Without building a single clinic
On 13 October I quote-posted a clip on X. Kevin Rose tells Tim Ferriss how he edited his podcast without touching the editing software: he dropped in three camera angles and two audio tracks, and watched ChatGPT make the cut. His conclusion: “You don't need the software anymore.” My question underneath: does that apply to an EHR as well?
Later I realised my question was too narrow. The record is only one of the screens between a patient and the people who treat them. The other is the front door: the phone call, the booking page, the referral. AI is reaching for both.
A clinic is not a warehouse
The sharpest frame comes from retail. Two a16z partners argued on 29 September that AI assistants don't need to replicate Amazon's warehouses to put pressure on Amazon's profits. They only need to become the place where you decide what to buy. Amazon made $69 billion from advertising in 2025, money earned by owning the moment of choice.
Translate that to healthcare and it stings. An AI assistant can hurt a provider without building a single clinic or hospital. It only has to sit where the patient decides.
The front door is moving. This month a Reddit user rang their dentist to move a cleaning and got a voice agent instead of hold music. It offered two slots, checked their insurance and texted a confirmation, within two minutes. They came away “weirdly impressed”. That agent worked for the dentist. The next one works for someone else. Avery, the AI assistant of US health insurer UnitedHealthcare, phones doctors' offices on the member's behalf. In a live demo it found an orthopaedic surgeon, told the practice it was the insurer's assistant and booked a slot. It's rolling out to more than 20 million members, and the president of rival insurer Aetna puts it plainly: “This is an agent doing this.” You can hear where this goes: the insurer's bot calling the clinic's bot, no hold music, nobody at either front desk.
Europe's version comes from the marketplace side. On 13 October Nvidia announced a minority stake in Doctolib, the booking platform with 50 million users. According to Le Monde, the money speeds up Doctolib's own AI models and a “personal health assistant for patients”, independent of OpenAI or Anthropic. That's Amazon's lesson learned early: become the agent before someone else's agent stands between you and your users.
The record stays, the screen goes
The EHR won't vanish like a video editor, because it holds the legal record, the audit trail, the orders and the bill. What changes is its role as the interface. 62.6% of US hospitals on Epic have adopted ambient scribes, so the clinician talks and the agent types. And patients' agents now pull the record straight out: since 8 September, Americans can connect their health history to Muse, Meta's personal agent, which then drafts questions for their next visit.
That same month, Amazon banned Muse from its shop. The agent that may not buy you a toaster may read your medical record. And a journalist at Inc found it had synced 187,000 lines of his private messages while his Mac's Full Disk Access setting was switched off.
The EHR keeps the data while the conversation moves elsewhere. A vendor that doesn't build the agent risks becoming plumbing, which is why Epic is building an Agent Factory for hospitals.
Whoever owns the moment a patient decides, and the moment their data opens, will earn the margin that used to belong to the provider.
Who really owns the patient?
In shopping, the assistant works for you, at least in theory. Avery works for the insurer. When it picks that surgeon, its ranking (price, contract, outcomes, or whoever pays) becomes a clinical decision made by a company with a stake in the answer. And a16z's warning deserves a second read: if the customer returns to the assistant each time, you haven't won a customer, only an order, and next time you have to win it again.
Here's how the chairs look once an agent sits at the front door:
Hospital
- Thinks it owns: the patient relationship
- Looks more like: capacity in someone else's funnel
Doctor
- Thinks it owns: a loyal patient list
- Looks more like: a slot that has to win every booking again
EHR vendor
- Thinks it owns: the clinician's working day
- Looks more like: the database behind someone else's screen
Insurer
- Thinks it owns: the claims
- Looks more like: the new front door, with a ranking nobody voted on
Patient
- Thinks they own: convenience
- Looks more like: the only party who could own the agent, if anyone builds one for them
That last row is Europe's opening. The European Health Data Space gives every citizen the right to access and share their record, with the first obligations landing in 2029. In Belgium, MijnGezondheid shows me my records, but it's a portal I log into, not a door my own agent can walk through. If public systems don't build that door, Doctolib, an insurer or Meta will, each around its own business model.
Take one question into your next strategy meeting: pick your most common patient journey and imagine an agent books it tomorrow. Whose agent is it, and why would it choose you? If nobody in the room can answer, someone outside it is writing that ranking right now.
💥 May this inspire you to ask whose agent stands at your front door.