Smart Discharge Navigator: An AI Agent for Hospital Readmission Risk — Built on IRIS for Health

Hospital readmissions cost the US healthcare system $17 billion annually. A significant portion of those readmissions are preventable — but only if the right information reaches the right clinician at the right moment: at discharge.

That's the problem I set out to solve with Smart Discharge Navigator, my entry for the InterSystems Programming Contest: AI Agents for FHIR 2026.

Hi Community,

Have you ever wished your EHR could think? Not just display data. Not just fire alerts. But actually read a patient record, reason over clinical guidelines, and write a structured referral order back to the system — in response to a single message from a clinician

In this article, I am going to show you how to create your own custom clinical AI agent.

🏥 About iris-fhir-agents App

iris-fhir-agents is a multi-agent clinical AI platform built entirely on InterSystems IRIS for Health.

When I started building Smart Discharge Navigator, I faced a common challenge: FHIR data is stored as JSON bundles, but the analysis I needed required joining multiple resources together, the kind of thing SQL was built for.

InterSystems FHIR SQL Builder solved this completely. Instead of parsing JSON bundles in application code, I was able to write plain SQL directly against FHIR resource projections inside IRIS for Health. This article shows exactly how I used it to build the population-level readmission risk scoring engine at the heart of the application.

An AI agent reads the FHIR patient record before the consultation, asks the right questions based on what it already knows, detects critical red flags, and writes its findings back — so the physician arrives prepared.

Healthcare Pain Points Addressed

Before a patient walks into a consultation room, a critical failure has already occurred: nobody read their medical history. The physician has 15 minutes. The patient repeats their conditions, medications, and allergies for the third time that year.

Hi Community,

In this article, I will introduce my application iris-fhir-agents A multi-agent clinical AI platform powered by InterSystems IRIS for Health. Features agents for triage, specialist consultation, pharmacy safety, and FHIR server exploration — all grounded by IRIS Vector Search RAG. Includes a no-code Agent Builder that lets you design and deploy custom clinical agents without writing a single line of code.

In the previous article, we used pyprod to create production components while relying on the UI for production configuration. That same production can now be defined entirely in Python:

from intersystems_pyprod import Production, ServiceItem, ProcessItem, OperationItem

iris_package_name = "HelloWorld"

class MyProduction(Production):
    services = [
        ServiceItem(
            "MyServiceName",
            "HelloWorld.MyService",
            host_settings={"target": "MyProcessName"},
        )
    ]
    processes = [
        ProcessItem(
            "MyProcessName",
            "HelloWorld.MyProcess",
            host_settings={"target": "MyOperationName"},
        )
    ]
    operations = [
        OperationItem("MyOperationName", "HelloWorld.MyOperation")
    ]

On save the ClassMethod:

ClassMethod create() [ Language = python ] {

 print("python") 

}

it has received the error : Compilation started on 06/03/2026 02:15:21 with qualifiers 'cuk /multicompile=0'

 ERROR #7802: Worker job/s '1078:17' unexpectedly shut down in group '#Default:(9119826733444):0'.

 ERROR #7802: Worker job/s '1078:17' unexpectedly shut down in group '#Default:(9119826733444):0'.  

with the compileFlags "cuk" the return is:

ERROR #7802: Worker job/s '1160:34' unexpectedly shut down in group '#Default:(6933525859080):0'.