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By Alexis Kayser
Healthcare Editor
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Girish Navani gets emails imploring him to sell the company and retire, "pretty much every week." They suggest that it's time for the eClinicalWorks cofounder and CEO to get on the golf course, on the water—away from the health care industry's AI arms race.
The senders ask, "'Why do you keep doing this?'" Navani, 59, told customers during the keynote address at the health tech company's National Conference in Nashville last weekend. "But there is a much deeper sense of what we do and the pride we take in doing it, and the purpose with which we put ourselves to this."
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That purpose is closely tied to keeping advanced health care technology within reach of providers that lack the resources of major hospital systems, Navani told Newsweek during an October 23 interview. He believes the company can afford to give away some of its newest AI capabilities at no additional cost, even as competitors race to monetize the technology.
At the conference, Navani unveiled a redesigned EHR experience, a platform for building AI agents and two new business units that will take eClinicalWorks further into inpatient care and pharmacy management.
The announcements came alongside a significant financial milestone: eClinicalWorks and its patient engagement subsidiary, healow, expect combined revenue to exceed $1.3 billion in 2026. Healow alone is projected to generate $175 million.
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In speaking with Newsweek, Navani said the company's growth and privately held structure give it the financial flexibility to absorb costs that might otherwise be passed along to customers.
"We are a private company with no shareholders, so I have two choices, I don't have three," Navani said. "I don't have to worry about shareholders. I only have to worry about employees, and I have to worry about my customers."
That philosophy is increasingly central to the company's AI strategy, which Navani calls "democratizing AI."
AI adoption is advancing unevenly across health care. A 2025 American Medical Association survey found that 72 percent of employed physicians reported using AI, compared with 64 percent of physicians in private practice. The gap is even more pronounced among hospitals. Federal data shows that 86 percent of system-affiliated hospitals used predictive AI in 2025, compared with 37 percent of independent hospitals. Another Menlo Ventures report found that 27 percent of health systems had adopted AI, compared with 18 percent of outpatient providers.
But eClinicalWorks aims to balance the scales.
"We want to make AI affordable to even the solo practice," Navani said.
What eClinicalWorks is giving away
The centerpiece of the conference announcements was version 12.04 of eClinicalWorks' EHR, which introduces a redesigned interface called "Canvas for Care," also referred to as "Smart Canvas."
Rather than requiring clinicians to navigate multiple screens, menus and pop-up windows, the new interface is designed to bring patient information, AI-generated summaries, recommended actions and relevant tasks into a single workspace.
The feature addresses an administrative burden that has persisted despite years of investment in electronic health records.
A 2025 Commonwealth Fund report identified nonclinical forms among primary care physicians' leading sources of administrative work, recommending that EHR vendors integrate commonly used forms into their platforms and allow them to automatically populate patient information. In a separate 2026 survey by practice technology company Tebra, medical practices reported spending an average of 13 hours per week processing, correcting or following up on patient intake paperwork.
Whether eClinicalWorks' new tools will meaningfully reduce that workload remains to be seen, although Navani told customers to expect a 30 percent improvement in practice efficiency upon upgrading to 12.04.
"The number 30, while it sounds high, is not unrealistic," Navani told Newsweek. "We've done some internal benchmarks on just the revenue cycle mnagement side. The early number is 50."
"I could do double the work with the same number of people. That is not an insignificant game changer."
The company also introduced an AI-powered form builder and healowIQ, a conversational clinical intelligence tool integrated with EBSCO DynaMed that allows clinicians to ask patient-specific questions and review supporting medical evidence within the EHR.
Some of these capabilities will be included in existing subscriptions at no additional charge.
"[Version] 12.04 is going to include Smart Canvas and Form Builder and many other AI capabilities at no additional cost," Navani told Newsweek. "eClinicalWorks is absorbing the whole cost structure there."
It's an important distinction for health care organizations, especially in eClinicalWorks' market, which targets smaller, independently owned and local practices that often lack the resources of leading smart hospitals. Generative AI creates ongoing computing expenses, particularly when software repeatedly calls large language models to interpret information or perform tasks.
Navani said eClinicalWorks has calculated the likely usage costs of functions such as clinical documentation, form creation and scheduling, allowing the company to incorporate those expenses into its existing business model.
The company is drawing a line, however, at its new AI Workbench.
The platform allows health care organizations to build, deploy and manage their own AI agents, including agents that automate referrals, prior authorizations, revenue cycle tasks and value-based care workflows. It also supports connections to outside software, allowing organizations to develop automations that extend beyond eClinicalWorks' own EHR.
Unlike the more predictable usage associated with built-in AI features, customer-created agents could generate varying computing costs.
"Workbench is not free," Navani said. "I cannot eat their Claude tokens."
The platform will use a consumption-based pricing model, with customers paying according to usage. Navani said the company plans to provide some initial credits so customers can experiment.
For the capabilities included in existing subscriptions, however, the company is prepared to absorb the expense.
"It's going to cost a lot of money, but it's free [for customers]," he said.
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Building a business model around smaller practices
Navani argues that eClinicalWorks' ability to subsidize AI comes from two advantages: revenue growth and independence from outside investors.
The company is growing at approximately 12 percent, according to Navani, and has remained privately held since its founding in 1999.
"Any business that grows can afford to do what we are doing," he said.
Its existing scale is substantial. According to the company, its technology supports more than 1 million medical professionals and 180,000 provider organizations, particularly independent physician practices, federally qualified health centers, urgent care facilities and hospital systems.
For smaller organizations, the price of implementing AI can determine whether the technology becomes part of routine care or remains out of reach. Navani wants eClinicalWorks to make that decision easier by incorporating more capabilities into the software customers already use.
The company is also betting that its redesigned EHR will deliver meaningful productivity gains.
During his keynote, Navani predicted that organizations adopting version 12.04 could improve efficiency by approximately 30 percent within a quarter of implementation.
He told Newsweek that internal benchmarks in revenue cycle management suggest even greater potential, although those findings do not establish that medical practices will achieve comparable results.
The company's broader argument is that meaningful productivity improvements require redesigning clinical workflows rather than attaching isolated AI tools to existing software.
Health systems have struggled to integrate the technology into everyday operations, even after investing in the infrastructure to support it. In a June 2026 survey by Deloitte and the Scottsdale Institute, 30 health system executives gave their organizations an average score of 2.7 out of 5 on their ability to scale care delivery transformation. AI-driven role redesign scored even lower, at 1.7 out of 5, reflecting the difficulty of moving beyond isolated AI applications.
"Bolting on AI on top of a legacy architecture of technology is not going to work," Navani said.
"You're not going to attain that 30 percent [efficiency gain] by bolting on AI. It has to be immersive. Your core day-to-day workflows have to be changed and adjusted with agentic processes. It cannot be any other way."
The next test will be implementation at scale. The company plans to begin rolling out the new capabilities in November, with existing-customer upgrades to version 12.04 beginning January 15, 2027.
Navani expects most customers to upgrade during the first half of next year, citing the company's cloud infrastructure and experience deploying past versions. A spokesperson noted that between 92 and 93 percent of eClinicalWorks' cloud customers are on version 12.03, adding that while overall customer figures are undisclosed, most users are cloud-based.
Expanding to inpatient units and pharmacies
The conference also marked a significant expansion beyond eClinicalWorks' traditional ambulatory care business.
The company announced a new AI-native inpatient EHR aimed particularly at smaller community and critical access hospitals, alongside an integrated pharmacy management platform.
The inpatient system is designed to streamline hospital operations and connect them with pharmacy workflows and patient records.
Four hospitals have committed to early implementations, according to Navani, with at least 25 additional prospects expressing interest.
He sees an opportunity among smaller hospitals that may lack the financial and technical resources needed to implement or maintain more expensive enterprise systems.
"That tier of the market has been underserved with modern technology," he said.
Navani estimates that at least 2,000 U.S. hospitals fall into the market segment he hopes to reach, although that figure is his assessment rather than a verified count of prospective customers.
"People want to desperately figure out how to switch to a cloud-first, an AI-first product. They don't want the legacy. It costs too much. It's antiquated into design. They want to figure out something else, so that segment of the population of the hospitals definitely needs one."
The pharmacy business represents another potential growth opportunity.
Developed with East Georgia Healthcare Center, the new platform connects pharmacy inventory, prescription processing, electronic prior authorizations and 340B compliance with the patient record. It also incorporates healow Genie, the company's AI-powered contact center, to respond to routine prescription inquiries.
Navani hopes to have 100 pharmacies using the system next year.
Both businesses could expand the company's revenue base while reinforcing its broader strategy of connecting more health care services through a common technology platform.
"Pharmacy is going to be a big growth engine. Inpatient is going to be a big growth engine," he said.
For Navani, entering these markets is consistent with the same principle that has guided eClinicalWorks' expansion over nearly three decades.
"If you build good products with good service at good price points," he said, "you can always create a market."
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