cost-per-transaction data before scaling |
| Health centers: evaluate eCW Pharmacy against current 340B split-billing and inventory system | Pharmacy director / CFO | 2027 | Validate 340B controls, reconciliation, and audit records before relying on the integration |
| Rural networks: request inpatient EHR references after first go-lives | CEO / CIO | Mid-2027 | Single-vendor clinic-hospital-pharmacy record |
| Download missed breakout decks from my.eclinicalworks.com | All attendees | Now | Recovers session content for the 100+ breakouts you could not attend |
The 2026 eClinicalWorks and healow National Conference (Nashville, October 23–25) introduced V12.04 with Canvas for Care, a redesigned AI-native workspace; healowIQ, a clinical intelligence tool integrated with EBSCO DynaMed; major Sunoh.ai updates including Smart Commands and 10-language support; an AI Workbench and Agent Store for building and deploying AI agents; autonomous RCM and value-based care agents; a multichannel healow Genie; a redesigned healow patient portal; and two new business units, an AI-native inpatient hospital EHR and an EHR-integrated pharmacy management system. eClinicalWorks also projected 2026 revenue above $1.3 billion.
Canvas for Care, also called Smart Canvas or Canvas Design, is the redesigned V12.04 interface that brings patient context, task queues, AI-generated summaries, recommendations, and one-click actions into a single workspace, replacing pop-ups, OK/Cancel dialogs, and tab switching. In eClinicalWorks’ keynote time study it was 43% faster than the prior version, with 19% fewer clicks, 31% less mouse movement, and about 32% fewer pop-ups. Providers can choose Canvas or the legacy design screen by screen.
eClinicalWorks announced deployment of new technologies beginning November 1, 2026, with existing-customer V12.04 upgrades scheduled to start January 15, 2027. CEO Girish Navani told Newsweek he expects most customers to upgrade in the first half of 2027, with uptake ramping to roughly 500–600 upgrades per day; these are company forecasts, so confirm your practice’s date and feature availability with eCW. An eCW spokesperson told Newsweek in October 2026 that about 92–93% of eCW cloud customers were on V12.03.
Canvas for Care, Smart Scheduling, and Form Hub (the AI form builder) are included in the standard V12.04 upgrade at no added cost; eClinicalWorks says it is absorbing the AI cost. healowIQ is included at no added cost for Sunoh.ai and AI-bundle customers. AI Workbench is not free: it uses token-based consumption pricing, with initial credits provided for experimentation. Sunoh.ai and healow Genie remain separately licensed products.
AI Workbench is eClinicalWorks’ agentic AI platform for using, customizing, and building AI agents and workflows that connect the EHR, payer portals, documents, Microsoft 365, and other business applications, with REST, FHIR, and Model Context Protocol (MCP) endpoint support. Its Agent Store offers prebuilt agents including Profy (autonomous revenue cycle), Clara (prior authorization), Scouty (value-based care), Cleo (email and scheduling), and Sparky (urgent telephone encounters). Governance features include configurable permissions, approval checkpoints, an audit trail, and a kill switch.
eClinicalWorks said its autonomous RCM agents can automate up to 98% of manual revenue cycle work by monitoring activity, flagging denials, finding reimbursement opportunities, and reducing manual follow-up across claims, payment posting, statements, and appeals. In a separate keynote demonstration, agents handled 359 transactions over seven days, and Navani cited an internal improvement figure of 50% without defining the metric. The 98% figure is a vendor automation claim, and the demonstration and internal figure do not establish results for an individual practice. Billing teams should pilot under human-in-the-loop review.
Sunoh.ai’s 2026 updates include Smart Commands and enhanced verbal keywords that turn spoken phrases such as “annual physical labs” into recommended order sets the provider confirms with one click; personalization that follows each provider’s HPI style and links assessments to supporting findings; Smart Edit, which updates every affected section when a change is made; Sunoh Synthesis, an AI chart review highlighting abnormal values and trends; one-click merge into the progress note; and support for Spanish, Arabic, Chinese, Hindi, Russian, Korean, Vietnamese, Filipino, Portuguese, and French, with German, Hebrew, Ukrainian, and Polish coming. Sunoh’s recap cites more than 25 million ambient visits for 2026 but doesn't clarify the calculation or reporting basis.
healowIQ is a conversational clinical intelligence tool inside the eClinicalWorks EHR, eClinicalMobile, and eClinicalTouch that lets clinicians ask natural-language, patient-specific questions and review evidence from EBSCO DynaMed, the patient’s chart, and outside records retrieved through PRISMANet. It includes more than 700 clinical calculators that populate from chart data and clinical-trial matching. healowIQ is included at no additional cost for Sunoh.ai and AI-bundle customers; the provider reviews the evidence and makes the clinical decision.
Health centers received the most setting-specific value: eClinicalWorks Pharmacy, an EHR-integrated pharmacy management system with real-time inventory, claims adjudication, electronic prior authorizations, and tools to support 340B compliance (the covered entity remains responsible for compliance), developed with East Georgia Healthcare Center and now live in Georgia; a UDS reporting agent demonstrated on stage; Sunoh.ai support for 10 non-English languages; multilingual healow Genie voice; healowIQ, first previewed at the May 2026 Health Center Summit; and PRISMANet’s pledge to become a CMS Aligned Network. eClinicalWorks reported adding 51 health centers in the past year.
Yes. eClinicalWorks announced a new AI-native inpatient hospital EHR business unit aimed at smaller community and critical access hospitals, a segment Navani estimates at 2,000 or more U.S. facilities. Four hospitals have signed with go-lives starting as early as year-end 2026: American Specialty Hospital (Plano, TX), Cleveland General Hospital (Cleveland, TX), Lakeland Community Hospital (Haleyville, AL), and Riceland Medical Center (Winnie, TX), with at least 25 more prospects. The inpatient system connects to the ambulatory EHR and the new pharmacy system.
Baseline efficiency and revenue cycle metrics (time-per-note, charge and claim lag, clean-claim and denial rates, call abandonment, check-in participation) so the projected 30% efficiency gain can be measured; schedule an early upgrade window and a Smart University training plan; decide whether to license Sunoh.ai or the AI bundle to unlock healowIQ; clean up templates, order sets, and claims-screen workarounds that will interact with Canvas; and establish agent governance (owner, approval checkpoints, token ceiling, kill-switch protocol) before piloting AI Workbench.
The 2027 eClinicalWorks and healow National Conference is scheduled for October 8–10, 2027, in Orlando, Florida. Navani has described eCW’s pattern as previewing products in October and shipping them starting the following January, but the 2027 product agenda has not been announced.
Nashville was the year eClinicalWorks stopped bolting AI onto the EHR and rebuilt the EHR around it. For practice leaders, the decision tree is simpler than the keynote made it sound. Plan the 12.04 upgrade early and around readiness: Canvas, Smart Scheduling, and Form Hub carry no added license cost, so the business case comes down to whether your measured gains outweigh training, configuration, testing, and transition costs. Resolve the Sunoh.ai question, because healowIQ and the Smart Commands order workflow now give eCW its most complete documentation-to-order workflow. Treat the agents differently: Workbench is metered, autonomous RCM is a vendor claim until your own exception audit says otherwise, and both require governance you may not have built yet. Health centers and rural networks should be first to evaluate, because the pharmacy, inpatient, multilingual, and UDS capabilities were built for their settings, with adoption paced to readiness and validated performance. Everyone else should measure before and after, and hold the 30% projection to the evidence. Related reading: why HIMSS 2026 mattered for medical practices and 18 technologies and strategies to strengthen your practice in 2026.
Canvas, Smart Commands, and autonomous RCM only pay off if your configuration, coding, and denial management are ready for them. Revele specializes in eClinicalWorks revenue cycle management and EHR optimization for independent practices, specialty groups, FQHCs, and RHCs.
Start with a complimentary revenue cycle analysis to baseline your KPIs before the upgrade, or learn how the RISE Program brings elite eClinicalWorks optimization to practices of every size.
Sources: eClinicalWorks press release (Oct. 23, 2026); eClinicalWorks conference recap; Day 1; Day 2; Day 3; eClinicalWorks AI Workbench; Sunoh.ai 2026 Updates (Oct. 29, 2026); Healthcare IT News; Healthcare IT Today (Oct. 26, 2026); Newsweek, Navani interview; Newsweek Access Health (Oct. 29, 2026); Newsweek, Recovery Consultants of Atlanta; Health API Guy, October Monthly Review; Goodtime Family Care case study (Sept. 24, 2026); Kodiak Solutions denial data (May 21, 2025); Conifer-sponsored article published by HFMA, mid-cycle revenue operations (July 10, 2023); HRSA 340B Program Requirements; CMS APCM Services; CMS Chronic Care Management Services (MLN909188); CMS SMD #26-001; CMS-2454-IFC, Federal Register (June 3, 2026); CMS MLN MM12185, RHC payment limits; AMA, AI use by practice setting; eClinicalWorks, AI Scribe for Pediatrics (Oct. 15, 2026); CMS Ambulatory Specialty Model FAQ; attendee posts on LinkedIn by Todd Thurman Jr. and Magaly López (Oct.–Nov. 2026).
Disclaimer
This article is provided for general informational and educational purposes only. It does not constitute legal, regulatory, coding, billing, medical, financial, accounting, or tax advice.
Healthcare regulations, payer policies, fee schedules, and vendor product terms change frequently and can vary by payer, state, specialty, contract, and date of service. Product capabilities, pricing models, release dates, and availability described here reflect what eClinicalWorks, healow, Sunoh.ai, and the cited publications reported as of November 2026 and are subject to change.
Performance figures in this article, including efficiency gains, time-study results, automation percentages, call-resolution rates, adoption figures, and customer outcomes, are vendor-reported or illustrative. They are not guarantees of payment, performance, or results for any practice, and Revele has not independently verified them.
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Sources and figures note: Product announcements and figures are drawn from eClinicalWorks, healow, and Sunoh.ai materials and the press coverage listed above. Regulatory references include Public Law 119-21 Medicaid provisions (CMS SMD #26-001; CMS-2454-IFC), Medicare RHC payment limits (CMS MM12185), HRSA 340B Program requirements, and CMS care-management guidance. The under-5% denial-rate benchmark is cited from a sponsored article published by HFMA; the 11.81% initial denial rate is Kodiak Solutions platform data. Revele is an independent revenue cycle management company and is not affiliated with, endorsed by, or acting on behalf of eClinicalWorks or healow. Current through November 2026.