Healthcare crosses organizations. Our technology should too.
A prior authorization, a referral, a prescription — each depends on different organizations working together. Yet our systems still rely on disconnected networks, portals, and paperwork. Smart Health Network provides a common foundation for trusted interaction across healthcare.
Cut paperwork. Not care.
Developers: start testing →
One Patient Journey — the Smart Health Network explainer (45 seconds). Captions available in the player.
We’ve digitized institutions, not the connections between them.
Payer portals. Point-to-point EHR integrations. Clearinghouses. Trust arrangements negotiated relationship by relationship. Each solves one connection — and every new relationship starts the work over again.
Healthcare already has EHRs and payer systems · FHIR, X12, NCPDP and other standards · APIs and portals · data exchange.
What is still missing: a common way for independent systems to work together · reusable cross-organization connectivity, identity, authority and accountability · a scalable way to discover, reach and qualify counterparties · a way to follow an interaction from request through responsibility and outcome.
Standards define how systems exchange information. Smart Health Network provides the common infrastructure that lets organizations use those standards to work together.
Repeat onboarding, credentials, configuration and testing across each payer-provider relationship.
Establish the common connection and testing work, then reuse it as more organizations participate.
Before: separate arrangements, repeated work. Repeated onboarding, credentials, configuration and testing across payer-provider relationships (N x N).
After: one shared network, reusable connections. Establish the common connection and testing work once, then reuse it as more organizations participate (N x 1).
Reach participating organizations through supported transactions. Each organization keeps its systems, data and decisions.
Does the second connection become easier than the first? Does the fifth? That is the test.
When the handoff fails, the patient carries the burden.
The doctor sent the request. The plan could not see the attachment. The patient is waiting. The problem is not that one message failed to move — it is that no common infrastructure makes the whole interaction reliable and accountable across institutions. Cut paperwork, not care.
You can track a pizza. You should be able to follow a request for care.
Was the request received? Is something missing? Who needs to act next?
SHN can bring those answers together across the provider and health plan, so the person waiting for care does not have to piece them together by phone.
- Request submitted · deliveredDelivery confirmed by the network
- Received by the planSource: the plan’s system · Updated 10:42 AM · Next: plan review
- Decision reportedSynthetic source decision, reported by the plan
Illustrative Member experience, not a live patient tracker. Member-service availability will be announced separately.
When a missing document becomes a delay in care
From a recorded Delaware prior-authorization call, May 15, 2026:
Dr. Hockstein: “Well, you had my note. You did have my note.”
Reviewer: “We did not have your note.”
Dr. Hockstein: “You have no clinical information on this patient?”
Reviewer: “I have nothing attached to this patient’s request. That is why we said we could not approve it.”
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
One common network for trusted interaction.
Smart Health Network is a shared, governed network for the work between organizations: identity, authority, discovery, protected exchange and accountability. The standard path runs Application → Gateway → Hub → Gateway → Application — the Hub routes encrypted messages without reading their contents or holding the keys to decrypt them.
Existing systems keep their jobs. FHIR, X12, NCPDP, APIs, files, documents and human-readable messages retain their native meaning and behavior; the Gateway can be self-operated, embedded in a product, or operator-supplied.
Start with one payer. Add another. Then another transaction.
The first connection establishes your Gateway, network identity and trust evidence. The second payer reuses all of it — only the new relationship’s scope is configured. Another transaction type reuses the same foundation while its native behavior is implemented and qualified. That is the network effect, measured in work you do not repeat. How it works →
The First State goes first.
The State of Delaware is investing $50 million over five years through its Rural Health Transformation Program to put the shared network to work statewide — Medicaid, health plans, providers and technology partners, together. Not a pilot — a state committing to common infrastructure, starting with prior authorization.
Demonstrated, on synthetic data: at the October 14 Connectathon, 25+ outside organizations completed 178 test exchanges, including 72 test authorization decisions, with 97.5% of evaluable responses successful — independent systems exchanging prior authorization end to end through the shared network (recap). Testing results, not production volumes.
Other states and participants can use the same network and build on the implementation experience rather than start over.
Join. Connect. Choose. Transact.
The test is simple: does the next counterparty or transaction take less work to activate than the first? How it works, step by step →
What this means for you
Open Access, with independent governance.
SHN charges no fees to join or connect, and no transaction fees for designated Open Access transactions, including the designated CMS interoperability transactions.
Organizations can choose additional help operating a connection, managing their network relationships or producing authorized analysis. Those services are optional. Participants still cover their own integration and operating costs. What is included and what is optional →
SHN is a neutral public-benefit utility. Its Public Benefit Corporation structure, common rules and independent Governance Council protect that purpose; an independent Data Rights Trust safeguards defined patient data rights, and a Participant Advisory Council gives users a voice in how the network evolves. How neutrality and patient rights are protected →
October 8, 2026: Version 1.0 of the Network Rules and Participation Agreement is published. Rules & Participation →
Built for the work across healthcare.
One patient. Many interactions.
1. Check coverage. Is the patient eligible, and what benefits apply?
2. Obtain prior authorization. Was the request received? Is information missing? Has a decision been made?
3. Coordinate treatment. Can the specialist, hospital and referring clinician complete the handoff?
4. Manage medications. Can prescribing, coverage and fulfillment work across their separate systems?
5. Follow up. Does the next person or organization know what it is responsible for?
Different transactions. Different systems. The same underlying problem. The infrastructure connecting healthcare should be reusable across all of them.
And AI makes this urgent. AI can make individual applications more capable. It cannot, by itself, resolve fragmented cross-organization identity, permissions, connections and accountability — without common infrastructure, we are automating the workarounds.
Common infrastructure can work across jurisdictions while institutions retain local authority over their systems and data.
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 →
Connect once. Do more together.
Bring a prior-authorization workflow, an existing implementation or the organizations in your market. Start with the systems you already have and identify the work that can be shared.
Bring one workflow, one implementation challenge or the organizations in your market. Start testing, join an Action Forum or talk with the team about how to participate.
Please do not include patient information, passwords or production credentials. See our Website Privacy Policy for how inquiry information is handled.
Smart Health Network PBC · A mission-locked Delaware Public Benefit Corporation