Cut Paperwork, Not Care.
A shared health data network, built around the person.
Smart Health Network is building reusable connections between the systems health plans, providers and their partners already use. Less repeated setup and administration for organizations. More understandable information for people and their care teams.
We are starting with prior authorization. Organizations can test with synthetic data now while preparing the legal, security and operating arrangements for live use.
Delaware Launch & Connectathon — what happened
More than 200 participants, in person and online, at the University of Delaware on July 13. The first health plan connected and began testing prior-authorization workflows; a state HIE connected self-service, straight to the hub; providers, networks, and HIEs are connecting — all on synthetic data, end to end.
Read the recap →People should not have to connect the pieces themselves.
A request is submitted. Information is missing. Someone needs to respond. Too often, the patient, practice or plan has to work out what happened across disconnected systems.
Organizations face the same fragmentation: repeating connection, identity, security and testing work with different partners. A shared network can make more of that work reusable without replacing the systems each organization depends on.
Illustration — from a recorded Delaware prior-authorization call, May 15, 2026:
Dr. Hockstein: “You don’t have my note. You have no clinical information on this patient?”
Reviewer: “I have nothing attached to this patient’s requests — and this is why we said we could not approve the request.”
Dr. Hockstein: “So it was denied without asking for additional information?”
— Neil Hockstein, MD · Delaware Surgeon General · Health Care Commission Chair · practicing head & neck surgeon
The note wasn’t missing. The bridge was.
One reusable connection between the systems already in use. See how it works →
Every party connects to every other party. Thousands of point-to-point integrations.
Every party connects once.
The Hub routes — and stays payload-blind.
Separate connections: repeated setup and maintenance between organizations.
Shared network: a reusable connection method for supported, authorized exchanges.
The Gateway connects an organization’s systems and applies the required checks and message protection. The Hub routes encrypted messages. The included Network Console shows authorized records and status supplied by the responsible systems.
Plans retain their coverage decisions. Providers retain their care decisions and workflows. A network delivery receipt is not a healthcare determination.
The routing Hub is designed to carry encrypted healthcare messages without the keys to read them. Access, retention and use of information remain limited to the work and authority involved. Participation or hosting does not give SHN or an infrastructure provider independent rights to sell information, train unrelated models or disclose a participant’s identifiable performance to competitors.
Available now: synthetic prior-authorization testing, published developer resources and reference components.
Production target: the first accepted Delaware prior-authorization pathways in January 2027. Each connection and workflow must meet its own requirements before live use.
Additional capabilities will be described with their scope, availability and terms as they are ready. A future service is not required to complete an included exchange.
Start testing today. Don’t let the January deadline go to waste.
You don’t need a production agreement to begin testing the network. The sandbox is open: synthetic data, CMS-0057 Da Vinci workflows.
Start simple. Deepen over time.
Keep the systems and standards-based APIs you already use — one shared network connection makes them reachable across the market.
Payers begin on the sandbox APIs they’re already building for CMS-0057, then choose who runs their Gateway — deployed in infrastructure they control, or authorized to a qualified HIE, cloud environment, technology partner, or managed operator — and shared testing is itself the first saving: conformance is established once against the network, not proven counterparty by counterparty. Providers begin in the cloud sandbox, then connect through their FHIR server, their EHR’s native Da Vinci API, or a SMART on FHIR app. You can deepen how you connect without starting the relationship over.
No local infrastructure; self-service client registration; synthetic data only. Validate CRD/DTR/PAS construction against the available test routes.
Start in the cloud sandbox →Prove deployment: run the gateway in your environment — keys generated and retained locally — connect the EHR or payer sandbox, and validate full EHR/payer → gateway → hub routing and conformance.
Set up a local gateway →Many teams do both: cloud first to prove the requests, local second to prove the deployment.
AI needs trusted connections, too.
More capable software does not remove the need to know who is acting, what they are allowed to do and who remains responsible. Shared, governed connections can help authorized applications work across organizations without creating a new pool of unrestricted healthcare data. Read the perspective →
One connection gets more valuable as the network grows.
Prior authorization is first. But every new transaction, participant, and market increases the value of your connection.
Washington set the requirements. Smart Health Network is the shared path to 0057 readiness — and the network beyond it.
The federal Interoperability and Prior Authorization rule requires impacted payers to support electronic, FHIR-based prior authorization, meet defined decision timeframes, and report their performance publicly — with API compliance dates beginning January 1, 2027. CMS has been clear that getting there is not a job any one organization can do alone.
“Prior authorization won’t be fixed by technology alone. It requires the entire healthcare system to work together to solve real-world challenges.”
That is exactly what a shared hub makes possible. Smart Health Network has pledged to support the CMS Health Technology Ecosystem — and we’re building the connective layer that turns each organization’s readiness into working, cross-sector exchange. The payers and providers preparing for 2027 can connect once and reach every enabled, authorized counterparty, instead of building one-to-one, plan by plan. The nation’s major payers have also publicly pledged to streamline prior authorization on the same timeline — one connection supports both the mandate and the pledge. State legislatures are moving the same direction: prior-authorization laws are now on the books in some forty states, with more advancing every session. But if every payer complies separately, fragmented APIs are just fax machines in modern clothing.
One network, every party at the table.
Included exchange. Optional additional services.
Defined network exchanges carry no SHN participation, network-access, transaction or required Gateway-software-license fee within their activated scope and operating limits. Required status and records are part of that service.
Organizations may run the Gateway themselves, select a qualified operator or purchase Managed Gateway from SHN. Additional management and analytical services are being developed and will have explicit scope and pricing before purchase.
Implementation, infrastructure and vendor costs may still apply. More counterparties do not themselves create an SHN fee. See what is included →
Delaware is the first implementation, not the boundary of the network.
Delaware is bringing public leadership, health plans, providers, DHIN and technology partners together around shared prior-authorization implementation. Testing and implementation evidence will determine which pathways are ready for live use.
Other states can begin by convening their stakeholders and joining shared testing and learning. A new SHN program procurement or budget is not required for that initial convening step. Organizations do not have to wait for a new State sponsorship agreement to explore participation.
Delaware implementation → · A practical starting point for states → · Sept 9: Delaware briefs the states →
Built for shared use, with defined accountability.
SHN’s Board and management run the company and its services. The Governance Council holds specified reserved powers, including approval of changes to Open Access designations. The independent Data Rights Trust protects defined individual rights, and participants have an advisory channel for issues and recommendations.
Buying a service does not buy superior Network rights. Qualified operator choice does not change those rights.
Build on the network.
Smart Health Network runs on open standards — HL7 FHIR today, with X12 arriving at the edges alongside the April claims release — so the work your systems already do for CMS-0057 and Da Vinci makes you ready to connect. One connection reaches every authorized participant; the network provides the common identity, authorization, and audit framework. The sandbox is open now — synthetic data, self-service registration. Connect directly, or through a certified partner — same network, same conformance, same Open Access rights. →
Built by people who have done this before.
The team behind Smart Health Network has built and operated real-time health infrastructure at national scale — across providers, payers, and the standards bodies that govern how health information moves. Meet the people →
Join us in building the digital foundation for the future of health.
“The question is not whether digital transformation will occur — it is essentially inevitable. … We can intervene now and organize the healthcare industry and regulatory levers around a digital and data architecture to create a better health future for all.”
Find the right next step. Tell us about your organization and the connection or workflow you want to explore. We will help identify the relevant testing, participation or service discussion.
Smart Health Network PBC · A mission-locked Delaware Public Benefit Corporation