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Nov 02 2026
Artificial Intelligence

How Health Systems Are Building the Data Foundation for Agentic AI

Before providers deploy agentic artificial intelligence, they should start with a solid foundation of data governance.

Healthcare organizations are finding plenty of use cases for agentic artificial intelligence, from increasing staff productivity to reducing data fragmentation. To fulfill their aspirations through agentic AI, providers need a reliable data foundation that comes with strong governance.

“AI can definitely increase efficiencies, but the key is getting it to increase productivity for the organization,” says Christian Lindmark, vice president and CTO at Stanford Health Care and the Stanford University School of Medicine. “That's where governance really comes into play.”

Widespread adoption of healthcare data standards supports the work agentic AI can do. Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs) and U.S. Core Data for Interoperability (USCDI) health data classes and data elements, along with terminologies such as SNOMED CT and LOINC, provide an essential base, says Faila Santos, senior digital health adviser at HIMSS.

“Fragmentation does not disappear, but these standards can reduce the need to rebuild the plumbing for every new task,” says Santos, who is also a family nurse practitioner.

EXPLORE: Build a foundation for scalable artificial intelligence with an AI-ready infrastructure.

Stanford Health Care Builds AI Agents for Cancer Research

In 2025, Stanford Health Care partnered with Microsoft to use the company’s healthcare agent orchestrator to reduce fragmentation and produce insights from data that was challenging to search. The Palo Alto, Calif.-based health system decided on thoracic tumor boards as the first use case. Stanford Health Care uses Microsoft Azure for its cloud infrastructure and builds out its own AI agents. Databricks houses Stanford’s data lake.

Tumor boards require oncologists to gather patient history and diagnostic information for creating a treatment plan, collaborating with surgeons, radiologists and other specialists. Now, AI agents can automate the creation of patient summaries before the meeting.

Stanford Health Care began the tumor board project with a pilot implementation that ran for about three months. After some feedback, the organization moved the pilot to full production use.

“To schedule an appointment, it used to take several days. Now, their backlog is the same day,” says Anurang Revri, vice president and chief enterprise architect at Stanford Health Care.

The time savings created with the tumor board AI agent is a major achievement, Lindmark notes: “To be able to get a few weeks back in terms of that cancer spreading or other things taking place, that's a huge win from a patient outcome standpoint.”

When implementing advanced AI, trustworthy data and responsible practices should be given priorities, Santos says: “Agents need a governed way to retrieve the right information in the right context, under defined identities and permissions appropriate to the use case.”

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At Stanford Health Care, for example, its Data Science Executive Committee (DSEC) oversees governance for AI models that includes providing approvals and education on change management. The committee also oversees new tech funding, and Lindmark has one chance per year to ask for operating money for the health system’s budget.

“Any new AI agent that's going to come into the organization that will affect the clinical outcomes in any way has to be presented to the DSEC, which is chaired by our CEO and our CMIO,” Lindmark says. “They review all those requests and sign off to ensure that they agree with the assessment that's been done, and it’s responsible and safe for deployment.”

It also helps when a solution isn’t reliant on one model. “The models are changing so fast, it’s best to ensure that whatever you're building can be model-agnostic as newer versions come, or if you want to use a lower-cost model, have the ability to go between models fairly easily,” Lindmark says.

As to what’s next, Revri plans to create more agentic workflows at Stanford Health Care to build on the tumor board’s work.

“We are starting to move more toward a service-line focus, which is cancer treatment,” he says. “What is needed for cancer treatment? We look at it holistically to see if a series of agents can help.”

Similar to how oncologists can choose among a set of agents to help with their job, cardiologists could as well, Revri says. In addition, Revri and his team are evaluating the ROI of low-cost models versus frontier AI models.

Stanford Health Care will also fine-tune the agents to improve their efficiency, Lindmark adds.

READ MORE: Here's what infrastructure can and cannot do for your data.

Allina Health Develops AI Agents to Assist Clinical Workflows

Minneapolis, Minn.-based Allina Health is developing a next-generation data architecture with Databricks to connect all of its data pieces together so that AI agents can operate on top. “Getting the data structured, having it well defined and then continuing to manage and govern it is critical,” says Chief Digital and Information Officer Dr. Dave Ingham.

An interface layer is a key aspect of the agentic AI data foundation, he notes, describing it as a computing structure that acts like a translator to communicate in the language of various systems to request data.

“They don't talk to enough things, and that's why we have the robust interface engine to go get the data and perform the tasks,” Ingham says. “That's what really unlocks automated complex workflows that until now have always required humans.”

Allina Health has developed an AI agent called Alli, which acts as both an operational and clinical AI assistant. The idea is to take pressure off contact center human agents and help with patient triaging to find out why they are calling, Ingham says.

Meanwhile, another AI agent reviews the charts of incoming psychiatry patients for violent history, Ingham says. It uses thresholds with a color code to determine which patients have been violent. “It helps keep our patients safe, keep our care team members safe or at least more prepared for potential outbursts,” Ingham says.

32%

The percentage of healthcare organizations that cited data quality or access issues as challenges that previously limited their use of AI but that are no longer challenges

Source: deloitte.com, “Many health care leaders are leaning into agentic AI as adoption hurdles ease,” Feb. 11, 2026

In addition to the interface engine, Allina’s agentic AI data foundation includes a robust data governance strategy, including a rigid intake process for AI. When the organization develops an idea for a new project, it goes through many reviews, such as a privacy review, a security assessment and now an AI review, Ingham says.

The AI review team evaluates if the project makes sense and fits into Allina Health’s tech ecosystem. The team is reviewing more than 50 tech ideas, which is stretching its capacity. Strategic partners can help break these logjams; Allina Health works with CDW on mid- to lower-complexity agentic AI workflows to determine where the data needs to go, Ingham says.

“I am hopeful that the platform we're building in house with some support from CDW is going to help us to rapidly turn around some use cases, because we have a lot of really good ideas that come from our operational teams,” Ingham says. “We're trying to build that skill to more rapidly crank through the use cases and all the great ideas that are out there.”

Duke Health’s AI Governance Process Ensures AI Agents Are Safe

For N.C.-based Duke Health, data and AI governance are paramount for high data quality and reliability, and to deploy solutions that are safe and effective for patients. “Data governance should not be an afterthought,” says Chief Health Information Officer Dr. Eric Poon, a doctor of internal medicine. “To have good data to feed the AI, you need to understand where the data is coming from.”

The health system formed a clinical group to ensure that its Scout AI tool performs complex tasks accurately, such as when summarizing a hospital course for the purpose of preparing a discharge summary on a patient’s hospital stay. Scout relies on agentic AI to break down chart review tasks into different components. Then, subagents go into a patient’s electronic health record to find answers to questions.

Scout uses foundational large language models such as GPT, Poon notes. “We access the GPT-5 model from OpenAI through APIs that Microsoft provides to us through our subscription to the Azure Cloud,” he adds. It involves a combination of cloud and on-premises infrastructure, AI and integrations with Epic’s EHR platform.

As Duke Health deploys more agentic AI tools, it wants to collect data on their impact, Poon says. For example, the organization found that Scout can reduce the time to complete tasks by about 40%.

“We don't want to deploy tools just because they appear to work well. We want data to back it up,” he says. Within the first month of deployment, 2,000 clinicians have used Scout.

While many agentic AI tools are just starting to prove their worth, providers are optimistic about their staying power. “Agentic AI will only succeed when the health system has the right data foundations, the right governance, workflow integration and human accountability to let AI act both safely and effectively,” Poon says.

Photography by Angela DeCenzo