Originally published in Becker's Health IT.
Healthcare’s interoperability problem has never really been about whether data exists. It’s about whether the right application can reach it, act on it, and hand off the result without a human stitching the pieces together by hand. That is the gap Magical, an AI agent platform for healthcare operations and revenue cycle management, is addressing with an expanded SMART on FHIR architecture spanning Epic, Oracle Health/Cerner, eClinicalWorks, athenahealth, Veradigm and Netsmart.
What is SMART on FHIR?
FHIR (Fast Healthcare Interoperability Resources) is the international standard governing how healthcare data is structured and exchanged. SMART on FHIR is the authorization layer built on top of it, the set of rules that determine whether an outside application is allowed to connect to an EHR and what it’s permitted to see or do once it’s inside. Together with OAuth 2.0, the industry-standard protocol for secure authorization, these three pieces form the backbone that any serious healthcare integration has to work through.
For years, read & write access to EHR data through “standardized” APIs has been inconsistent across vendors, even as most systems are expected to support FHIR. That inconsistency has been one of the quieter reasons healthcare automation projects stall: an agent or application might know what it needs to do, but getting a clean, timely read on appointment details, clinical notes or coding data from the EHR itself or writing back the gathered details exactly where you want them has often been the harder half of the problem.
By building on the current SMART on FHIR standards, Magical has positioned its agents to scale their ability to push & pull that context consistently. This makes it easier for agents to execute a prior authorization, follow up on a denial, or update a patient record at scale.
What’s built and what’s coming
Magical applications have been submitted, accepted and published for Epic’s Showroom, Oracle Health’s Partner Marketplace, eClinicalWorks’ Open Developer Portal, Meditech’s Greenfield Workspace, NextGen Healthcare and athenahealth marketplace, covering both sandbox and production environments. Veradigm, the makers of PracticeFusion, and Netsmart CareConnect integrations are submitted and pending approval.
Separately, Magical’s Agents are already hard at work providing deep operational experience inside these systems. Their work spans patient access, verification of benefits, prior authorization, coding, and accounts receivable follow-up across EHRs and connected payer and clearinghouse systems. That kind of cross-system execution, not just standardized data access, is what the company argues actually moves the needle on administrative burden.
“Every health system has been promised interoperability before, and every health system knows the promise usually stops at a data feed,” said Harpaul Sambhi, CEO and founder of Magical. “We didn’t build toward SMART on FHIR to check a compliance box. We built it because it’s the fastest path into the systems where the real work lives.”
Built for security, built for scale
Security remains central to how Magical operates. All authorization and FHIR traffic runs over secure, encrypted connections, and access requests are scoped to only the data and operations a given workflow requires. Each connection is customer-authorized and auditable, with human review built into the workflow rather than an afterthought.
For health systems evaluating AI-driven revenue cycle tools, the practical question is less about whether a vendor mentions FHIR and more about what happens after the data is retrieved. Magical’s near-term milestones include expanding from marketplace listing toward full production status with additional EHRs, and continuing to add new EHR connections as adoption grows.
The company says each new connection reduces the setup lift health systems face when bringing Magical’s agents into their existing environment. As more EHRs adopt consistent SMART on FHIR support, the industry’s long-standing implementation bottleneck may finally start to shrink, provided vendors pair that access with the operational execution to act on what it surfaces.
To learn more about how Magical applies agentic AI to healthcare revenue cycle and operational workflows, visit getmagical.com.