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HIStalk Interviews Andrew Smith, Managing Partner, Impact Advisors

April 7, 2025 Interviews No Comments

Andrew “Andy” Smith is founder and managing partner of Impact Advisors.

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Tell me about yourself and the company.

I started Impact Advisors 18 years ago with my brother, my wife, and one of our dear friends. It has been a journey. I feel very blessed and grateful for all of the great clients that we get to work with and all the great associates that have joined our team.

We are dedicated to healthcare. We have become a full-service healthcare management consultancy over the last 18 years. I am  proud of the work we’ve done.

What topics are top of mind for health system IT leaders?

It’s no surprise that merger and acquisition activity is driving a lot of work, particularly in the technology space. The technology becomes the central nervous system of a health system. As you merge, acquire, and increasingly, divest, we’re seeing a lot of investment to standardized systems. 

That ultimately drives standardization of systems, workflows, and process. That’s the biggest driver of technology change, and in itself, drives a lot of other things in terms of change management, optimization around clinical or rev cycle, labor force, or supply chain. We have built a lot of services to complement the technology change. We consider ourselves a technology-enabled process improvement firm. That’s an important part of catalyzing change and making sure that it’s persistent.

How does cloud migration fit into the strategy of health systems?

The migration to the cloud is probably going slower than most people would anticipate. But it’s obviously important in terms of scalability, the ability to make change quickly and to do it economically. It’s definitely a direction that’s going to continue. We have built services to help our clients make that journey. We think it’s an important complementary technology to all the other things that we talked about in terms of standardization, normalization, and change management.

What is the level of demand for AI-related services?

The demand is high. I don’t know if we’re at the zenith of the hype curve, but we’re probably getting pretty close. It’s getting debated in boardrooms. People are concerned about it. Our particular perspective is that the promise of it is unparalleled. This is a real revolution in technology and the opportunity is amazing.

It has been a slow uptake. A lot of people are hoping that their core vendor platforms are going to help them with this. But we think it’s a much more nuanced kind of patchwork quilt that people are going to have to embed into all of their systems.

Our advice is, don’t take it all on at once. Find a particular area or use case and focus on that. It’s hard not to get excited about it, but we will have to go through that hype curve. Then it becomes useful and embedded in the technology and workflow.

AI is changing daily and switching costs seem to be generally low. How will vendors plan for possible churn?

Our advice is on these innovative things is, don’t bet the farm. Place bets that you may be OK with displacing in two or three years as the market evolves, where it’s really nascent where we are right now. There will be a lot of change, a lot of dynamicism. It’s important to pilot. It’s important to be able to move quickly if you recognize that things aren’t working and cut bait and move on.

How are health systems addressing clinician burnout?

Just cleaning up the AI-generated note, abstracting, and patient communications are all good use cases for AI. All would help with clinician burnout. There’s high promise there. If you look at some of the EMR technology, what they’re doing in terms of building the note and building frameworks and templates for clinicians is probably one of the best things we can do with AI.

As they say, AI isn’t going to replace our clinicians, but clinicians who don’t use AI might get replaced by clinicians who do use AI. That’s really the future. This is not going to replace our clinicians. It’s got the promise to make their lives easier, to improve their efficacy, and to improve the clinical outcomes as a tool, but not as a displacement technology.

How do AI vendors pick a path to coexist with the handful of major health system EHR vendors?

There’s such a high barrier to entry. The path would be to find an area of expertise that’s maybe complementary or a different business model, like in the ERP space, where cloud vendors remove some of that high cost barrier to entry. 

We’ve condensed options in the EMR space to just a few platforms, and that won’t change any time soon. It takes years and it’s a complicated workflow that is hard for a new entrant. The technologies that I get excited about are those that are tackling or complementing a particular use case. Some exciting things are happening in the ambient documentation space, but it’s a high barrier to entry.

How do consulting companies resist the urge to offer any services that someone will pay for and instead develop a narrower but deeper and more easily explained expertise?

We develop services in collaboration with our clients. We’ve got a really nice relationship with them, I am grateful and thankful for the clients that we get to serve. Our service lines are developed collaboratively where our clients have need.

A CEO told me that no matter what the market is, if you’re helping people be more efficient, be more safe, and provide better clinical outcomes at a better price, you’re always going to be successful as a health system. If we can support that mission, then we’ll always be successful as a consulting firm. 

We’re excited about data and AI as an important growth topic for us. Business process outsourcing is a huge growth area. As people reach steady state and have implemented new ERP and EMR platforms, how they can maintain and enhance those platforms at a cheaper price? That’s a huge growth area for us.

We’ve developed some near-shore capability. We’ve developed a lot of outsourcing capability. That’s a real growth engine for us. As I said, mergers and acquisitions are driving a lot of it. If we can help our clients get to whatever their new normal is, or their aspirational state post-merger, that’s important and something that our clients are going to demand.

What is the health system balance now among outsourcing, managed services, and contracted short-term resources versus building their own internal expertise?

I’ve seen growth in demand around discrete outsourcing around particular processes, particularly AR management, rev cycle, supply chain, and clinical help desk. Things that are discrete carve-outs that may not be the mission of a health system. Economies of scale can be provided if you outsource some of those things, and maybe a discipline and set of methodologies that might be helpful.

We’ve seen a return to full outsourcing over the last couple years, but I’m not sure that’s always as effective. Sometimes the health system needs to control those moments of truth — their interaction with their customers, their clients, and their caregivers.

What is the status of remote work?

It has been fascinating to see how quickly that changed with COVID. We have always been remote. We have two offices, both in the Chicagoland area, but we are working in 48 states right now and have people living in all 50 states.

It has been an interesting shift for our clients as they move to remote. It requires a different management model and a different level of discipline and  communications to make that effective. Some of our clients have struggled with it, and some are really excelling at it.

I don’t see that it’s ever going to go back to the expectation that everybody will be in the office five days a week. Our clients like some flexibility, their staff likes some flexibility, and our staff likes the flexibility. It hasn’t reduced the efficiency of our clients or certainly our business, but you do lose some things around communication, teamwork, and joint problem solving. A hybrid environment makes a lot of sense.

We were wondering if this would be threatening to a consulting model, that all of a sudden our clients, instead of hiring consultants or purchasing services, they would just hire people in Fargo, California, New York, or wherever the talent may be. That has happened a little bit, but for the most part, we haven’t seen a huge displacement of our services resulting from that.

How are health systems and your company reacting to recent economic events, the possibility of major HHS changes, and the unknown role that the federal government wants to take in overseeing health systems?

I’ve talked to a lot of our clients and they are all worried about it. It’s at the top of everybody’s list. They are worried about cuts to Medicare, and Medicaid. 

NIH cuts have already affected them. I met with a researcher at a children’s hospital a couple of weeks ago whose entire budget had been slashed. They had longitudinal studies in flight and they are scrambling to find private and other public funding sources. Hospitals and providers will have to make some pretty difficult choices about whether they continue to fund these through operating income or they close down and scuttle some of these programs. 

They are all threatened and not quite sure what exactly it means, but I see our clients starting to tighten the belt, start some austerity, and get nervous about these anticipated changes.

It’s a tumultuous time for our providers and our health system right now. I feel an obligation to help find a way out of this, to find creative solutions. The answer is almost always that you can do things more efficiently. If you can do them more effectively, if you can make things safer and improve outcomes, that’s good for everybody. That’s what we’re going to stay focused on.

We talk about rising tide and waning tide services. Rising tide services might be as health systems can make big investments in big technology platforms, that’s a rising tide. We can help them with that. If there is waning tide, austerity, or labor issues, we have a set of services to help with that, too, in terms of labor optimization, change management, and workflow optimization. We can do that in different ways, such as that we would only benefit if they benefit. We can price things differently and more creatively. We can help our clients navigate these tumultuous times, but it’s going to be weird for a bit and our clients are nervous about it.

Despite some of the challenges, I’m really excited about the promise and potential of the solutions, the creativity, the technology, and the change. It seems like we’re working through a really magical time in our industry. We’ve seen a lot of change. I’ve been in this industry for 30 years and I’ve never been more excited about the pace of change, the opportunity, and the new and novel things that we’re doing as an industry. It’s an exciting time. I’m pleased to be serving our clients in the industry and I’m proud of our team that we’ve built and the work that we are doing.

Curbside Consult with Dr. Jayne 4/7/25

April 7, 2025 Dr. Jayne No Comments

I spent the majority of this weekend training to use a new electronic health record system and completing practice onboarding.

I’m going to be doing some per diem work at a local practice. It is busier than it wants to be, but not quite busy enough to support adding an additional physician. The practice needs additional coverage, especially before and after their physicians have scheduled vacation. Those are windows of time that usually end up overbooked, as physicians struggle to see people before they leave town or face an overloaded schedule when they return.

They are also looking for inbox coverage and possibly some acute care coverage during the vacation. It’s an ideal scenario for me because the physicians typically schedule their vacations six months in advance. That gives me plenty of lead time to build my consulting engagements around those weeks. I’ll also be doing some coverage here and there during the intervening months to become familiar with how the office runs.

The practice uses a fairly well known EHR. They signed me up to watch some online training modules first. I’ve used so many different EHRs over the years that I didn’t expect anything earth shaking as I sat down with my laptop and a nice cup of tea.

The first thing that struck me as I logged into the learning management system was that they had assigned comprehensive training to my profile, which included a broad swath of specialties that I don’t practice and won’t be covering. I called the office manager to make sure that this was intentional since family medicine uses a lot of the subspecialty templates. It wasn’t immediately clear whether that choice was made by the office or the EHR vendor.

Since I was being paid for the full time that was needed to cover all the assigned courses, I didn’t want to spend more time arguing about it. Not to mention that I figured that it would be a great way to see what vendors are developing and whether there’s anything new.

I had the practice’s training environment open while I was watching the modules. I have found that to be the easiest way to handle content, such as personalizing the physician workspace or setting up medication favorites. I learn by doing, so I was surprised that following the prescribed learning plan meant sitting through almost 90 minutes of content that didn’t contain anything that was remotely interactive. It reminded me of the old-school training I used to see when I was first doing informatics work, with a deluge of material that just droned on and on.

I’ve had enough experience working with people who are well versed in adult learning theory to know that this isn’t ideal. The voiceover for the training almost lulled me to sleep several times. I decided to switch from tea to my favorite coffee concoction, which is jokingly referred to as rocket fuel by those who have sampled it.

I have to say that this level of caffeine jolt was sorely needed. I ended up having to wade through specialty documentation with no way of fast forwarding or indexing to the part covering templates that would actually be of use to me. For example, the OB/GYN content wasn’t subdivided by template or visit type. I’m not going to be doing any obstetric visits, but do need to know what content is available for acute GYN problems.

I ended up just letting the video run its course and randomly surfing through the content that was available in the training environment, learning in a more hands-on way. I’ve done enough locum tenens and per diem work over the years that if I can document my top 15 most common visits, I’ll be good to go for at least the first day and will eventually pick up the rest of the workflows I need to know.

I was somewhat surprised when I arrived at the coding and billing part of the documentation template. It didn’t seem to be taking into account the newer coding guidelines that went into place a couple of years ago. The suggested codes were easy to override, but it gave me a bad feeling about the vendor in general, as if they weren’t keeping up with the times.

I couldn’t figure out how to see what version I was using or when the last update was, so I jotted those down as questions for my next conversation with the office manager. It also didn’t look like the Health Maintenance guidelines were totally up to par, because the recommendation for RSV vaccination for non-elderly adults wasn’t current, either. That’s a newer item, so I could see how it might be coming in a future upgrade, but  not having it in the reminders would be a bit of a pain for clinicians.

Day 2 was filled with completing all the practice’s HIPAA, Conflict of Interest, Ethics, and Fraud / Waste / Abuse training. I’ve done so many of those over the years that I can just about recite them. I can also generally predict the clinical scenarios that are going to be used. As someone who has worked in so many different places, I have a dream of a training passport that would exempt people from having to do the training at every new place, but I know organizations like to put their own spin on training.

I’m always on the lookout for a module that will top the wildest one I’ve ever seen, which I had the pleasure of watching when HIPAA first came out. It was a badly acted video with mafia overtones, kind of likening the idea of violating HIPAA to a brush with organized crime. It was so bad, but so attention getting, that nothing has really topped it yet.

I also had to fill out a ridiculous amount of credentialing paperwork, which I haven’t had to do in a number of years. Fortunately, I had a copy of the last packet that I had to complete, so it was straightforward. although tedious. Once I turn that in, they’ve assured me that I will be granted access to the production EHR. Then I can see what’s really in there and start the process of making sure that I have all the shortcuts enabled that I can, such as medication favorites, quick phrases, and other preferences.

It’s always fun to get those things set up. It reminds me a bit of getting your backpack ready for that first day of school. Even though it’s not as cool as a 64-pack of brand name Crayola crayons, I’m pretty hyped about going for my first day. We’ll see whether the reality meets the expectation in a few weeks.

What’s your favorite “first day of school” memory? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/7/25

April 6, 2025 Headlines No Comments

Hinge Health is considering delaying its IPO as the markets plummet on Trump tariffs

Hinge Health is reportedly considering postponing its much-anticipated IPO due to stock market volatility.

Rite Aid plots second bankruptcy in two years… sparking fears of mass closures

Rite Aid is reportedly considering another bankruptcy filing less than a year after the drugstore chain exited Chapter 11, retreating from markets where it trails Walgreens and CVS to focus on regions where it’s the second-largest player.

United States Files False Claims Act Complaint Against Vohra Wound Physicians Management and Its Owner Alleging False Claims for Wound Care Services

The federal government files a False Claims Act complaint against Vohra Wound Physicians, alleging that it built an EHR system that automatically billed routine wound care as surgical debridement regardless of clinical justification.

Monday Morning Update 4/7/25

April 6, 2025 News 1 Comment

Top News

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Hinge Health is reportedly considering postponing its much-anticipated IPO due to stock market volatility.

The company filed IPO plans last month. Its most recent funding round in October 2021 valued the company at $6 billion.


HIStalk Announcements and Requests

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Respondents see little patient benefit to cloud migration. Some might argue that it’s not intended to impact patients directly, but others could reasonably ask, then what’s the point?

New poll to your right or here: What most limits your long-term career satisfaction in health system IT?


Thanks to these companies that recently supported HIStalk. Click a logo for more information.

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Sponsored Events and Resources

Live Webinar: April 15 (Tuesday) 1 ET. “Navigating ACO Quality in 2025: Lessons Learned and Future Directions.” Sponsor: Healthmonix. Presenters: Michael Lewis, VP of customer success, Healthmonix; Steven Tyson, senior account executive, Healthmonix.  Accountable care organizations (ACOs) must stay ahead of evolving quality requirements and reporting changes. Join us for an in-depth discussion on lessons learned from past ACO implementation, key areas for improvement, and the impact of Medicare Clinical Quality Measures (CQMs).

Contact Lorre to have your resource listed.


Acquisitions, Funding, Business, and Stock

Rite Aid is reportedly considering another bankruptcy filing less than a year after the drugstore chain exited Chapter 11, retreating from markets where it trails Walgreens and CVS to focus on regions where it’s the second-largest player.


Sales

  • Good Shepherd Health System chooses Mednition’s Kate AI.

People

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Door County Medical Center promotes Erick Schrier, MBA from CIO / compliance officer to chief administrative officer.


Government and Politics

The federal government files a False Claims Act complaint against Vohra Wound Physicians, alleging that it built an EHR system that automatically billed routine wound care as surgical debridement regardless of clinical justification. The company is also accused of setting revenue-driven debridement quotas and hiring inexperienced physicians who were misled during training about Medicare billing rules.

Hospital price transparency data remains mostly inaccessible and unhelpful to consumers due to complexity and inconsistent reporting, a KFF Health News report concludes. The White House plans to step up enforcement of a mostly ignored executive order from six years ago even though consumers haven’t found the cost data to be immediately useful – since it doesn’t reflect their actual out-of-pocket costs – and could encourage hospitals to raise prices if they learn that competitors charge more. 


Other

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Penn Medicine News profiles SVP of Data and Technology Solutions Mitchell Schnall, MD, PhD.


Sponsor Updates

  • Capital Rx releases a new episode of “The Astonishing Healthcare Podcast” titled “Healthcare Sector Update & Outlook, with Bloomberg Intelligence’s Jonathan Palmer.”
  • Ellkay offers a new success story featuring WakeMed Health.
  • Nordic releases a new “Designing for Health” podcast featuring Mark Mabus, MD.
  • Nym names Tal Shmuel junior backend engineer, Rashad Kanaaneh and Mark Kapilyan software engineers, Idan Bressler NLP research engineer, and Roee Mey-Tal and Hadar Dikstein medical data analysts.
  • Praia Health celebrates its first anniversary.
  • The AONL Foundation for Nursing Research and Education recognizes Symplr as its 2025 Friend of the Year Award honoree.
  • Tegria will present at the IPMI Healthcare Finance Institute April 7 in Orlando.
  • Wolters Kluwer Health adds conversational AI to vrClinicals for Nursing.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

Morning Headlines 4/4/25

April 3, 2025 Headlines No Comments

HSCC Calls for One-Year Consultative Process with Administration on Healthcare Cybersecurity Requirements

The Healthcare and Public Health Sector Coordinating Council Cybersecurity Working Group urges the White House to launch a one-year consultative process with healthcare leaders instead of proceeding with the planned HIPAA Security Rule update.

Senate confirms Oz as head of CMS along party lines

The Senate confirms former cardiologist and television show host Mehmet Oz, MD, MBA as administrator of CMS.

Oracle privately confirms Cloud breach to customers

Oracle acknowledges the previously reported breach of certain Cloud servers, telling customers that the FBI is investigating.

News 4/4/25

April 3, 2025 News No Comments

Top News

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Leaders from the Senate and House Veterans’ Affairs and Appropriations Committees ask the VA to submit an updated schedule and cost estimate for its Oracle Health EHR Modernization program. by September 30, 2025.

The group’s letter notes that “compliance with these laws, directives, and GAO recommendations is a critical step to ensuring EHRM’s success and accountability.”


Reader Comments

From HS CIO: “Re: Oracle breaches. Our Oracle Health rep said there was a call Monday evening where it was stated that the breach impacted legacy databases that were involved with migrations (I’m guessing Epic or the OCI instance of the EHR). On the cloud breach, the rep said that the message they were given is that no databases were breached, which seems to leave the door open. Wondering if you’ve heard anything similar from Oracle Health customers?” I invite those on the front lines to let me know what’s going on. Oracle has defended its claim that Oracle Cloud wasn’t breached because the incident apparently involved an older platform called Oracle Cloud Classic, although that is also an Oracle-managed cloud service. Meanwhile, a federal lawsuit that seeks class action status was filed against Oracle on Monday that involved both the cloud and Oracle Health breaches, accusing the company of violating Texas breach notification laws by not informing the alleged victims of the breach within the required 60 days. 


Sponsored Events and Resources

Live Webinar: April 15 (Tuesday) 1 ET. “Navigating ACO Quality in 2025: Lessons Learned and Future Directions.” Sponsor: Healthmonix. Presenters: Michael Lewis, VP of customer success, Healthmonix; Steven Tyson, senior account executive, Healthmonix.  Accountable care organizations (ACOs) must stay ahead of evolving quality requirements and reporting changes. Join us for an in-depth discussion on lessons learned from past ACO implementation, key areas for improvement, and the impact of Medicare Clinical Quality Measures (CQMs).

Contact Lorre to have your resource listed.


Acquisitions, Funding, Business, and Stock

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Business Insider profiles the 29-year-old executives who are leading Palantir’s healthcare business, neither of whom has prior healthcare experience.


People

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PeaceHealth hires Julie Eastman, MBA (UCI Health) as SVP/CIO.

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Healthcare IT Leaders hires Paul Cannon (5plus2) as CTO.

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Trimedx hires Neil de Crescenzo, MBA (Optum Insight) as CEO.

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Apree Health, which was formed in the 2022 merger of Castlight Health and Vera Whole Health, promotes Jonathan Porter to CEO and restores the Castlight and Vera brands.

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Advocate Health promotes Andy Crowder to SVP/chief digital officer.


Announcements and Implementations

A Stoltenberg Consulting survey of healthcare CIO members of CHIME finds:

  • The top priorities for 2025 are improving clinical workflows, improving the patient experience, and optimizing EHRs.
  • The #1 investment area is cybersecurity, privacy, and risk management.
  • Getting the most out of existing technology reached an all-time high of 62% of votes.
  • Clinician burnout rates are continuing their steady drop.
  • The top IT support frustration involves lack of training.
  • The biggest challenges are staff shortages, inadequate budgets, and EHR optimization.
  • More than half are exploring or using AI tools in areas such as revenue cycle management, clinical documentation improvement, and predictive analytics.
  • Health systems will continue to use hybrid or fully remote IT staffing.
  • IT budgets are flat or declining in 61% of respondent organizations.

Privacy and Security

The Healthcare and Public Health Sector Coordinating Council Cybersecurity Working Group urges the White House to launch a one-year consultative process with healthcare leaders instead of proceeding with the planned HIPAA Security Rule update.


Other

A class action lawsuit accuses a University of Maryland Medical Center pharmacist of installing webcam-activating software on at least 400 hospital computers over a 10-year period to spy on young female doctors and residents as they undressed or pumped breast milk. The six plaintiffs also allege that he installed keystroke logging software to steal their passwords, then accessed their home computers to watch them via webcam and to steal information from their cloud accounts. They are suing the hospital, who has fired the pharmacist, for negligence.


Sponsor Updates

  • Medicomp Systems releases a new “Tell Me Where IT Hurts” podcast titled “Live From HIMSS25 in Fabulous Las Vegas!”
  • AGS Health CEO Patrice Wolfe joins Verisma’s board.
  • CereCore publishes a new case study titled “Virtual CISOs Bring New Hope to Orgs Without Security Officials.”
  • A new analysis from Black Book Research identifies top global growth opportunities for OpenEHR adoption in 2025.
  • Symplr will accept nominations for its new Karlene Kerfoot Nursing Leadership in Technology Education Grant, named in honor of its late CNO, beginning June 1.
  • Clearwater announces the publication of its “Cyber Risk Benchmark Trend Report for Healthcare Vulnerability Management.”
  • WellSky announces CarePort Care Transitions Dashboard Suite.
  • The “Vanguards of Health Care” podcast features Capital Rx in an episode titled “How Capital Rx is Fixing America’s Broken Drug Pricing.”
  • Inovalon announces that its Safety Management solution is now available on the PointClickCare Marketplace.
  • Redox joins the CommonWell Health Alliance.
  • Ellkay will incorporate Dymo’s labeling solutions into its LKOrbit platform.
  • First Databank names Kelly Marino regional sales manager, and Thomas Pugh and Joseph Kuruvila software engineers.
  • FinThrive will present at the IPMI Healthcare Financial Institute April 7 in Orlando.
  • Infinx offers a new case study titled “New York Hospital Solves Prior Authorization & Scheduling Overflow With Tech-Enabled Patient Access Solution.”
  • WEDI’s “The Collective Voice of Health IT Podcast” features Linus Health Chief Strategy Officer John Showalter, MD.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

EPtalk by Dr. Jayne 4/3/25

April 3, 2025 Dr. Jayne 1 Comment

A blue and white logo

AI-generated content may be incorrect. 

I finally have some solid data from the recent residency match, as administered by the National Resident Matching Program.

For those who might not be familiar, this is where medical students indicate where they want to do their residency training; training programs indicate who they want to fill their allocated number of training slots; and an algorithm tries to bring them all together. This year’s match had 52,409 applicants, for which only 47,208 submitted a final rank order list. The candidates were competing for 43,237 positions. At noon Eastern time on match day, all the applicants learn where they’re going to be for the next three to seven years.

Different medical schools handle the big reveal in different ways, with some handing out sealed envelopes for class members to open privately. Others throw blowout match day celebrations complete with “walk-up” music like you might see at a major league baseball game, followed by live reveals as candidates open their notices. The latter can be a difficult environment for those who didn’t get their top choices, but everyone still acts thrilled regardless.

Those who didn’t match were notified earlier in the week and have the opportunity to compete in The Supplemental Offer and Acceptance Program (SOAP), commonly referred to as “the scramble,” where unfilled slots are offered and candidates have only two hours to accept a potential offer. If you saw a graduating medical student with their phone glued to their body March 17-20, chances are they were part of the scramble.

It’s a brutal process for those who have been through it, although some of my classmates who had top scores were largely unfazed. The final match data can be telling as far as what students think about a particular specialty, and following the worst parts of the COVID-19 pandemic we saw a significant drop in matches to emergency medicine as students saw what that specialty had become. After experiencing an 81.8% fill rate in 2023, emergency medicine rebounded to 95.5% in 2024 and landed at 97.9% for 2025.

Primary care specialties ended up with a 93.5% fill rate, even with an increase of 877 in the positions available. Family medicine matches fell from 87.8% to 85.0%, which means that we will continue to have shortages in that specialty for years to come. Unless healthcare payment policies change (and workloads shift), we’ll continue to see a decline as students choose specialties with higher compensation and better work-life balance.

A close-up of a ring

AI-generated content may be incorrect.

I had dinner with some friends last week, and one of them was showing off her Oura ring. She and her husband bought matching rings in an effort to use data to determine who was more disruptive during sleep. The company has been working to improve its sleep tracking algorithm, and although it’s better than competitor devices, it’s still not as accurate as formal polysomnography. Although it will probably be good enough to force one of the parties to consider seeking medical help, it’s not classified as a medical device, nor is it approved to diagnose, treat, or monitor health conditions. If you think your bed partner has apnea or another serious condition, it is best to see a licensed professional.

In another discussion, a friend asked me about this article on Gather Health, which aims to provide primary care services with a focus on keeping older patients out of the emergency department. Founded by an emergency physician who was tired of seeing patients seeking care in high-cost facilities when it could be better managed elsewhere, over 2,500 patients are enrolled, with the majority being covered by Medicare and Medicaid. The company has raised $17 million in funding and hopes to break even in 2025. The company pairs office-based care with home health, remote patient monitoring, and social opportunities to improve patient outcomes.

The article mentions revenue forecasts of $44 million this year. It hopes to expand from four to 17 sites in Massachusetts. Of course, when venture capital is involved, there’s an expectation that the services will yield a profit, and it would be interesting to learn more about how much money they think they can make on something like this. I’m not against people making a profit, but it’s the extreme focus on profitability that I’ve seen create a lot of issues in healthcare delivery organizations. Nearly every physician gathering that I attend features at least one horror story related to private equity or venture funding of care delivery organizations.

Caring for complex elderly patients is expensive and challenging. The company’s founder also served as chief operating officer of VillageMD, so it will be interesting to see what he does differently with this endeavor. From the patient perspective, I wish the company well and will be interested to see how it performs over the next few years.

A screenshot of a computer

AI-generated content may be incorrect.

The Open Payments program is a national system that creates transparency around payments made to physicians from drug companies, device manufacturers, and other regulated entities. Each spring, data is released so that physicians can review what is associated with their name and potentially dispute anything unexpected. It’s been many years since I attended so much as a drug company lunch, so I was surprised to see a significant amount of money posted against my name for the recent reporting period.

I’m glad I reviewed it, because the entry was from a company I don’t associate with and was tagged with a nebulous “food and beverage” category for a single event in the first few months of 2024. I’ve opened a dispute about the entry and hopefully it will be resolved quickly and with a minimum of extra work on my part. If you’re a provider subject to reporting, it might not be a bad idea to take a look at your account. Even if I’m unable to resolve it, my understanding is that my record will be flagged as “disputed,” which is good because I hate to break my record of perfect zeros.

Take-Back

Mark your calendar for the next DEA National Prescription Drug Take Back Day on Saturday, April 26. Communities will be holding collection events, often at local police departments or other health facilities. Unwanted and expired medications are a health hazard and also pose risks to the environment when people dispose of them incorrectly. Fortunately, my local law enforcement agency has a box that’s available for drop off around the clock, and I made good use of it when a relative passed away, leaving behind a cache of pain medications with a street value in the thousands of dollars. The program has collected 19 million pounds of medications over the years, which is pretty impressive.

Email Dr. Jayne.

Morning Headlines 4/3/25

April 2, 2025 Headlines No Comments

Leaders of the House, Senate VA Committee & VA Appropriations Request Cost Estimate for VA Electronic Health Record

Senator Jerry Moran (R-KS), chairman of the Senate Committee on Veterans’ Affairs, spearheads an effort to request that the VA submit to Congress an updated schedule and cost estimate for its EHR Modernization program by September 30.

Deacon Health Launches to Bring Tech-Enabled Care Coordination Services to Specialty Care

Specialty care management company Deacon Health launches with $7 million in seed funding.

CareCloud Acquires RevNu Medical Management, Completing Second Acquisition in 31 Days

CareCloud acquires RevNu Medical Management, an RCM company focused on audiology providers.

Healthcare AI News 4/2/25

News

Amazon releases Nova Act, an AI model that can perform actions within a web browser. 

An Israel-based medical advocacy group urges the health ministry to develop AI usage guidelines and enforcement, citing cases in which clinicians misused AI tools and harmed patients. It says that faulty AI-generated medication dosing and diagnostic suggestions have caused life-threatening errors.

Apple will reportedly add an AI health coach to an updated Health app as early as 2026.


Business

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Layer Health, which offers an AI-powered EHR data abstraction tool, raises $21 million in a Series A funding round.


Research

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A new KLAS report finds that many health system executives are wondering if their organizations are falling behind their peers in using AI, but most are just getting started with strategy, governance, and choice of specific products. All executives from large health systems report that their organizations are using AI. EHR vendors are driving AI adoption through integration with their core products. AI use in imaging, operations, security, and revenue cycle is more focused but growing.

A small Dartmouth study finds that people with significant behavioral disorders improved after using a therapy-focused chatbot app. Depression symptoms dropped by 51%, while those with depression, anxiety, and eating disorders saw smaller but still meaningful improvements. The researchers say that chatbot-delivered therapy rivaled the results of traditional outpatient care and could help ease the mental health provider shortage.


Other

A woman in Australia files a complaint with the health regulator after her doctor used ChatGPT to interpret her lab results during a visit, which she called “lazy and unprofessional.”


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HIStalk Interviews Justin Dearborn, CEO, Praia Health

April 2, 2025 Interviews No Comments

Justin Dearborn is founder and CEO of Praia Health.

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Tell me about yourself and the company.

Praia Health is celebrating our one-year anniversary of our spinout of the Providence health system and their incubation group. We are carving out a new space around consumer orchestration within health systems. Our primary customer is a health system that wants to improve their patient- and consumer-facing experiences, whether it be an app, web, or call center. We help with orchestrating all the touchpoints and coordinating those. It looks similar to how most consumers are used to interacting on the internet, being very personalized and removing friction where we can. It’s a new space of consumer orchestration.

Prior to coming to Praia, I was the CEO of another patient engagement company called Patient Bond that is now a part of Health Catalyst. Before that, I spent eight years at Merge Healthcare as CEO. They’re a publicly-traded medical imaging company that was acquired by IBM.

How much attention are health systems paying to the digital consumer experience compared to other industries?

There is interest and discussions. A lot is going on at the macro level that has maybe defocused some of those projects, but we’re still definitely in the early adopter phase of the market. Always good conversations with the chief strategy, chief digital, or chief transformational officer. Most of the meetings are very receptive.

There’s a lot that sometimes needs to happen on the back end to allow for a very elegant front-end experience. There’s some organizational change, some change management that is probably responsible for longer sales cycles, but we see receptivity to the message and everyone gets it and nods their head. We want a better consumer-patient experience. We want it to mirror Amazon, which is a tried and true analogy that everyone uses it because it’s a good analogy and it works.

It’s hard to say you wouldn’t want to deliver for your patients a very personalized experience at scale. If you and I were both using the Providence app, for instance, we could each open up our apps and we would have a different set of calls to action and information based on what they know that we want to see and don’t want to see. It expedites that and keeps you engaged. I don’t recall ever hearing, “I’m not interested, it doesn’t make sense.” It’s more about, do we have budget this year? Do we have resources? Is it on the roadmap? And now we’re going to try to figure out what’s going to happen with Medicaid and how that impacts our system. That’s not unique to Praia, of course, but just a little bit of distraction to start 2025.

How do you approach the return on investment questions?

This could fall into marketing, and not that those projects don’t need a tangible ROI, but absolutely, this is an ROI sale. We approach it that way. If something’s already been approved in a new project, a new website design, we could fold into that and enhance that. But overall, it is an ROI sale. We have incredible data from Providence that  we released a few months ago that shows a really compelling ROI. The ROI tool we use can scale up and down. Every system is not going to have the scale of Providence, but the same levers are in place across the board.

We’re very bullish on the ROI. We’ll actually contract around that, do some gain share and take some risks because we’re confident in the return. We definitely approach every opportunity or engagement that it has to have an ROI to get to the starting block.

What lessons have been learned from big companies in healthcare, such as chain drug stores or insurers, that could be applied to a health system?

We think it’s across verticals. It’s just loyalty and driving engagement. It’s been proven by some great research that’s out there that nudges within an app work. You have to be cognizant not to over message, which some industries have been guilty of, but keeping a patient or consumer engaged.

One of the theses for Providence, where this was designed five years ago, was that they were seeing only about 1.7 visits a year per adult, and the average adult has five different interactions with the health system. They found that most health systems don’t have compelling reasons for you to go back and visit the health system in between episodes of care. They can deliver up content that’s relevant to you. Every health system has a plethora of health and wellness data, but how does it get served up to you? How do you know about it? It could even  be spiritual in Providence’s case. They have a great library of material and they know who want to engage with that and who won’t.

It’s really just serving up content and making it relevant for you. When you have a health and wellness concern, go to the Providence app first, there might be something there for you even if they don’t deliver the service. They might have a network of providers. It could be physical therapy, it could be through a medicine partner. They can deliver you into that experience through the Providence app in a frictionless way. You don’t have to create another ID, log in, or manage 18 or 20 different apps. It can all be delivered within the Providence app, even if it’s not a Providence service, per se.

Do consumers feel aligned with a health system that is attempting to market to them or engage them between encounters with what might feel like a sales pitch?

There’s definitely that risk. But great data suggests that patients trust their health system, whether it be big brands like Cleveland Clinic, Mayo, and Providence. Maybe to the same extent, for independent pharmacists. Depending on where you live, there still are some independent pharmacies where you get to know your pharmacist and have a trusting relationship .

But otherwise, the research would suggest that people do want to get content a from a health system. I think that’s well earned. Over half of the health systems are non-profits and a lot of them are faith-based, so they are mission driven. They have to run businesses, but they really do have the patient’s benefit in mind. You can draw comparisons to some that are purely profit-driven and you could tell the difference in experience.  I think they are a trusted source.

Some maybe have been a little bit complacent with that status, and they are getting channeled into some new business models. One Medical is a great example. They do a great job, but they are forcing some systems to start moving and focusing on digital, because One Medical is a great digital experience. It’s only going to get better with Amazon owning them. That’s creating some pressure, and that’s sometimes what is needed to force some innovation. But health systems are trusted sources in the community, and they are more and more starting to leverage that.

A business would target those consumers who have the potential to be the most profitable. Do health systems look at providing services such as population health or do they focus on selling profitable services?

I’m sure that goes on. I would say that a lot of the non-profits we’re working with do focus on top of funnel. Once they are in this system, so to speak, and they’re a digital user, they will  interact with them around knowing that a care gap is coming up. I haven’t seen, “Let’s go target this audience because we need to fill up the ortho schedule for knee replacements,” but they will absolutely do a great job with tools like Praia targeting, “ You’re overdue for your colonoscopy” or “you’re overdue for your mammography exam.”

The click-throughs and actions are taken when it’s delivered through an app, and Providence has allowed us to publish on this, it’s three and four acts of a text message and email, et cetera. Phone calls are great as well, but they don’t scale as well, of course, and most people don’t answer their phone. It’s more targeted around care gap closures, I will say that some more nimble systems, if they know that they’re having a couple of open days, will reach out to folks that in the past who needs a knee replacement but didn’t schedule for whatever reason. Maybe nudging those along. There’s some incentive to do it because there’s going to be some openings in the schedule. But what we see predominantly is more around care gap closures. There’s enough of that to keep them busy.

What are the challenges in communicating with people who prefer texting or emailing to a phone call or vice versa?

You would naturally think that it’s going to be age driven, but we’re definitely seeing that it’s not. My grandmother was 92 and she was texting her clinician. It’s going to be more pronounced as everyone ages into it and has grown up texting and using email and app communications. It’s definitely a split.

AI comes up in every conversation, so every health system is analyzing how to use it, more on the back office side and the first line of interaction. But because it’s healthcare and it’s personal, a good mix should be available. There are people that want to talk to an empathetic caregiver and somebody who’s going to actually walk them through something and hold their hand, so to speak, over the phone. But they are more routine communication for sure.

Providence has another product they built internally around email. They analyzed the number of emails that their physicians get and it can be hours a day of cleaning out your inbox. They found is 80% were more routine and could be handled by a front office person or a password reset or something like that. Trying to make the clinicians more efficient, because they all recognize — especially the faith-based and non-profits — this is personal. Most people, when it comes down to something life threatening, want to talk to a human being.

What other data sources outside the EHR might be useful for a health system that is trying to address consumers rather than just episodic patients?

That is the key selling attribute of Praia. We leverage all the great work that the EHRs do. We see MyChart and they do a great job, but it’s really designed and focused on the clinical interaction. Even some of that could be done a little.

In a Praia experience, and I’ll use Epic again, MyChart will be will show up. At every screen, you can punch out and click through to MyChart if you want to look at your lab work. Depending on the system and the health system, you could schedule through Epic, but there’s a lot of other scheduling applications as well. We definitely leverage that and enhance the value, because more digital users in a system are better for the health system, better for the EHR, better for us. We absolutely drive adoption there.

Rock Health did a great paper on this last year. About 80% of health and wellness happens outside the clinical visit. How do you get into more of that? We have a couple of partners on the Praia platform, Foodsmart being one of more food is medicine. That’s a very rightfully popular area right now. That’s a separate company. But Providence has a relationship and we can serve that up in the Praia app, make it seamless for a consumer-patient within Providence app to leverage that. There are other companies like Rosarium, where if you’re qualified from your insurance or Medicaid and will be using a wheelchair for six months, they will build a ramp and make it accessible in other areas. The ecosystem of partners is unlimited, but that’s outside the clinical interaction. Providence and forward-thinking systems want to be a part of that and keep you engaged with them to make your life easier with just one application.

Amazon is using AI in its health assistant to push specific products based on a user’s profile and their use of its website. Could AI be misused in an attempt to personalize the healthcare consumer experience?

The systems we’ve interacted with are very cognizant of overreaching there. Providence, for example, has a governance committee. They are focused on AI  in the background. Administratively looking at whether the bill’s coded correctly. Can we answer some of these questions around like password reset, or what’s my insurance deductible? They use AI for that, but as far as interacting, anything touching clinical, anything that could be seen as practicing medicine, systems haven’t, for the most part, taken that leap. I think they are conscious of what you just said.

Another example is Abridge. It has been in the news a lot and they’ve done a great job with ambient listening, which is making the physicians more efficient. Most systems and patients are comfortable with things like that. They do a lot of voice of customer, voice of patients research around this and  are comfortable. Does anyone want to interact directly with an AI bot yet? Not for clinical. Where’s my bill, or I have a question about it, maybe. They are being methodical about how AI interacts.

On the Praia side, our platform can ingest any AI agent or application that a system has built and deliver that. But we’re also taking a very measured approach around that. Hype is probably unprecedented, but there’s not a lot of tangible ROI yet. Every health system is experimenting and piloting, but there’s not a ton of great use cases outside of the couple that I mentioned.

What factors will be most important to the company over the next couple of years?

More customer input, and customer being the health system. This was built at Providence. It was intended to be commercially facing me, not solving a Providence-only problem. We just need more data points, more customers on the platform.

Unfortunately for first half of the year, a lot of systems have been reluctant for systems to move forward, which is not just a Praia concern. With the potential cuts in Medicaid, and other grants have been cut, we’ve been interacting with a lot of systems and we’re pretty far down the road. Then budgets have been frozen because of the some of the NIH grants that roll downhill.

But I think there will be a tipping point where a couple of big, notoriously skeptical, hard-to-hard-to-get-on-board health systems will come on board with Praia. Then it will be like what happens with a lot of startups, where the momentum will move fast from there. But really, it’s it’s around knocking down those next group of health systems so we can continue to increase the the R&D spend and get additional perspectives on what will be helpful.

What we’ve found so far is that once the platform is in place, a lot of use cases come up. We’re trying to be careful to only bring to market use cases that have applicability across every health system. Like it can be vaccine scheduling with Walgreens, or we announced a partnership and investment from Labcorp streamlining the way lab ordering works from the physician pen, so to speak, to the patient and making sure they show up knowing what’s expected of them so they show up at the right facility at the right time and have done the right preparation in advance. Things like that will continue drive use cases and, frankly, value from the platform. But really, for us, the focus is just onboarding more customers in 2025 so we can continue to build that knowledge base.

Morning Headlines 4/2/25

April 1, 2025 Headlines No Comments

ATA Action Acquires Digital Therapeutics Alliance, Launches New Advancing Digital Health Coalition

ATA Action, the advocacy group of the American Telemedicine Association, acquires the Digital Therapeutics Alliance and creates the Advancing Digital Health Coalition.

Vaco Holdings rebrands as Highspring

Vaco Holdings, whose brands include MorganFranklin Consulting, Pivot Point Consulting, Focus Search Partners, and Built, renames itself Highspring, with the talent solutions platform taking the name Vaco by Highspring.

Inside a Toronto mall, a new kiosk is changing how families access health care

Toronto’s Hospital for Sick Children opens a staffed virtual urgent care kiosk in a shopping mall to ease ED wait times.

News 4/2/25

April 1, 2025 News 1 Comment

Top News

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The VA names nine facilities that will go live on the department’s Oracle Health-based EHR next year.

Medical centers and associated clinics in Alaska, Indiana, Kentucky, and Ohio will join four locations in Michigan as part of the VA’s accelerated deployment plan.

The VA expects to complete full implementation at all VA facilities nationwide as early as 2031.


Reader Comments

From Tressa: “Re: Oracle. It seems strange for the cloud and the legacy databases to be compromised at the same time. Also, I hadn’t heard if our data was affected and texted our CMIO with the information you posted. He contacted our Cerner account executive, who claimed to know nothing about it. It seems bizarre for the account execs to not be made aware of something that has been publicly reported on.”


Sponsored Events and Resources

Live Webinar: April 15 (Tuesday) 1 ET. “Navigating ACO Quality in 2025: Lessons Learned and Future Directions.” Sponsor: Healthmonix. Presenters: Michael Lewis, VP of customer success, Healthmonix; Steven Tyson, senior account executive, Healthmonix.  Accountable care organizations (ACOs) must stay ahead of evolving quality requirements and reporting changes. Join us for an in-depth discussion on lessons learned from past ACO implementation, key areas for improvement, and the impact of Medicare Clinical Quality Measures (CQMs).

Contact Lorre to have your resource listed.


Acquisitions, Funding, Business, and Stock

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Virtual care company AvaSure acquires Nurse Disrupted, which offers virtual nursing services for hospital and home-based care. Nurse Disrupted founder and CEO Bre Loughlin, MS, RN will join AvaSure as executive director of virtual care innovation.

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Well Health Technologies will take control of Healwell AI as Healwell acquires New Zealand’s Orion Health. Well Health, which invested in Toronto-based Healwell and bought its clinical assets in 2023, saw its shares drop 30% Monday after it disclosed a US federal investigation into billing practices at its subsidiary Circle Medical Technologies that will delay its fiscal year reporting. WELL.TO shares rose 19% in the past 12 months, valuing the company at $1 billion.

Automated chart review startup Layer Health raises $21 million in a Series A funding round.

ATA Action, the advocacy group of the American Telemedicine Association, acquires the Digital Therapeutics Alliance and creates Advancing Digital Health Coalition.


Sales

  • Ballad Health (TN) selects specialty pharmacy analytics software from Loopback Analytics.
  • Providence Swedish (WA) implements remote patient monitoring software and services from Starlight Health as part of a new post-discharge pilot program at its First Hill hospital.
  • Columbus Public Health will implement Epic through an arrangement with Ohio State University Wexner Medical Center.

People

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ReferWell names Kevin Healy (Chicago Pacific Founders) CEO.

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Dale Sanders joins Unite Us as chief product and technology officer.

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Hippocratic AI names Hollie Vugrinovich (Notable) chief growth officer and Brij Aswani, MBA (MD Clarity) VP of sales.

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California health data network Manifest Medex hires three executive directors: Eva Williams, PhD (Centene), Southern Inland region; Ednann Naz, MD, MPH, MBA (ProNexus Advisory), Central and Northern region; and Erin Henke (Engaging Solutions), Bay region.

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Risant Health hires Jessica Bartell, MD, MS, MBA (UnitedHealthcare) as CMIO. 


Announcements and Implementations

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Toronto’s Hospital for Sick Children opens a staffed virtual urgent care kiosk in a shopping mall to ease ED wait times. Families can connect with the ED team, print documents, or be referred to a nearby hospital. The site, which is open daily, includes a private room for virtual consults and live interpreter access. It targets low-income areas to address gaps in technology and privacy.

Vaco Holdings, whose brands include MorganFranklin Consulting, Pivot Point Consulting, Focus Search Partners, and Built, renames itself Highspring, with the talent solutions platform taking the name Vaco by Highspring. The company has 10,000 employees who work from 45 global offices and seven delivery centers.


Government and Politics

A federal judge in Florida sentences Colton Neal to two and a half years in prison for stealing a physician’s professional and digital health credentials that he used to issue 144 controlled substances prescriptions. He advertised on the dark web, used an EHR and telehealth service to issue the prescriptions, and collected payments via cryptocurrency.


Other

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Epic’s April 1 announcements include an Epic Aerospace rocket launch, a telehealth bloopers TV series titled “America’s Funniest Video Visits”, a short-form video function for clinician notes called TikDoc, and a MyChart enhancement for lung training and hearing assessment named Care-oke.


Sponsor Updates

  • AGS Health will exhibit at Healthcon 2025 April 6-9 in Orlando.
  • Black Book Research survey-takers rank InteliChart as the top end-to-end patient engagement solution vendor.
  • Healthmonix will exhibit at the NAACOS Spring 2025 Conference April 22-24 in Baltimore.
  • CereCore releases a new podcast episode titled “CNO Day in the Life: Leading through Change.”
  • Barwon Health in Australia will implement Agfa HealthCare’s Enterprise Imaging Platform.
  • The “HealthTech with Purpose” podcast features Arrive Health COO Christie Callahan.
  • Capital Rx will exhibit at the AMCP Annual Meeting through April 3 in Houston.
  • Censinet will sponsor the 2025 Health-ISAC Spring Americas Summit May 19-23 in Naples, FL.
  • Clinical Architecture partners with Velox Health Metadata to help health plans navigate clinical data management.
  • The “Health Innovation Matters” podcast features DrFirst CMO Colin Banas, MD, MHA.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

Morning Headlines 4/1/25

March 31, 2025 Headlines No Comments

AvaSure Acquires Nurse Disrupted to Advance Clinically-Developed Virtual Nursing Across Care Settings

Virtual care company AvaSure acquires Nurse Disrupted, which offers virtual nursing services for hospital and home-based care.

Well Health to Exercise Call Right and Acquire Majority Controlling Interest in Healwell AI concurrent with Healwell’s Proposed Acquisition of Orion Health

Canadian healthcare technology and care delivery company Well Health Technologies will acquire a controlling interest in Healwell AI, concurrent with Healwell’s forthcoming $116 million acquisition of Orion Health.

VA names nine additional facilities that will deploy Federal EHR in 2026

The VA identifies the nine additional medical centers and associated clinics that will go live on the department’s Oracle Health-based EHR next year.

Curbside Consult with Dr. Jayne 3/31/25

March 31, 2025 Dr. Jayne 7 Comments

As someone who is knee deep in healthcare on a daily basis, there are a lot of things going on in the world that I follow with varying levels of attention. Sometimes these move more into or out of focus depending on the kinds of consulting engagements that I’m doing.

For example, if I’m working on quality improvement projects, I do a lot of reading to make sure that I’m up on the current metrics. If I’m working on a project involving order sets, I make sure that I’m up on the latest and greatest guidelines and treatment plans for whatever conditions I’ll be addressing.

As an HIStalk contributor, I try to keep up more broadly with everything that is impacting healthcare and healthcare IT as a whole, including worldwide health conditions, new scientific discoveries, emerging technologies, and where organizations are spending their money, whether they’re hospitals, healthcare systems, solution vendors, or independent physician practices.

There are dozens of other CMIO and CMO level consultants who are in the same position. Most of us are also keeping a close eye on what’s happening in government, especially where it comes to changes in staffing levels for the Department of Health and Human Services, the National Institutes of Health, the Centers for Disease Control and Prevention, and similar state-level organizations.

Changes in those organizations have a trickle-down effect on the patients who have trusted me with their care, along with every other person in the US. With changes to the US participation in the World Health Organization and withdrawal of funding for global vaccination programs, changes to health policy in the US also impact people around the globe.

These changes have also impacted me as a patient. I recently learned that a clinical trial to which I have been accepted has lost part of its funding. I have met the qualification criteria, but they aren’t randomizing any new patients into cohorts.

It has been months since I started the process to be part of this trial. It was an emotional rollercoaster as I went through the qualifying process, having to send medical records from multiple institutions and hoping they not only got there in a timely fashion, but were accurate and not full of a bunch of EHR-generated nonsense.

Once all the records finally made it there and were reviewed, I went through an intake process that included genetic counseling as well as testing beyond what I’ve already had. I’ve received the results and was in the final stages of being assigned to a trial arm, only to have the rug pulled out from under me.

When people talk about the “waste” in clinical trials in hyperbolic and abstract ways and imply that funding cuts were deserved, it makes my stomach clench. I’ve spent a significant amount of my professional career doing process improvement and eliminating millions of dollars of waste from healthcare organizations, so I know what waste is. I know how to identify programs that aren’t running efficiently and those that are doing well. I know how to lead change and how to strip significant dollars out of organizational budgets in a compassionate way.

None of that has ever been done by just walking into a hospital or health system and announcing sweeping cuts without any consideration whatsoever. There are consultants who do that, but I’m not one of them, nor will I ever subscribe to that philosophy.

Many of the clinical trials that are being impacted by slash-and-burn cuts affect real live patients. We’re not fruit flies in a lab, or some futuristic technology that someone just cooked up to draw down funds.

Fortunately, the study in question has multiple sources of funding, including a number of private ones, so it hasn’t had to shut down completely. Those who were already randomized into a cohort will continue to receive the intervention to which they’re assigned. It’s just the rest of us that are in limbo. I’m happy that it’s continuing to run because hopefully I’ll be able to benefit from the results of the study once they’re known, but watching this unravel has been truly depressing.

When you agree to participate in a trial, you realize that you might receive “standard care” and not the intervention, and you have to come to terms with that. Now I’m definitely receiving standard of care, and it’s not the missing out on the intervention that I’m really sad about as much as having been excited to participate and to be able to make some kind of good come out of my situation. Not to mention that the results of this trial will impact women for decades to come and may yield a change in direction for the care that is received by millions of mothers, sisters, grandmothers, aunts, and daughters.

Some of you may be asking, “What does this have to do with healthcare IT?” or commenting that I’m on my soapbox again. Indeed, I’ll admit it. After nearly 1,500 posts that span more than a decade, I reserve the right to share the patient experience, even if it is my own. I also reserve the right to write about things that might be construed as “political” when they impact patients, because everything that impacts patients is in my physician lane. I will also keep calling out waste when I see it, whether it’s in the form of unnecessary testing and treatment or the misalignment of healthcare resources, incentives, and technologies.

I think that all of us that work in healthcare IT have the opportunity to do better and be better when we consider how our daily actions can impact patients in our world, our nation, and even our neighborhood. We are literally all connected in ways that we might not imagine.

I have a friend who sells interventional radiology solutions that are highly reliable and come from a trusted manufacturer. Physicians prefer them to the competition and feel they they support higher-quality procedures. When he gets tangled up in his company’s sales processes, he focuses on a mutual friend who recently had a procedure that falls within his solution’s scope. He reminds himself that even though he doesn’t like some of the things he has to do in his job, they need to be done to get the best solution to the point of care in more places every year. With the assistance of this mindset and keeping the patient at the center of his work, he routinely meets his company goals, and when you hear him talk about his job, it’s easy to understand why.

There’s an episode of “The Simpsons” called “And Maggie Makes Three” where Homer explains why there are no pictures of Maggie in the family photo albums. He tells Bart and Lisa that the pictures are where he needs them, which is in his office at the nuclear power plant. They cover some letters on a company placard to change “Don’t forget, you’re here forever” to “Do it for her.”

Let’s all remember why we do what we do and remember that there’s a patient on the end of every decision, and eventually we will all be patients. Be aware, be informed, and be involved in understanding what happens in industry segments other than your own. When you’re the one on the exam table in 10 or 20 or 30 years, you’ll be glad you did. 

Email Dr. Jayne.

Readers Write: AI to the Rescue: Revolutionizing Efficiency in Healthcare Workflows

March 31, 2025 Readers Write No Comments

AI to the Rescue: Revolutionizing Efficiency in Healthcare Workflows
By Caleb Manscill

Caleb Manscill, MBA is president of Vyne Medical.

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The healthcare industry is at a tipping point. With rising demands for high-quality care, increasing financial pressures, and widespread staffing shortages, healthcare providers face an uphill battle to maintain efficiency while meeting patient needs.

Operational bottlenecks and administrative burdens have long weighed down progress, but a game-changing shift is underway: the rise of AI and machine learning. These cutting-edge technologies are not just tools. They are a jumping point for innovation, set to change healthcare workflows, optimize decision-making, and deliver better care outcomes.

The Role of AI and Machine Learning

The adoption of automation technologies in clinical and administrative workflows is accelerating at a fast pace. By 2029, the global workflow automation market is projected to surge to $34 billion, up from $21 billion in 2024, reflecting the pivotal role these technologies play in healthcare transformation. At the heart of this revolution, AI and machine learning are taking on the most pressing inefficiencies, reshaping operations to unlock productivity, accuracy, and cost savings.

Impact on Administrative Workflows and Resource Optimization

AI-powered solutions address some of healthcare’s most persistent challenges by automating time-intensive administrative tasks, allowing staff to focus on higher-value activities. For example, data transcription, a necessary yet manual process, can now be completed in just 30 seconds with over 90% accuracy, compared to the five minutes it once required. These gains drastically reduce errors and boost productivity without sacrificing quality.

Though the front-end processes are critical to getting things right, they’re only half the story. Beyond administrative tasks, AI also optimizes documentation, scheduling, and claims processing to ensure that back-end operations run smoothly. By streamlining these processes, organizations can eliminate redundancies, reduce operational overhead, and achieve greater financial stability. AI further enables leaders to strategically allocate resources, improving patient flow and enhancing revenue cycle management. Together, these improvements drive measurable efficiency and cost-effectiveness.

Enhancing Decision-Making and Clinical Workflows

AI also enhances clinical workflows by enabling smarter, data-driven decision-making. Through advanced algorithms, AI analyzes patient data to identify patterns, predict outcomes, and recommend treatment options, supporting clinicians in providing more personalized care. Process automation helps streamline clinical workflows by reducing manual processes, allowing care teams to spend more time with patients and less on administrative tasks.

For example, AI can prioritize urgent tasks, reduce delays in patient care, and foster collaboration across departments. The impact of these efficiencies includes improved patient experiences, reduced clinician burnout, and better overall care delivery.

Take a surgery order workflow as an example. When a hospital system receives a surgery order, teams traditionally need to extract key details manually and link them to the patient’s electronic medical record (EMR). By using AI and machine learning, much of this process is now automated. AI extracts data from the order, indexes it to the appropriate patient record, and forwards it seamlessly to the EMR system.

However, the next step, leveraging Generative AI, takes this automation to a higher level. Gen AI can resolve more complex challenges, such as identifying and associating the correct patient record when multiple entries exist in the EMR. Traditionally, humans spend significant time verifying patient information, such as matching dates, MRNs, or account numbers, across hundreds of transactions daily. Gen AI can take over this decision-making process for straightforward cases, sending the data directly to the EMR.

By tackling inefficiencies, reducing administrative burdens, and empowering smarter decision-making, this technology is setting a new standard for operational excellence. As healthcare systems continue to navigate workforce pressures and resource limitations, the integration of AI is no longer a luxury — it is an urgent necessity. With its potential to streamline workflows, enhance outcomes, and drive sustainability, AI is the key to building a more resilient and efficient healthcare ecosystem.

Morning Headlines 3/31/25

March 30, 2025 Headlines No Comments

Oracle has reportedly suffered 2 separate breaches exposing thousands of customers‘ PII

Oracle deals with a breach to its Oracle Health systems and the theft of patient data, and a separate breach of its Oracle Cloud servers that has led to the login credentials of 6 million users being put up for sale.

Bankruptcy judge: MercyOne should produce records related to Mercy Iowa City downfall

A federal judge orders MercyOne to produce records related to its management of the now bankrupt Mercy Iowa City, including those pertaining to the troubled roll out of an EHR that may have contributed to the hospital’s financial troubles.

Update Regarding Medical Transition Services at Premier Health

Premier Health (OH) will end its transcription services since most providers have shifted to Dragon speech recognition and built-in Epic tools.

Monday Morning Update 3/31/25

March 30, 2025 News 4 Comments

Top News

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A hacker has breached Oracle Health systems and stolen patient data with the intention of extorting providers, according to a customer communication from Oracle. The FBI is investigating.

Oracle says the intruder used a customer’s stolen credentials to access legacy Cerner servers that hadn’t yet been moved to Oracle’s cloud. The company didn’t say how one user’s credentials could have been used to access the information of other clients.

Oracle said it became aware of the breach on February 20, 2025. Customers learned of the breach only when they received notification from Oracle’s external law firm. Oracle reportedly told those hospitals that they, rather than Oracle, are responsible for determining whether the stolen data violates HIPAA, and if so, for notifying affected patients.

In related news, a hacker claims to have breached Oracle Cloud servers and is offering the login credentials of 6 million users for sale. Oracle denies the claims of the threat actor, who provided a sample of the stolen data that customers verified as belonging to them.


Reader Comments

From Redzenskyca: “Re: Baptist Health South Florida. Moving away from Cerner to Epic.” Unverified. Nothing new so far in job postings or UserWeb accounts.

From Jimmy the Greek: “Re: comments. I’ve commented on Dr. Jayne’s Curbside twice now, but the comments don’t appear. What gives?” I found your comments. They were sent to suspected spam because they included several links. I’ve activated them.


HIStalk Announcements and Requests

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About one-fourth of poll respondents say that their employer’s support for work-life balance has declined over the past two years. Two poll commenters say that theirs improved because they changed jobs for that reason.

New poll to your right or here: Which initiative is burning the most time and money while delivering little improvement to patients?

There’s little health tech news happening, so let’s give you some free time after a brief musical mention. Listening: Postmodern Jukebox, a “rotating musical collective” that reimagines pop hits into retro-style covers that are weirdly compelling. Examples: “Ain’t Talkin’ ‘bout Love” as a 1960s girls group or “A Bar Song (Tipsy)” as Sam Cooke might have done it. In that same vein of interesting weirdness is Flaming Lips, a trippy, psychedelic musical art project that I regret not seeing when they played near me a while back.


Sponsored Events and Resources

Live Webinar: April 15 (Tuesday) 1 ET. “Navigating ACO Quality in 2025: Lessons Learned and Future Directions.” Sponsor: Healthmonix. Presenters: Michael Lewis, VP of customer success, Healthmonix; Steven Tyson, senior account executive, Healthmonix.  Accountable care organizations (ACOs) must stay ahead of evolving quality requirements and reporting changes. Join us for an in-depth discussion on lessons learned from past ACO implementation, key areas for improvement, and the impact of Medicare Clinical Quality Measures (CQMs).

Contact Lorre to have your resource listed.


Announcements and Implementations

Premier Health (OH) will end its transcription services since most providers have shifted to Dragon speech recognition and built-in Epic tools.


Sponsor Updates

  • Black Book Research publishes the “2025 Black Book of Patient Engagement and Healthcare Consumer Communications Technology.”
  • The Alliance for Health Information Operations and Standards re-elects HealthMark Group CEO Bart Howe president and elects MRO CFO Nate Eastman treasurer.
  • PerfectServe publishes “How to Reduce Missed Calls with an Effective Answering Service” featuring Women’s Health Associates (TX).
  • Praia Health achieves SOC 2 Type 2 certification.
  • RLDatix supports the ACHE Congress as a premier corporate partner.
  • WellSky will present at the Minnesota Home Care Association Leadership Summit April 2 in Maple Grove.
  • Vyne Medical publishes a paper titled “From Costly Paper Processes to Streamlined Operations: How Healthcare Can Build a Better Future.”

Blog Posts


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