No rip-and-replace
Over the existing EMR
Modern patient access on current systems.
At a multi-branch eye-hospital group, care was organised around the hospital's systems rather than the patient's journey. Appointments ran largely through phone operators, visit history was fragmented across branches, and legacy software recorded what happened without proving who was accountable for it.
Mnerva built Hygieia, an AI-native hospital operating system that sits over the existing EMR with no rip-and-replace. It pairs modern patient access with governance built into the core — and connects the hospital to India's national health rails. AI assists; people decide, approve and remain accountable.
No rip-and-replace
Modern patient access on current systems.
Consequence-based authority
The greater the consequence, the more explicit the approval.
Provenance ledger
Who decided what, when, and on whose authority.
Most appointments were booked by phone through a small team of operators — a bottleneck that depended on staff availability, with little self-service even for returning patients. Records did not follow the patient cleanly across branches, and there was limited operational visibility into utilisation, no-shows or where the day was slipping.
Underneath, the real gap was accountability. When software touches a clinical or billing decision, someone has to remain responsible for it — and legacy systems were never designed to prove that.
Rather than replace working systems, Hygieia extends them. The hospital's existing EMR remains the clinical source of truth; Hygieia adds a modern experience layer and a governance layer alongside it — so the hospital gains new capability without a risky migration.
Patients book by branch, speciality and doctor in minutes — instead of a 15-minute phone call.
A unified visit history follows the patient, removing duplicate registration and re-entry friction.
Pay online or in person, check in on arrival, and see live queue position.
Clearer cross-branch scheduling and a single view of the day's patients and status.
Governance built in, not bolted on
AI assists; people decide, approve and remain accountable.
Hygieia is designed to work within the national health ecosystem — so the hospital stays compliant, interoperable and insurance-ready, with patient consent and accountability preserved end to end.
Links records to a patient's ABHA (Ayushman Bharat Health Account) under the Ayushman Bharat Digital Mission — consent-gated, so patients control what is shared.
Clinical data exchanged in FHIR, so records move cleanly across the network while the hospital remains the source of truth.
Designed to support insurance and cashless/TPA claim workflows, with the documentation and audit trail claims require.
Designed to support NABH-style quality and safety expectations — structured records and provenance keep the operation audit-ready.
Access, roles and auditability follow DPDP Act 2023 and ISO 27001 / ISO 42001 thinking.
Every disclosure is patient-consented and recorded, so sharing never comes at the cost of control.
Integration scope spans live and in-progress capabilities; specifics are confirmed per deployment.
Healthcare doesn't need AI bolted onto the edges. It needs intelligence inside the operating system of the hospital — where it can remove load and improve responsiveness, while accountability stays architectural rather than a policy afterthought.
For NIO, that meant a modern patient experience and national-standard compliance, on a foundation where AI assists and people remain firmly in charge.
See where a governed, AI-native operating layer could create capacity — starting with a Business View.