Morning Headlines 7/8/25

CDC data chief announces departure from agency

CDC Chief Data Officer Alan Sim announces his departure from the agency after nearly five years in the role.

VitalHub Announces Acquisition of Novari Health Inc.

Health and human services technology company VitalHub acquires patient flow software vendor Novari Health for $32 million.

VA to reduce staff by nearly 30K by end of FY2025

The VA announces that it is on track to reduce its staff by 30,000 by the end of the year without the need for a reduction in force.

Curbside Consult with Dr. Jayne 7/7/25

I’ve spent a lot of my career working on the “softer” side of clinical informatics, such as change management, governance, adoption, and optimization. Although I’ve implemented a couple of technologies in my career that have been dramatic, most of the time I’m working on projects that are a little more subtle.

I’m appreciative of projects like that when I have to gain buy-in from difficult stakeholders. When they don’t feel like you’re yanking the carpet out from under them, they are more likely to align with the goals and objectives. On the other hand, sometimes when projects are too low-key they’re not perceived as valuable. It’s a fine line that has to be walked.

I can’t even count the number of practices where I’ve helped implement EHRs over the years. I’ve worked with people ranging from those who have never used computers prior to the EHR to those who have been using them since birth.

In the early days of EHR, people used to talk about the “older” physicians being resistant. Fortunately, I had a good story to counter that after meeting a curmudgeonly colleague who informed me that he had been “advocating for electronic charting since long before you were born, young lady.” He and I actually competed for the first EHR-related role in our health system. I think he was a little grumpy that he didn’t get the position. I grew to appreciate his point of view as he pushed back on some of the things we were trying to do, because he always wanted to make things just a little bit better.

I’ve also worked with younger physicians who were incredibly resistant to adopting technology, particularly anything other than the one that they personally felt was the best. There’s nothing quite as entertaining as watching an Apple devotee argue with the IT team about how he absolutely, positively cannot use the PCs that are present in every shared workspace in the hospital. Folks like that were especially fun during the early days of “bring your own device” programs. They demanded to be able to use hardware that didn’t comply with the published standards.

I’ve worked with ER physicians who complained about how long it took them to do their charts, yet were found to be spending a good chunk of their day on the Zappos website. 

These examples show how differing perspectives and experiences can have a tremendous impact on the success of a project. In turn, how those outcomes can ultimately influence the patient experience. When you have one physician in a practice who refuses to do the recommended workflow, it can cause extra work for the staff. It can also result in confusion and delays for patients who are waiting for their results or for a response from the physician.

I’ve long wondered what makes one person think a new solution is awesome and another one thinks it’s awful when they are doing the same work and caring for the same patients. An informatics colleague and I were talking about this over a recent round of cocktails. She brought up a recent study from the Proceedings of the National Academy of Sciences that looked at how different people perceive works of art.

Although I lived with an art history major for a number of years, I hadn’t heard of the concept of the “Beholder’s Share,” where a portion of a work of art is created by the memories and associations of the person viewing or experiencing it. I suppose it’s a more academic rendering of the idea that beauty is in the eye of the beholder.

The researchers behind the article employed high tech means to look at it, however, using functional MRI (fMRI) imaging to identify how people used their brains differently when viewing different types of art. Apparently abstract art results in more person-specific activity patterns, where realistic art delivers lass variable patterns. They also noted activity in different parts of the brain when looking at abstract art. 

I’d love to see how different end user brains would react to differences in EHR screens and workflows. Maybe we could use that information to better predict how users will perform with different tools. Instead of looking at a subject’s brain activity while looking at a Mondrian painting, as the study did, we could see how their brains perform when confronted with different user interface paradigms.

I’ve seen EHR and clinical solution designs over the years that were jarring in color or layout. I’ve seen those that were so vanilla that nothing seemed to catch the user’s attention.

Another concept in the art world is that of shared taste. It explains why some groups of people prefer the same things, where others might find them objectionable. People typically know if they prefer art from classical times, the Renaissance, the Impressionists, or from abstract or modern artists, I would bet that we can create groupings around different types of clinical data visualization and how they can best be used in patient care.

Similarly, I would be interested to see if users who have certain sentiments about a given piece of technology can be grouped in a particular way, such as by specialty, user demographics, location, or tone of the program where they completed their training. Similar to the concept of precision medicine, I wonder if we could use that information to create precision training or a precision technology adoption curriculum that could help users adapt to new tools that end up in their workflows.

Even without the expense and risk of something like fMRI scans, I would bet that we could do a lot in clinical informatics to better understand our users and the learners with whom we are engaging. I’ve seen quite a few surveys that ask new employees about their experience with electronic documentation or technology in general, but they are fairly superficial. They usually have questions like, “Which of the following systems have you used?” with a list of vendor names. They don’t recognize if the user was on a heavily customized version or an out-of-the-box configuration. Most users wouldn’t know anyway unless they have experience behind the informatics curtain. 

Institutions have come a long way recognizing different learning styles and whether people prefer classroom, asynchronous, or hybrid learning methods. I don’t doubt that the training and adoption efforts that we see today might be supplanted by other paradigms in the future.

Is the beauty of the EHR in the mind of the beholder, or is it something with which users simply have to cope? Is one platform more abstract than the other? Will we ever see an EHR with a classical sense of style? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/7/25

Blue Stream Academy Joins Agilio Software to Create an Integrated Healthcare Training and Compliance Platform

England-based healthcare software vendor Agilio acquires Blue Stream Academy, which offers healthcare e-learning services.

The Villages Health Announces Strategic Restructuring and Agreement to be Acquired by CenterWell

The Villages Health, which offers healthcare services to the 150,000 residents of The Villages retirement community in Florida, files Chapter 11 bankruptcy and will sell itself to Humana’s CenterWell health services business.

Complete Family Medicine to launch Epic EHR System

Complete Family Medicine, a part of Hannibal Regional Healthcare System (MO), will implement Epic July 9.

Island Health lays off VP, ‘several’ executives, citing financial pressures

In Canada, Island Health lays off a number of executives amidst an organizational restructuring that has also eliminated IT positions related to the health system’s 300-site EHR implementation.

Monday Morning Update 7/7/25

Top News

Symplr acquires the Smart Square staff scheduling system from AMN Healthcare for $75 million.

HIStalk Announcements and Requests

A majority of poll respondents attribute Best Buy’s exit from its Current Health business as being due to its underestimation of healthcare’s complexity.

New poll to your right or here: Will insurers follow through on their pledge to streamline prior authorization? My take: only if it makes them more money. What I expect:

• They will use FHIR to quickly render only those PA decisions that involve high-volume, inexpensive items since they get an immediate labor reduction payback.
• Complex but urgent items will still require review by their own clinicians, whose relevant credentials may be skimpy and whose job is more to say “no” than “yes.”
• Policies related to patient transitions between insurers will be loaded with exceptions.
• Note that insurers pledged to address PAs in 2018 by (a) reducing PA requirements for providers who have a good performance history and who demonstrably adhere to evidence-based medicine, and (b) automating the process using national standards.
• CMS issued a rule in January 2024 that required payers to publish a prior authorization API by January 1, 2027, although the insurers will be given three days to respond to urgent requests and seven calendar days for standard requests.

Sponsored Events and Resources

July 22 (Tuesday) 1 ET. “Innovating the Consumer Experience Beyond the EMR with Open Standards.” Sponsor: Praia Health. Presenters: Ryan Howells, principal, Leavitt Partners and program manager, The CARIN Alliance; David LaBine, VP of software engineering, Providence Digital Innovation Group; Robin Monks, CTO, Praia Health; Kristen Valdes, CEO, b.well. As healthcare faces rising consumer expectations and tighter regulations, the high cost of maintaining fragmented, proprietary systems is no longer sustainable. While patient data access has improved, the lack of open standards continues to hinder innovation, drive up integration costs, and limit the potential of digital health beyond the EHR. This webinar will discuss how open standards like OIDC,  HL7 FHIR, and open technology requirements are essential for reducing integration burdens, accelerating development, and lowering maintenance costs. Panelists will describe how every closed integration represents a lost opportunity and will offer practical strategies for leveraging open technology as a competitive advantage that improves efficiency, ensures compliance, and strengthens patient trust.

Contact Lorre to have your resource listed.

Acquisitions, Funding, Business, and Stock

England-based healthcare software vendor Agilio acquires Blue Stream Academy, which offers healthcare e-learning services.

The Villages Health, which offers healthcare services to the 150,000 residents of The Villages retirement community in Florida, files Chapter 11 bankruptcy and will sell itself to Humana’s CenterWell health services business. TVH reportedly owes the federal government nearly $400 million in Medicare overpayments.

People

Franciscan Alliance promotes Joseph Schnecker, MD, MMM to CMIO.

I missed this earlier. Nebraska Medicine promotes Michael Ash, MD to CEO. Ash, who is also a pharmacist, was chief medical officer for Cerner for 11 years and chief transformation officer of the health system for eight years.

Announcements and Implementations

Researchers find that prescription costs for Medicare Advantage beneficiaries didn’t go down following implementation of a real-time prescription benefit tool.

Other

OpenAI hires a forensic psychiatrist to assess the emotional impact of ChatGPT use. Mental health experts have raised concerns about people relying on AI as a therapist, pointing to cases in which chatbots were linked to mental breakdowns and suicides.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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EPtalk by Dr. Jayne 7/3/25

I’m not a superfan of The Joint Commission, but I was interested to see their press release about partnering with the Coalition for Health AI (CHAI) to create AI best practices for the US healthcare system. The partnership plans to develop AI tools, playbooks, and it wouldn’t be The Joint Commission without a certification program as one of the offerings.

If anyone wants to lay odds on the cost of such a program, I’m happy to run the betting pool. Initial guidance will be issued in the fall, with AI certification to follow. I’ve done consulting work around patient-centered medical home recognition, EHR certification, and other compliance-type efforts, so I’ll be looking for the devil in the details as they are released.

As a primary care physician at heart, I’m sensitive to the multitude of recommendations that we give to our patients, often all at one time. For example, a patient who is newly diagnosed with diabetes may need to have labs drawn, see a diabetic educator, visit an ophthalmologist, consult with a podiatrist, and manage prescriptions from a retail pharmacy and a mail order pharmacy. Health systems are investing in solutions to reach patients via patient portal, text, interactive voice calls, paper mail, and email, which has resulted in patients being overwhelmed. I’m intrigued by Lirio’s concept of “Precision Nudging” (they have trademarked the term) to help manage this problem.

AI is involved via their large behavior model that aims to use elements of behavioral science along the way. It pulls together engagement and outcomes data with consumer understanding to identify the most appropriate channel to reach a given patient. Interventions are modified based on patient response and are tweaked along the way.

I have followed other companies like this over time, but Lirio seems to get it better than others, going beyond vague concepts like “wellness” and “engagement” to actually talk about specific screening programs and revenue-generating interventions that can boost patient quality and deliver a solid return on investment. They do have a bit of a revenue cycle background, so I’m sure that helps.

I was also geeked to learn that the company’s name actually has meaning rather than being something that either just sounded good or hadn’t been registered yet, as one commonly sees in younger companies. It’s actually named after Liriodendron tulipifera (the tulip tree), which apparently is the state tree of Tennessee. Props to the marketing team for its use of the phrase “lustrous branchlets” to describe the company’s strengths. This wordsmith salutes you.

Mr. H already mentioned this, but I wasn’t surprised to see that Best Buy has sold Current Health, returning the company to its former CEO and co-founder. A Best Buy executive said that growing its home care business has “been harder and taken longer to develop than we initially thought.”

I can understand that given the performance of their booth team at HIMSS25. On one of my booth crawls, my companions and I stood in their large booth for probably 5-7 minutes chatting before anyone approached us, despite there being multiple employees in the booth staring at their phones. I didn’t mind it too much because we were enjoying their extra-thick carpet, but if they were looking to capture leads, they were falling down on the job. Once a rep finally approached, the conversation was passable, but negative first impressions are hard to undo.

As much as I think I’m with it as far as keeping up with healthcare IT news and trends, I still rely on HIStalk for information on a regular basis. There’s always some tidbit that I haven’t gotten to yet, which is not surprising given the calamitous state of my inbox these days. HIStalk was the first place I learned about the new CMS prior authorization program for traditional Medicare. I’m all for catching bad actors, such as the durable medical equipment companies that cold-call patients offering knee braces and other questionable interventions, then rely on relatively clueless physicians who have rented out their medical licenses to enable a high-volume prescription mill situation.

However, I feel like the majority of physicians caring for our nation’s seniors aren’t committing fraud. They are negotiating the complex interplay between evidence-based medicine, the costs of various treatments, and patient beliefs and preferences. Sometimes the “best” treatment is unaffordable for a given patient, or you’re working with patients who can barely afford food, let alone their medications.

They’re going after specific procedures, including knee arthroscopy for arthritis, along with skin and tissue substitutes and nerve stimulator implants. You know what else would help reduce these unneeded procedures? Greater health literacy and patient education campaigns, which are parts of public health that we continue to neglect in this country. Hopefully the program will remain with these high-dollar, low-benefit procedures and won’t creep into primary care on the whole.

Given the amount of data that CMS has on every prescriber’s habits, they should be able to hire some clinical informatics folks to find those who are practicing inappropriately and go after them rather than putting processes in place that annoy those who are trying to do the right thing.

I recently had a rough travel day with significant delays. As I was waiting for my inbound aircraft to arrive, I noticed two fire trucks pull up on the tarmac. They did a quick test that I recognized as preparing to deliver a water salute. I’ve seen it for Honor Flights that were returning to the airport and for a pilot retirement.

Since the airport was small, I could see my inbound plane taxiing at a slow speed, which was unusual given the airline’s propensity to get planes to the gate quickly, especially after delays. A few minutes later, a Marine Corps Honor Guard arrived and I realized this flight was carrying a deceased service member. The waiting passengers in the terminal gradually fell silent and stood to show their respect, with hardly anyone moving until the transfer was complete. It was a sobering reminder that no matter how bad I felt my day was, steps away from me was a family that was having one of the worst days of their lives.

As we approach the Independence Day holiday, I’m grateful for everyone who has put on a uniform and sworn an oath to protect and defend our country. Freedom comes at a high price. Thank you to all current and former service members and their families for being willing to make that sacrifice.

Email Dr. Jayne.

Morning Headlines 7/3/25

Symplr Acquires AMN Healthcare’s Smart Square Scheduling Software, Enhancing AI-Driven Workforce Optimization for Health Systems

Healthcare operations software vendor Symplr acquires AMN Healthcare’s Smart Square workforce scheduling software.

Feeling sick? Use ‘ChatGPT of the NHS’ first, patients to be told

England’s NHS will enhance its patient app with an AI-powered assistant called My Companion that helps users review their health information and explore care options.

Mayo Clinic’s AI tool identifies 9 dementia types, including Alzheimer’s, with one scan

Mayo Clinic researchers develop an AI tool that can identify the brain activity patterns of nine types of dementia, including Alzheimer’s disease, from a single PET scan.

Healthcare AI News 7/2/25

News

England’s NHS will enhance its patient app with an AI-powered assistant called My Companion, which it describes as a “ChatGPT for the NHS,” that helps users review their health information and explore care options. A separate feature, My Choices, will let patients compare providers based on wait times, clinical outcomes, and satisfaction scores.

Duke Medicine Chief Health Information Officer Eric Poon, MD, MPH says that ambient scribing is being used in 70% of Duke’s primary care visits. He notes that the technology saves him two hours on his own clinic days and admits that he hadn’t realized how much of his focus had been consumed by acting as a “courtroom transcriptionist.”

China-based Ant Group launches AQ, an AI app that lets users consult with AI avatars of real physicians before receiving priority access to care scheduling. The company says that AQ stands for “answer your question,” an English-focused name that suggests plans for a wider rollout. Ant, which is affiliated with Alibaba, operates Alipay, one of the country’s two major mobile payment systems. The company is increasingly focused on offering health-related services that it says are used by 800 million people.

CMS announces WISeR, a pilot project that will use technologies such as AI to expedite Medicare prior authorization for services that are vulnerable to fraud, waste, or inappropriate use.

Business

Sweden-based startup Tandem Health raises $50 million in a Series A funding round to further develop its Europe-focused ambient documentation system.

Website protection vendor Cloudflare is testing a pay-per-crawl system that allows content owners to either block AI training web crawlers entirely or charge them a fee for access.

Research

AI-powered drug discovery and design advances from theoretical to actual, as an AI-designed drug reaches phase 2a clinical trials. Rentosertib shows safety and efficacy in the treatment of idiopathic pulmonary fibrosis. AI was also used to generate the target before designing the molecule itself.

Mayo Clinic researchers develop an AI tool that can identify the brain activity patterns of nine types of dementia, including Alzheimer’s disease, from a single PET scan.

Other

Bioinformatics researchers at Vanderbilt University Medical Center find that rural US medical centers face significant barriers to adopting AI. They conclude that limited data availability, lack of infrastructure, and inadequate staffing could create an AI divide between urban and rural hospitals that can be addressed through research, partnerships, and policies.

People are seeking advice from ChatGPT on how to inject themselves with facial filler at home to puff up their lips and cheeks.

Contacts

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

This Week in Health Tech 7/2/25

Morning Headlines 7/2/25

VisiQuate Acquires Etyon to Supercharge Insight Automation and Denials Management for Healthcare Providers

RCM technology vendor VisiQuate acquires Etyon, whose technology optimizes revenue cycle workflows.

More than 300 employees cut in Sharp HealthCare layoffs

Sharp HealthCare (CA) lays off 315 employees, with several media outlets reporting IT staff among those affected.

Nordic Capital partners with Arcadia to drive data-focused healthcare innovation

Nordic Capital takes a majority stake in health data insights vendor Arcadia.

News 7/2/25

Top News

RCM technology vendor VisiQuate acquires Etyon, whose technology optimizes revenue cycle workflows.

Reader Comments

From Dark Daze: “Re: Sharp HealthCare. Cut 315 FTEs yesterday, 150 of them from IT, which is a 25% haircut.” Unverified, although the local TV station reports that IT was one of the departments affected and Redditors claim that IT was the hardest-hit area.

From Isthmus: “Re: Sharp HealthCare. Laid off most of their Epic IT staff with plans to have their Epic system supported by a third party.” Unverified.

Sponsored Events and Resources

None scheduled soon. Contact Lorre to have your resource listed.

Acquisitions, Funding, Business, and Stock

Premier acquires IllumiCare, which adds a financial component to clinical decision support, and will market it under its Stanson Health brand.

Sales

• Valley Health System (NJ) will use technology and services from Inbound Health to launch a hospital-at-home program.
• Emory Healthcare (GA) selects Aidin’s post-acute care transitions software.

People

Ralph Porpora (Grand View Health) joins Deborah Heart and Lung Center (NJ) as VP of IS/CIO.

Pager Health names Ken Yamaguchi, MD (Northwestern University’s Feinberg School of Medicine) chief medical officer.

BayCare (FL) names Patrick Brown, MD (Centra Health) VP/CMIO and Philip Karp, MS (NYU Langone Health) VP/CTO.

Medical error prevention pioneer Lucian Leape, MD died Monday at 94. He was involved in the Harvard study that resulted in the landmark 1999 report “To Err Is Human: Building a Safer Health System.”

Announcements and Implementations

Spartanburg Regional Healthcare System (SC) implements precision medicine technologies from 2bPrecise.

Microsoft’s AI team claims that one of the company’s diagnostic tools can outperform physicians in solving the toughest cases, correctly identifying 85% of 304 real-world cases that had been published weekly in the New England Journal of Medicine, four times the success rate of doctors. This is an interesting test, with these caveats:

• The research involved published cases, so physicians were barred from using electronic medical records, care guidelines, textbooks, colleagues, and other LLMs that could have accessed the answers.
• NEJM cases are “pedagogically curated” rather than real-world examples.
• Nobody knows whether commercial LLMs were trained on the actual published case studies, which would have given them an unfair advantage.
• The physicians who were involved had a median experience of 12 years, but still diagnosed correctly just 20% of the time, raising questions of the validity of the hypothetical cases.
• The NEJM cases are created to be interesting, challenging, and pathology-focused. They may contain red herrings and often involve obscure diagnoses. They require the reader to make a diagnosis without having access to the patient’s medical record, without being able to examine the patient or ask them questions, and without the benefit of observational findings.
• The study is an interesting proof of concept, but should not be taken to mean that doctors can’t diagnose correctly 80% of the time or that AI can do a better job in clinical situations.

Government and Politics

CMS approves Eko Health’s Sensora digital stethoscopes cardiac algorithm for payment under the Hospital Outpatient Prospective Payment system.

The Washington Post provides details from court documents of the federal government’s Operation Gold Rush, a massive fraud takedown where Medicare was billed $10.6 billion for medical devices that were not medically necessary or actually delivered to patients:

• Prosecutors say the schemers used stolen identities of 1 million Americans to flood Medicare with bogus claims, including 1 billion urinary catheters.
• The fraud was funneled through 30 Medicare-approved medical supply companies that the perpetrators had quietly acquired.
• HHS and CMS teams blocked 99% of the attempted Medicare payments, signaling a shift from the traditional “pay and chase” model to one of proactive prevention.
• Despite that success, the scammers still collected $1 billion from Medicare supplemental insurers.
• Most of the accused reportedly never set foot in the United States.
• Medicare received 400,000 complaints from patients questioning why companies like Pretty In Pink Boutique were billing for catheters they neither needed nor received.

Privacy and Security

Central Maine Healthcare restores its IT systems and resumes normal operations after a June 1 cyberattack forced it to downtime procedures.

Other

In South Africa, the Gauteng health department denies reports that a hospital morgue was backed up with two weeks’ worth of bodies because it couldn’t print death certificates due to a shortage of printer cartridges.

Sponsor Updates

• A new analysis from Black Book Research reveals a sharp escalation in state-level legislative actions that are reshaping revenue cycle management frameworks.
• Nordic releases a new episode of its “Designing for Health” podcast featuring UXonSpec founder and CUO Randolph Bias.
• CereCore releases a new podcast episode titled “Building Trust: From Expanse Rollout to High Reliability Organization.”
• Vyne Medical releases a new case study titled, “How Mayo Clinic Reduced Lab Data Entry Time by 50% While Increasing Data Volume.”
• AdvancedMD adds health insurance contracting and consulting services firm NGA Healthcare to its partner integration marketplace.
• Agfa HealthCare releases a new guide titled “Purchasing a Cloud-Hosted Enterprise Imaging Solution.”
• Clinical Architecture releases its “2025 Healthcare Data Quality Report.”

Blog Posts

• Enhancing Clinical and RCM Efficiency with Coding Automation (AGS Health)
• 4 Takeaways from Rooted in Purpose: Advancing Whole-Person Care for Individuals with IDD & Autism (Netsmart)
• New Nursing Charge Automation Adds $45K in Weekly Revenue (CereCore)
• EPRs at the heart of urgent and emergency treatment centres: Delivering safer, faster care (Altera Digital Health)
• How Vanderbilt University Hospital Tackled Readmission Rates By Leveraging Artera for Post-Discharge Communication (Artera)
• Set the foundation: How to prepare your data for AI transformation (Philips Capsule)
• From Texas to Wisconsin, Cardamom’s David Gibson shares his winding journey in health IT (Cardamom)
• MUSE 2025: Innovation, Connection, and Giving Back (Consensus Cloud Solutions)
• Why It’s Time to Rethink Prior Authorization—Especially for Specialty Medications (DrFirst)

Contacts

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

Morning Headlines 7/1/25

Premier, Inc. Expands Clinical Decision Support (CDS) Capabilities with Acquisition of IllumiCare

Premier, Inc. acquires IllumiCare, which adds a financial component to clinical decision support, and will market it under its Stanson Health brand.

NHS will use AI in warning system to catch potential safety scandals early

England’s NHS will deploy an AI-powered early warning system that will analyze near real-time data to look for patterns of problems that will trigger urgent inspections.

Steward Health Plans Litigation to Unwind Transfers to Cerberus, Other Insiders

An investigation by the bankrupt Steward Health Care System finds that its former private equity owner and former executive Ralph de la Torre improperly extracted $1 billion from the hospital chain during its insolvency.

Curbside Consult with Dr. Jayne 6/30/25

The Journal of Graduate Medical Education published a thought-provoking article this week titled “A Eulogy for the Primary Care Physician.” It reflects on the original purpose of a primary care physician as the trusted physician “who knows their health inside and out, who guides them through the complexities of the medical system, and who fosters relationships not with charts, but with people.”

This is exactly the kind of old-timey family physician that many of my peers and I thought we would become. That’s what we were trained to be during our residency programs. Little did we know that the forces that would actually align against our being able to do that.

First, there were the turf wars. I was trained to perform a variety of procedures during residency, including minor office-based surgeries, biopsies, wound management and repair, and sigmoidoscopy. I was also trained to deliver prenatal care and perform non-operative deliveries in partnership with local OB/GYNs who served as backup.

I quickly found that I wasn’t able to do most of those things in my hospital-sponsored practice. Family physicians weren’t allowed obstetric privileges, full stop, even if we had an OB/GYN who agreed to back us up. One of the hospitals where I was forced to be on staff didn’t even have obstetrics, which somewhat limited my ability to recruit newborns to the practice.

After six months of appeals, I was allowed to seek newborn nursery privileges at a competitor hospital in an attempt to maintain that part of my skillset, although caring for infants became increasingly rare.

Second was the pressure for primary care to support the volumes of all of the other specialties. If there was a procedure to be had, I was expected to send those patients to my proceduralist colleagues so that they would have adequate volumes.

Numerous procedures can be done by appropriately trained primary care physicians in a high-quality and cost effective manner. However, I was told that it was unseemly to hoard those procedures, and I needed to refer them out and show that I was a team player. It didn’t matter that patients would prefer not having to make a second appointment, take off work again, or pay a second co-pay.

The only thing I was able to hang onto were the skin biopsies, because I could do them relatively quickly and they didn’t have a significant supply need or cost therefore they were somewhat “invisible” to the medical group administrators who actually ran the show.

There were a hundred other things that steered my work as a family physician in a different direction from what I thought it would be. When I was offered the opportunity to work with the electronic health record project, I jumped at it. Maybe that would be the answer to regaining autonomy since I would be able to run reports and see data on my work without external support. Previously, I had to rely on the business office to do so via our green-screen practice management system.

Because of my protected time to work with the EHR, I was somewhat buffered by the pressures to constantly see more patients, although I was still juggling dozens of patient messages and requests on the days when I wasn’t in the office. In hindsight, I probably worked 1.25 FTEs during that time, despite being paid as a 1.0 FTE, but I was the only person in my position and I didn’t know how to push back given the pressures that were on the other primary care physicians in my group and which seemed worse at the time.

Although the Eulogy article cites burnout, declining reimbursement, and private equity as significant contributors to the demise of the primary care physician, I would add other elements. The consumerization of healthcare continues to be a major force, as physicians are incentivized around patient satisfaction, sometimes to the detriment of quality of care.

As an example, two areas on which physicians are incentivized are patient satisfaction and avoidance of unnecessary antibiotics. For every patient who calls wanting a Z-Pak for what is undoubtedly a viral illness but who “wants to get ahead of it” or says “I know my body and what I need,” there is only a lose-lose situation. I’ve been roasted via online review sites for refusing to call in antibiotics without seeing a patient. I’ve been threatened with complaints to the state board. I’ve been ripped in Press Ganey surveys.

My quality numbers remained high, but when you get bad reviews (justified or not), your paycheck suffers. Physicians should not be placed in these crosshairs, but we do it every day. I know it’s the proverbial dead horse, but educating patients about the risks of unwarranted antibiotic prescriptions is another public health intervention at which we’re not very good.

When I had the opportunity to expand my informatics work and change to a different environment for patient care, it was bittersweet. Although I missed the regular “continuity” patients with whom I had bonded over five years, I was glad to get out from under all the patient portal messages and communications that didn’t stop while I was out implementing the EHR, training peers who refused to work with non-physician trainers, and trying to figure out our group’s strategy for health information exchange.

I thought that would be the death of my career as a primary care physician, but little did I know that once I started working in the emergency department and urgent care settings, more than half of my work would be primary care anyway, since many of our community used those environments for their primary care services.

The Eulogy states, “The PCP is survived by the independent physician assistant, nurse practitioner, and generative artificial intelligence.” As someone who is starting to have more encounters with the patient side of the healthcare system than I would like, I worry quite seriously about how my generation will be cared for in the future.

Every time I see my own primary care physician, who is a few years older than I am, I don’t leave without asking the question of when he sees himself retiring so that I’m not caught in the lurch. Fortunately, most of my subspecialist physicians are younger than I am, so I’m less worried in those areas.

With regard to generative AI replacing primary care, I think we have many years of it augmenting rather than replacing. I’ve been unimpressed by many of the solutions that I’ve seen. I hope clinicians remain skeptical as developers work through issues with quality.

What do you think about the death of primary care in the US and how healthcare information technology might be able to resurrect it? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/30/25

CMS Launches New Model to Target Wasteful, Inappropriate Services in Original Medicare

CMS announces a six-year pilot in six states to test tech-enabled prior authorization for traditional Medicare, which has traditionally avoided prior authorizations.

CalmWave raises $4.4M for tech that targets non-actionable patient alarms in hospital ICUs

Seattle-based medical device alarm management software startup CalmWave raises $4.4 million in seed funding.

Handspring Raises $12M Series A to Expand High-Quality Mental Health Care for Children and Families

Virtual mental healthcare clinic Handspring announces $12 million in Series A funding.

Monday Morning Update 6/30/25

Top News

CMS announces a six-year pilot in six states to test tech-enabled prior authorization for traditional Medicare, which has traditionally avoided prior authorizations.

Participating organizations will be paid based on reducing inappropriate utilization. CMS is looking for companies that have implemented AI-powered PA programs for other payers.

CMS says that no new provider documentation will be required, but information must be submitted in advance.

CMS calls the program WISeR, the Wasteful and Inappropriate Service Reduction model.

Reader Comments

From Lou Lazuli: “Re: hospital sterilization methods. What’s your take on UVC light augmenting other methods for battling MRSA and VRE outbreaks? Is there a market need?” I’m far from an expert, but hospitals seem to be interested in using it to disinfect rooms after normal cleaning, where it reduces the transmission of superbugs. Hospitals are the target market due to the clinical and financial cost of hospital-acquired infections, which include CMS financial penalties. UVC robots like the one developed by Xenex might be an attractive offering if a business case can be made to offset the increased cycle time and capital investment that is required. It would be an easier sell if UVC replaced existing methods instead of augmenting them, but the expensive machines could be selectively deployed for use in vacated isolation rooms, surgery and procedure areas, and critical care units where any HAI could be especially disastrous.

From Chart Thief: “Re: VA scheduling and Oracle Health. It’s a management failure, not a tech problem, if the VA can’t implement the system it bought and instead continues to run legacy ones.”

HIStalk Announcements and Requests

Most poll respondents aren’t too worried about AI encroaching on their employment.

New poll to your right or here: What is the remote patient monitoring takeaway of Best Buy’s divestiture of Current Health?

Sponsored Events and Resources

None scheduled soon. Contact Lorre to have your resource listed.

Sales

• Trinity Health (ND) will implement Epic, replacing Oracle Health.
• QHIO SacValley MedShare joins the KONZA Health QHIN.

Announcements and Implementations

Optum launches an AI marketplace of products developed by the company and its third-party partners.

Former grocery store bagger turned self-styled medical entrepreneur and disruptor Ryan Egypt El-Hosseiny asserts that he has resurrected the lab testing firm Theranos after validating the fraudulent claims of former CEO and federal inmate Elizabeth Holmes. He made the announcement at a Miami nightclub, where he was flanked by rappers, fake cops, and a Holmes impersonator wearing an orange jumpsuit. El-Hosseiny, who is pushing RFK Jr.’s Make America Healthy Again platform and lobbying for President Trump to pardon Holmes, calls himself “the Steve Jobs of medical labs” and is among the Grade D actors who appear in his cringeworthy YouTube film titled “Just Blood: The United States vs. Elizabeth Holmes,” where his fake mustache appears to be summiting his external nares and his fellow thespians are repeatedly caught by the camera trying to suppress grins of participatory embarrassment. Records indicate that the Theranos trademark was abandoned when the company dissolved in 2018, so I assume he’s a squatter.

A new KLAS – Arch Collaborative report finds that ambient speech is improving provider EHR satisfaction and allowing more face-to-face interaction with patients. It is also boosting the EHR experience metrics of Epic-using ambulatory care providers. However, most users say that they aren’t willing to squeeze in more patient visits to justify the technology’s cost, preferring instead to improve patient care or their own work-life balance.

Government and Politics

Federal prosecutors indict 11 members of a Russia-based crime ring who allegedly used stolen information from 1 million Americans to bill Medicare $11 billion for medical equipment that was never ordered or delivered, netting $300 million.

Other

SCAN Health Plan President and CEO Sachin Jain, MD, MBA describes what he calls the “value-based delusion”:

Every conference deck, consulting proposal, and startup pitch has claimed to be “bringing value to healthcare.” But let’s be honest: in most cases, very little has actually changed in how care is delivered. Instead of reimagining the patient experience, many organizations have simply reengineered their revenue models. Networks get narrowed. Risk gets shifted. Coding intensity rises. But does care feel more human, more seamless, more dignified for patients? Too often, the answer is no.

Sponsor Updates

• Black Book Research announces a revamped RCM KPI framework that incorporates critical areas like AI integration, transparency, and automation.
• Surescripts VP of information security and CISO Judy Molenaar joins the DirectTrust Board of Directors.
• Nordic announces its ISO 9001 Quality Management Systems certification in Europe.
• Nym names Aya Weinstein VP of product, Amir Cohen senior software engineer, Alvera Abouseif customer success manager, Michal Attias bookkeeper, and Debra Whitley senior manager of product and coding compliance operations.
• Redox welcomes Ferry Health to the Redox Connection Network.
• Rhapsody Health offers a new customer story titled “Qventus achieves 10X performance and reduces customer onboarding time by 50%.”
• VitalChat announces the availability of a ProConnections Conversion Kit for those providers left with unsupported virtual care infrastructure following the closure of tele-ICU vendor ProConnections.

Blog Posts

• Spotting the Red Flags in Your Analytics and How to Fix Them (FinThrive)
• How Mobile Scheduling Software Solves Healthcare Staffing Chaos (Inovalon)
• From Pilot to Practice: 10 Keys to AI Adoption in Behavioral Health (Netsmart)
• Simple, obvious, ignored: The real work of improving patient experience (Nordic)
• Preparing Your Staff for a Cerner-to-Epic Conversion in 5 Key Steps (Optimum Healthcare IT)
• For patient education, place evidence at the center of care (Wolters Kluwer Health)
• When Not to Automate: Lessons from the Front Lines (VisiQuate)
• Healthcare Integration for Startups: A Scalable Guide to EHR Interoperability (Zen Healthcare IT)

Contacts

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

Morning Headlines 6/27/25

Certify Secures $40M Series B Funding to Continue Building the Healthcare Provider Data Infrastructure of the Future

Provider data management vendor Certify raises $40 million in a Series B funding round.

Arine Raises Series C to Scale AI-Driven Medication Optimization and Power Value-Based Outcomes

Arine, which offers an AI-powered medication optimization platform, raises $30 million in a Series C funding round.

Novo Nordisk says WeightWatchers will sell Wegovy, announces $299 price

Novo Nordisk will make its weight-loss drug Wegovy available to WeightWatchers members through its online prescription service.

News 6/27/25

Top News

Best Buy sells remote patient monitoring technology company Current Health back to its co-founder and CEO Christopher McGhee (formerly known as Christopher McCann). 

Best Buy acquired the company in October 2021 for $400 million and has struggled with its in-home healthcare business since, including taking two write-downs totaling nearly $600 million this year.

McGhee left Best Buy in March 2024. I interviewed him in April 2022. Several former Current executives will return to the company with him.

Best Buy’s CEO said in its most recent earnings call that hospital-at-home solutions business was advancing more slowly than it had expected.

Reader Comments

From Blew Button: “Re: AI strategy. Everyone is pushing for faster adoption. How are health systems balancing that with validation, integration, and project priorities? We can’t skip the hard parts just because execs and the board are believing the AI hype.”

HIStalk Announcements and Requests

Microsoft’s retirement of Skype pushed me to use Teams instead for my weekly English sessions with my Ukrainian student. Teams has been unreliable, slow, and maddening (why can’t I test my camera and microphone without connecting to a meeting?) Teams repeatedly froze the connection this week, so we tried WhatsApp, which had better quality and reliability for at least those few minutes. I will confirm next week after we try our full-hour session on WhatsApp.

Sponsored Events and Resources

None scheduled soon. Contact Lorre to have your resource listed.

Acquisitions, Funding, Business, and Stock

Mandolin, which uses AI agents to manage specialty drug intake, benefits, prior authorizations, and RCM, raises $40 million in seed and Series A funding.

Veradigm reaffirms its intention to have its shares relisted in 2026. The company said in its earnings call that it is gaining new provider business in specialty practices, value-based care, and especially in revenue cycle. Revenue is flat as the company expected, however, and it continues to see attrition among larger clients.

Provider data management vendor Certify raises $40 million in a Series B funding round. Founder and CEO Anshul Rathi, MS started the company in 2021 after managing network data for Oscar Health.

Arine, which offers an AI-powered medication optimization platform, raises $30 million in a Series C funding round. CEO Yoona Kim, PharmD, PhD worked in pharma and at Proteus Digital Health before she co-founded the company in 2017.

People

Evidently hires Chris Cowart (Xsolis) as head of growth.

Tony Murdoch (Bamboo Health) joins Zus Health as VP of business development and partnerships.

Announcements and Implementations

Altera Digital Health launches Sunrise CarePath, a mobile patient engagement platform that is integrated with its Sunrise EHR. It offers secure messaging, self-scheduling, patient notifications and appointment reminders, and billing integration.

Researchers describe ECGFounder, an ECG foundation model that was trained on 11 million ECGs and their cardiologist notations. They theorize that its expert-level diagnostic performance could provide useful in analyzing ECG data from wearables.

KLAS surveys C-level health system executives about their technology vendor expectations. Recommendations to companies:

• CEO: address big-picture value of the platform; back up claims with real-world metrics from other health systems; be prepared to pitch at a board level.
• CFO: provide contracting transparency; be flexible in negotiations; show line-item cost implications; partner to perform post-implementation financial impact reviews.
• CDO: provide integration playbooks; provide change management toolkits; partner in developing data governance frameworks.
• CIO: address how the solution fits into the broad IT strategy; provide proactive support from implementation through optimization; partner on rationalizing legacy technology and vendor sprawl.
• CISO: provide risk documentation and real-world threat models; provide easily deployed security tools; include advisory services in the engagement model.
• COO: provide turnkey dashboards that integrate operations, finance, and quality; provide industry benchmarks and advisory services; provide quick-win use cases and tactical automation.
• CTO: provide architecture diagrams, threat models, and deployment recipes; include stakeholders in roadmap previews, especially when dependencies or APIs will change; share reference implementations and provide a sandbox to prove extensibility claims.
• CMO/CMIO: involve them in roadmap development; showcase measured clinical outcomes and provider satisfaction benchmarks; provide tools to help build consensus with clinical leaders.
• CNO/CNIO: shadow nurses to map workflows; provide real-time, around-the-clock support; get nurses involved in roadmap designs using clinical councils or pilots.

Government and Politics

Digital health companies Whoop, CoachCare, and Epic testify before the House Ways and Means health subcommittee about the benefits of wearables and remote patient monitoring. Their timing was ideal given HHS Secretary Robert F. Kennedy, Jr.’s recent call for every American to wear a device within four years, but less so given lawmakers’ focus on a proposed reconciliation bill that would strip coverage from 16 million people through Medicaid and ACA coverage cuts.

Privacy and Security

King’s College Hospital NHS Foundation Trust tells a patient’s family that a cyberattack contributed to his death. Pathology provider Synnovis was hit by a ransomware attack on June 3, delaying the patient’s critical test result.

Other

Microsoft profiles how 365 Copilot is used by the chief digital officer of a hospital in Brazil. He says it helped him improve his no-nonsense email style to be more polite and “really cute.” He adds that it has reduced his email management time by 70% and allows quicker decision-making by summarizing long email threads.

Sponsor Updates

• An unnamed Southern health system selects Vyne Medical’s Trace Platform to process inbound orders in its patient access department.
• Black Book Research poll-takers name the leading EHR-native patient accounting systems for 2025, including HIStalk sponsors Meditech and TruBridge.
• CereCore earns a five-star rating and “Best Practice” designation as an Infrastructure as a Service provider by Securance Consulting.
• Findhelp welcomes new customers City of Kansas City, MO; DSR Public Health Foundation; and Careforth.
• Five9 releases a new customer success book titled “Aeroflow Health Improves Efficiency with Automation.”
• Healthcare IT Leaders releases a new “Leader to Leader” podcast episode titled “From Technical Debt to Transformation: The Cloud Journey Healthcare Needs.”
• Meditech releases a new customer success story titled “Sierra View Medical Center Unleashes the Power of Data with Meditech’s Analytics Solution.”

Blog Posts

• How We Did IT: Oracle Health EHR Speed & Reliability Score Increased 17% (Goliath Technologies)
• Recent Enforcement in Healthcare Price Transparency: What You Need to Know (FinThrive)
• How Managed XDR Strengthened Cyber Defense at a Vermont Hospital (Fortified Health Security)
• Simplifying chronic care: What you need to know about APCM codes and MIPS MVP reporting (Healthmonix)
• 5 Strategies to Build a Motivated Healthcare Workforce (Inovalon)
• Advancing Data Integrity: DAV Cohort 10 Reflects KONZA’s Continued Leadership (Konza)
• How Orthopedic Practices Are Streamlining Patient Disability and FMLA Form Management with MRO (MRO)
• 5 key takeaways from our VBC initiatives roundtable (Navina)

Contacts

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

EPtalk by Dr. Jayne 6/26/25

The two hot topics around the virtual physician lounge this week, not surprisingly, involved comments or policies from the new Secretary of Health and Human Services.

Physicians are dreading upcoming changes in vaccine reimbursement, which will likely come if vaccines are no longer recommended by the reconstituted Advisory Committee on Immunization Practices. Commercial payers follow the actions of government payers, which could lead to a fair amount of work for everyone with an EHR and billing system as they reconfigure their systems to follow new rules.

I can also already see the new policies fueling burnout in the organizations that I’m closest to, as physicians again have to defend their practice of evidence-based medicine. It’s not a great time to be a frontline physician, particularly one in primary care.

The other hot topic was around statements that everyone in the US should have a wearable medical device in the next four years. Continuous glucose monitoring devices appear to be the darling of the day, with much skepticism from physicians who have already had to deal with the data provided by current users. There’s not a lot of data that supports the use of the devices unless a person is diabetic, prediabetic, or has one of a handful of other medical conditions.

Just wearing a device doesn’t drive the needle, either. Other services are needed to support patients as they make changes in their health, such as dietitians, nutrition counseling, and behavioral health interventions. Those also have a cost.

It’s great to say that people should take charge of their own health, but for those of us who have been in the public health trenches for decades, we know that patients can’t always control the fact that they live in a food desert. They can’t control their genetics. We live in a nation where health literacy is close to rock bottom.

Kennedy stated, “They can see, as you know, what food is doing to their glucose levels, their heart rates and a number of other metrics as they eat it, and they can begin to make good judgments about their diet, about their physical activity, about the way that they live their lives.” Having cared for thousands of average Americans during my medical career, I would hypothesize that less than a quarter of the patients I’ve seen would be able to take a device out of the package start managing their diet in the way that he describes without some serious intervention.

I don’t disagree that the nation needs a crash course in self-care. I’ve seen it myself as patients come to the emergency department for the common cold without having taken so much as an acetaminophen tablet. We see wounds that haven’t been washed with soap and water and sprains that were never iced, among other things, as the patients come to us and leave with a $1,000 hospital bill.

I would much rather see the country start pouring money into public health interventions that have been proven effective than see us throwing money at technology without all the ancillary services needed to truly drive the needle for patient outcomes. The nation’s many Federally Qualified Health Centers know a thing or two about this, as do the many county, city, and state health departments.

Speaking of high tech public health, I continue to be fascinated by the data and analytics around using wastewater for disease monitoring. I first heard of it during the height of the COVID pandemic, when it was being used to model the level of disease in our community, especially when we were having shortages of testing supplies for use in the office.

WastewaterSCAN is a nationwide system that is based at Stanford University in partnership with Emory University. It monitors 11 infectious disease indicators via bottles of wastewater that are shipped from around the country. Viral RNA material is sturdy stuff, and the diseases tracked include COVID, influenza A and B, respiratory syncytial virus (RSV), enterovirus, norovirus, hepatitis A, and many more. CDC also conducts testing, as do many municipalities, and most of the data is publicly available.

The higher-level information that is gleaned from wastewater can help public health agencies and care delivery organizations understand what viruses are surging in their communities and might be useful for creating recommendations on when to start testing for various diseases. It can also be used to inform staffing levels within facilities or to pinpoint increases that might result in an outbreak, such as high levels of a virus at an airport or tourist spot.

The next frontier in wastewater research involves identifying bacteria, although the process poses challenges. You can have two bacterial species that are similar, but only one causes a serious disease, and it can be difficult to differentiate between the two. Here’s to seeing what the next decade of innovation brings in this field, and to knowing that many of us are contributing to scientific advancement with every flush.

For some time now, I’ve been trying to clean up my provider data, including my NPI registration that still lists an address where I haven’t worked in a very long time. There are also problems with my CMS data, and the process to try to correct that is even worse.

In a typical employed provider situation, an office manager or administrator usually manages that for the employed physicians. But when you’re a 1099 contractor working for multiple organizations it’s up to the physician to make it work. The governmental data is particularly pesky, because it feels like you have to get a log in to site A that then gives you access to site B but the passwords time out and are a pain to reset. If anyone has a cheat sheet for cutting through all of this, feel free to send it my way. My current clinical situation tells me I’m on my own. Maybe someone could create an AI-powered bot that could take care of it all.

I was back on the patient side of the equation this week and was surprised by the speed at which I received a message that I had “new test results” in the chart. Once I made it through some pesky password issues that involved using my laptop instead of my phone, I was disappointed to find that the “result” was simply a message from the lab that said my specimen had been received. It’s been a long time since I’ve done lab interface work, but I would hope that such messages might be filtered to avoid causing extra anxiety for patients.

I was also disappointed by the quality of the visit notes that I could see. I was weighed during my visit, but my height was not measured. However, the note had a documented height but no weight, although a BMI was there. The combination of vitals showing up in the note seemed odd. The note from the first physician that saw me had no fewer than six exam findings that were most certainly not examined. Although one could blame templated documentation, there really is no excuse. If you’re not doing an ear, nose, and throat exam on every patient, it takes about 12 seconds to remove that from your template forever.

When you’re a patient, what’s your biggest frustration with healthcare information technology? Leave a comment or email me.

Email Dr. Jayne.