Microsoft is governing work agents. The patient's health agent is the layer nobody is governing yet.
Aria is the governed patient-agent layer for health systems, built on open-source Tula and the OpenClaw runtime Microsoft put at the center of Build. In 15 minutes, we will show it pull a live MyChart record and apply identity, policy, model routing, and audit to every call - with governance designed around the NIST AI Risk Management Framework.
No slideware: live chart pull, visible policy, replayable audit.
At Build 2026, Microsoft put OpenClaw into the enterprise-agent conversation and built the moment around one question: how do you let an autonomous agent act on real data without losing control of it? Microsoft answered it for work. The same question is unanswered for the patient. Aria is that answer.
Your patients already have a second conversation. It is happening outside your governance.
Your patients use MyChart for transactions. They use consumer AI for questions. The second conversation is ungrounded in their record, unmonitored, and increasingly habitual. It is already happening at scale.
MyChart
Transactional, secure, central to your workflow.
Consumer AI
The unsanctioned conversation. Ungrounded, unmonitored.
Aria
The governed patient-agent layer between them. Grounded in the patient's data via SMART on FHIR, with hospital-scale policy and audit over the same Tula skills patients already use.
Patient AI you can defend clinically
See the real chart pull, visit prep, and Lookout for me workflow - with the human and the audit trail still visible.
Watch what the briefing shows →Governance before the model call
Identity, policy, routing, and replayable audit over the same OpenClaw/Tula foundation your technical team can inspect.
Review the architecture →A pilot that does not start with theater
Start with a 15-minute live demo and a narrow 90-day path: real record, real governance, clear owner.
Book the 15-minute briefing →Three things that make Aria different
Built on the runtime Microsoft spotlighted
Aria runs on Tula, built on OpenClaw, the same open-source runtime Microsoft just put at the center of its enterprise agent strategy. The RealActivity team made that bet early.
Complementary, not competitive
Microsoft's agents live in your work data. Aria lives in the patient's clinical record, via SMART on FHIR. Different surface, different governance, different job.
The governance gap nobody owns
The governance problem Microsoft spotlighted at Build is unsolved for patient-side health AI. No one is governing the agent your patients use for their health. That is the layer Aria provides.
Open
Inspectable Tula core. No black-box vendor lock. Apache 2.0 licensed.
Verifiable
Full audit, policy enforcement, and hospital-controlled trust at every layer.
Patient Agency
The longitudinal record lives with the patient. They authorize, they hold the keys.
Real
Grounded in 30 years of operational reality across dozens of US hospitals.
What you will see in the demo
- health-records - pull medical records from MyChart via SMART on FHIR
- prep-my-visit - IPS-aligned visit prep from the patient's chart
- Lookout for me (myhealth-pulse) - curated health-signal digest
- Aria governance gateway - model routing and audit patterns designed around the NIST AI Risk Management Framework
Real record. Real governance. Not a slideware mockup.
Individual or caregiver? Join the My Aria waitlist. Prefer email? Ask for the pilot brief.
How it works
Patient authorizes through MyChart. Tula skills pull the record (health-records), prep the visit (prep-my-visit), and run Lookout for me (myhealth-pulse). Aria applies identity, audit, and model routing so the health system governs the same skills at scale.
Why RealActivity
RealActivity is a team whose work spans dozens of hospitals across the US over the past 30 years, with clinical, compliance, and engineering depth across the company, including governed AI proven in production inside an academic medical center. The team's methodology is accepted by CMS as an alternative to traditional time studies, used in successful third-party audits. RealActivity is a Microsoft for Startups graduate, Growth Phase, and a Cloud Wars healthcare AI analyst, and is partnering with Anthropic (in progress) to offer governed Claude Mythos Preview access for defensive code and systems review on the same harness as Tula and Aria. Tula is shipping today as the open-source core, and credible builders are contributing to it alongside the RealActivity team.
Microsoft is governing work agents. The patient's health agent is the layer nobody is governing yet. Let the RealActivity team show you the layer.
See it on your own record path
Book a 15-minute briefing. Name, organization, and work email are collected when you book; you will receive a Teams invite by email.
Not ready to book? Ask for the 90-day pilot brief or send two times that work for your team.