Dock for healthcare operations is the workspace where clinical-workflow agents draft chart summaries, prior-authorization packets, and throughput notes, and where a licensed clinician signs off before anything leaves the building. The chart lives in Epic. The encounter lives in Cerner. The agent's interpretation, the reviewer's name, and the timestamp live in Dock, attributable to a specific agent identity and a specific human, every action in an audit log a HIPAA security officer can read.
Where the line falls
Epic, Oracle Health (Cerner), athenahealth, Olive AI, and Notable stay the system of record for the raw clinical data. Dock is the system of record for what the agent interprets from that data: the prioritized worklist, the prior-auth draft, the reviewer's sign-off, the audit log. Each Dock row carries a pointer back to the platform record (epic_patient_id, cerner_encounter_id), the agent identity that wrote it, the clinician who approved it, and the timestamp. The agent re-fetches via FHIR when it needs current state. Dock holds the persistent interpretive layer that survives across sessions.
One Dock surface: the prior-auth worklist
| epic_patient_id | cerner_encounter_id | service | agent_draft_summary | clinical_evidence_cited | reviewer | sign_off_at | status |
|---|---|---|---|---|---|---|---|
| ep-447821 | cn-99214-A | MRI lumbar, w/o contrast | 6-week conservative therapy failed, radiculopathy on exam | PT notes 03/14, MRI criteria LCD L34423 | Dr. K. Patel, MD | 2026-05-29 14:22 | submitted |
| ep-448103 | cn-99215-B | Continuous glucose monitor | T2DM, A1c 9.1, on basal-bolus insulin | A1c lab 05/02, meds list confirmed | RN J. Ortega (pending MD) | pending | held: MD review |
| ep-448290 | cn-99213-C | Cardiac rehab, 36 sessions | Post-STEMI, ejection fraction 38% | Echo 04/18, discharge summary | Dr. L. Nguyen, MD | 2026-05-29 16:05 | approved |
The row is the unit of accountability. A regulator asking "who decided to submit this" gets a name, a credential, and a time.
A worked flow
A Notable agent pulls the day's prior-auth queue from Epic via FHIR. For each pending request, it reads the encounter, the meds list, and the relevant LCD, then drafts a packet into a new Dock row with cited evidence inline. The row is created drafted_by: notable-agent-clinops-02. The agent does not submit. The covering physician opens the worklist, reviews the draft, edits if needed, and signs. Sign-off flips status to submitted and triggers the payer API call. The audit log records agent identity, FHIR resource IDs, draft hash, reviewer NPI, sign-off timestamp. Reversing the submission requires a two-key handshake under the dangerous-ops contract.
Why this matters
Prior authorization is the highest-volume administrative workflow in US healthcare, and the AMA reports that nearly one in four physicians say prior authorization has led to a serious adverse event. Agents that can draft packets accurately are a real lever. But a draft is not a decision, and a decision without an attributable human reviewer is not defensible under HIPAA's audit and access requirements.
Dock fixes the seam. Every agent action is bound to an identity registered through agent identity and lifecycled through agent identity lifecycle. Every reviewer action is bound to an NPI. Every row points back to the EHR record it interpreted. This is what agent audit and compliance looks like clinically, and what Dock for compliance generalizes. AHA coverage of AI in hospitals treats attribution as a precondition.
Sign up for Dock and connect Epic, Cerner, or athenahealth.
FAQ
Is Dock HIPAA-eligible? Dock signs BAAs. PHI in a Dock row is encrypted at rest, scoped to the agent and reviewers on the workspace, and surfaced in the audit log.
Does the agent submit prior authorizations on its own? No. The agent drafts; a credentialed human signs. Submit is gated behind reviewer sign-off.
How does Dock connect to Epic or Cerner? Through FHIR APIs using OAuth-scoped agent credentials. Dock stores the agent's interpretation with a pointer to the source resource, and re-fetches when current state is needed.
Who is accountable when an agent drafts a bad packet? The reviewing clinician, the same as today. Dock makes the chain of evidence auditable, so the reviewer is reviewing a real artifact, not a black box.
