Governed AI · Academic Medical Centers

See how physician time is actually spent - and defend it in an audit.

RealActivity replaces manual time studies with a continuous, CMS‑accepted methodology that makes physician activity visible, auditable, and actionable - by the 15th of every month. Governed AI, on the provider side and the patient side.

100% accurate  ·  provider-verified  ·  by the 15th

100%
Data accuracy by the 15th of every month
<30sec
Monthly provider attestation - 60% done within 4 hours
15+ yrs
In production at Dartmouth Health
55+
Operational use cases from one master dataset
The principle beneath everything

Memory is not data.

For decades, physician effort has run on the least trustworthy data there is - human memory, reconstructed weeks after the fact and stretched across a year.

RealActivity doesn't ask anyone to remember. It captures activity as it happens and has a clinician confirm it in under thirty seconds. The result is a record you can do two things with that no one else can: defend it in a CMS audit, and safely govern an AI on it.

01

Capture at the source

Activity recorded as it happens, across the full period - no recall, no sampling.

02

Provider attests - under 30 seconds

The clinician reviews their own AI-curated record and signs off. A named human verifier on every entry.

03

Governed record

An attested, auditable record with provenance - ready to defend, and safe to feed an AI system.

One company, one record

Governed agents on both sides of care.

Governed data and a governed provider assistant on one side. Governed patient agents on the other. The human-verified, auditable record is the bridge between them. The RealActivity team is partnering with Anthropic (in progress) to extend governed Claude Mythos Preview access for defensive review of hospital code and systems - on the same OpenClaw harness as Tula and Aria.

Provider side · Governed data

Provider Activity & Ava

The system of record for how physician time is allocated - and an assistant that helps providers verify it.

  • Provider Activity Platform - CMS-accepted continuous attestation, by the 15th.
  • Provider Activity Studio - the workspace where providers review and attest.
  • Ava - the Activity Verification Assistant, governed by design.
How it works
Patient side · Governed agents

Tula & Aria

Open-source skills patients use today - records, visit prep, and Lookout for me - plus the governed platform hospitals run at scale.

  • health-records - pull medical records via SMART on FHIR
  • prep-my-visit and Lookout for me (myhealth-pulse)
  • Aria - governed patient agents at hospital scale

Patient side overview Watch the demo

Build 2026 · Patient frontier agents

Microsoft made work agents board-ready. The patient chart still needs a governance plan.

Aria is RealActivity's governed patient-agent layer for health systems, built on open-source Tula and the OpenClaw runtime Microsoft spotlighted at Build. In a 15-minute briefing, the team shows a live MyChart pull, visit prep, Lookout for me, and the audit trail around every model call.

See the Build26 briefing page Join My Aria waitlist Watch the demo

How RealActivity works

One platform. Three steps. Data you can defend.

AI curates activity data

RealActivity integrates with your ERP and EHR to compile all physician activity - clinical, research, teaching, and administrative - into a single, system-wide view. No manual collection. No surveys.

Providers attest in 30 seconds

Each month, providers review their AI-curated data and attest to their own percentage allocation. The form takes under 30 seconds - 60% are completed within 4 hours of notification.

Leadership gets defensible data

By the 15th, you have 100% accurate, provider-verified activity data. One dataset powers compliance, compensation, workforce planning, benchmarking, and audit preparation.

Activity Verification Assistant

Meet Ava. Governed by design.

Ava is the agentic assistant inside Provider Activity Studio, built on the same OpenClaw runtime that powers Tula. Providers ask questions about their activity data and complete the monthly attestation conversationally - in under thirty seconds.

Grounded in the attested record

Ava answers from the provenance-rich activity record - not from guesswork.

Human in the loop

The provider attests. Ava assists - it never decides the allocation.

Aligned with the NIST AI RMF

Designed to align with the NIST AI Risk Management Framework and its Generative AI Profile.

HIPAA, with a BAA

Operates under HIPAA with a Business Associate Agreement for deployments that touch PHI.

Proven at Dartmouth Health System

15+ years in production at a leading academic medical center.

The methodology was developed in direct discussions with CMS as an alternative to traditional time studies, and has supported successful third-party audits.

Compliance & Financial

Defensible where it counts

  • Medicare Cost Report (Schedule J) built on defensible physician time data
  • 340B drug program eligibility documentation maintained automatically
  • Successful third-party audit preparation with HHS and CMS
  • Compensation models defensible with RVU-matched benchmarks
Operational & Workforce

Capacity you can see

  • Clinical Workforce Committee makes hiring decisions backed by FTE data
  • Surplus capacity identified and redeployed across affiliate locations
  • Grant expiration planning gives months of advance notice
  • New affiliates onboarded within 2 months

// Phrasing note: "accepted by CMS as an alternative methodology." Case-study quotes pending Dartmouth sign-off before publication.

Why this matters now

The pressure on physician effort data is rising fast.

01

Unprecedented CMS audit expansion

CMS has expanded audit activity from roughly 60 to 550 plans annually, with medical coding staff scaling from 40 to 2,000.

02

Physician workforce crisis

The U.S. faces a projected shortage of 141,000+ physicians by 2038. AMCs that can't optimize capacity face compounding shortfalls.

03

340B under scrutiny

The 340B program faces intensified HRSA audits and manufacturer restrictions. Accurate effort documentation is foundational to compliance.

04

Rising physician labor costs

Physician labor costs rose more than $42 billion between 2021 and 2023. Leaders need precise data on how that investment translates to output.

Your trusted partner in mission-critical AI
Microsoft Solutions Partner Microsoft for Startups HIMSS openEHR Professional Members Azure
Start the conversation

Ready to make physician activity visible?

We offer a structured 90-day pilot on your data, with your providers, in your environment. The best first conversation connects your CMO and Compliance leadership.

hi@realactivity.com  ·  +1 857-206-1190  ·  Gloucester, MA