Primary care-focused EHR vendor Elation Health has acquired Aster, an AI-native EHR focused on women's health. In an e-mail Q&A, Elation co-founder and CEO Kyna Fong, Ph.D., described how the acquisition brings expertise in autonomous AI agents and accelerates Elation's development of what it calls an agentic operating system for primary care.

Aster’s team members, including co-founders Fifi Kara and Dr. Lailah Kara-Newton and Chief Technology Officer Nacho Vazquez, are joining Elation. 

Kara is a Y Combinator alum, and Fulbright Scholar who previously led design for Meta's Health & Fitness organization. Kara-Newton earned her MBBS from Barts and The London School of Medicine and has practiced obstetrics and gynecology for more than seven years, publishing research with the World Health Organization and the Royal College of Obstetricians and Gynaecologists. Vazquez designed Aster's full-stack technology and AI capabilities.

Healthcare Innovation: Could you describe what it was about Aster’s platform that made you want to acquire the company? How does what it created dovetail with what Elation already has in place?

Fong: Elation has been building AI natively into our EHR for several years, and we saw Aster as a team that could meaningfully accelerate that vision. They were already building sophisticated AI capabilities into their platform — clinical decision support, AI-assisted coding, OCR-based lab extraction, and more — and they built them with a clear point of view about how AI should actually work in a clinical environment. What we're acquiring is that expertise and approach. In Aster, we’ve found partners who share Elation’s vision for how AI can reduce the burden on clinicians, not add to it, freeing them to run sustainable practices and deliver the kind of patient care they went into medicine to provide.

HCI: Was the acquisition also about wanting to work with the Aster team?

Fong: Absolutely. Elation was founded in 2010 by me and my brother Conan, inspired by our dad's small primary care practice. Aster's co-founders are also siblings, Fifi and Lailah Kara-Newton. That shared origin story created immediate alignment around a clinician-first, patient-outcome-first philosophy. Aster has also shown it can work quickly and efficiently leveraging AI tools to build agentic software in its own company with its practice management tool for front-offices. We were impressed with what Aster’s team has built and wanted to ensure the talent made its way into the Elation team.

HCI: How is this deal representative of an evolutionary shift in the industry toward operational AI agents?

Fong: The good news is the sentiment is already there. According to our Elation Health Primary Care Pulse Survey, 78.8% of clinicians are already using AI, report it has impacted their practice favorably, with 45% of all practices planning to invest in AI or automation tools within the next 1 to 3 years. The foundation of trust is being built. What we're seeing now is the next evolution: moving beyond single-purpose AI tools toward agents that can take on comprehensive, complex, and repetitive end-to-end administrative workflows. That shift is especially significant in primary care. Primary care is the front door of healthcare. It is defined by referral management, multi-condition appointments, and longitudinal patient relationships, which means the documentation, billing, and operational demands are inherently more nuanced than in other settings. AI agents purpose-built on primary care workflows are what the industry actually needs to become sustainable now, both for independent practices managing costs and for physicians trying to work effectively and stay in the profession.

The urgency is real. This survey also found that 71.5% of clinicians are completing EHR work after hours daily or almost daily, and clinical documentation ranked as the single greatest operational burden, cited by more clinicians than any other challenge. That's not a minor friction point–it's a structural sustainability problem. This deal reflects an industry that has validated AI in principle and is now ready to deploy it on the front lines in pursuit of true impact and adoption. Primary care is where that shift is most overdue and most impactful.

HCI: What are some capabilities these AI agents can bring to primary care through your platform?

Fong: We’ve got a number of innovative capabilities our team is currently developing, all targeting routine work and administrative toil that are tedious, repetitive, rules-based. Managing appointment schedules, handling common billing workflows, ensuring the right patient information is collected upfront, and other administrative tasks are rich opportunities to free up clinicians and their staff to focus on more relationship-based work and enhancing patient care. The Aster acquisition has set the stage for several agentic opportunities that we know PCPs need and that our team is excited to deliver.

HCI: How long will it take for Elation to integrate the practice management functionality of Aster into its EHR platform?

Fong: We’ve built a number of core capabilities around practice management within Elation, such as Elation Analyst, which is an AI-powered chat feature that lets practices ask plain-language questions about their clinical and operational data. At Elation, we’re also working on automating scheduling appointments and inbound fax management. We know that given our focus on AI capabilities for practice operations, alongside our acquisition of Aster, the delivery of new functionality is imminent and we’re excited to continuously be rolling out fresh experiences for customers in the coming months.

HCI: Previously Elation acquired Lightning MD in 2023. Is this strategy of platform growth through acquisition something we are likely to see more of from Elation?

Fong: We’re open to it for the right opportunity. Our focus is on building the best platform for primary care. If it accelerates Elation’s mission and serves clinicians better, we'll consider it.