Tennessee’s Cookeville Regional Medical Center claimed by Rhysida ransomware gang
The Rhysida ransomware group posts data that it claims to have stolen in a July 13 ransomware attack on Cookeville Regional Medical Center, which is still working to recover from the breach.
The DoD extends Amwell’s contract for virtual care technology under the Leidos-led Digital Front Door initiative of MHS Genesis.
Cerebral Acquires Resilience Lab to Scale Proven Model of High Quality, Personalized Care
Online therapy and medication management company Cerebral acquires competitor Resilience Lab.
Hinge Health stock pops 6% after first quarterly report since IPO
Digital physical therapy vendor Hinge Health sees its shares jump on its first quarterly revenue report since its IPO in May.
The Rhysida ransomware group posts data that it claims to have stolen in a July 13 ransomware attack on Cookeville Regional Medical Center (TN).
According to the post, the hospital has until August 6 to pay the demanded ransom. Otherwise, the hackers say they will sell the data for $1 million.
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Healthcare workforce technology company HealthStream reports Q2 results: revenue up 4%, EPS $0.18 vs. $0.14, meeting Wall Street’s expectations for revenue and exceeding those for earnings.
Hims & Hers Health reports Q2 results: revenue up 73%, EPS $0.17 versus $0.06. Revenue dropped substantially as the company complied with FDA requirements to stop selling compounded versions of GLP-1 weight loss drugs in doses that are sold by the patent holder.
Supply chain technology vendor Capsa Healthcare acquires competitor BlueBin.
Experity names Bobby Ghoshal, MBA (ResMed) president and COO.
Christopher Kodama, MD, MBA (Embright) joins Milliman MedInsight as chief medical officer.
GLP-1 digital program vendor EMed Population Health hires Linda Yaccarino (X) as CEO.
The DoD extends Amwell’s contract for virtual care technology under the Leidos-led Digital Front Door initiative of MHS Genesis.
Epic offers a conference on integrating with its products for vendor and provider developers September 25 in Verona.
The California State Treasurer’s Office approves Adventist Health’s issuance of up to $1 billion in tax-exempt bonds to fund its Epic implementation. The 27-hospital health system began posting job notices for the project on LinkedIn last summer.
ASTP/ONC releases the HTI-4 final rule for certified EHRs, which includes updated criteria for electronic prior authorization, electronic prescribing, and real-time prescription benefit information.
A California class action lawsuit jury finds that Meta violated the state’s Invasion of Privacy Act by using data from Flo’s menstrual period tracking app to target ads.
A study of 28,000 inpatient visits across two hospitals finds that virtual nursing programs helped to reduce the average inpatient length of stay by 7% and readmission rates by 2%.
Astera Health (MN) implements a telehealth NICU program that enables clinicians to virtually connect with specialists at CentraCare – St. Cloud Hospital (MN).
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Skylight Health Launches Value-Based Multispecialty Platform
Multispecialty care coordination and analytics company Skylight Health launches with $13 million in new funding.
Brightstar Capital Partners acquires Analyte Health, a digital health company specializing in online diagnostic, treatment, and wellness services.
Audax Private Equity and Parthenon Capital acquire RCM vendor Elevate Patient Financial Solutions (formerly known as MedData) from Frazier Healthcare Partners.
HealthStream Announces Second Quarter 2025 Results
Healthcare workforce technology company HealthStream reports Q2 results: revenue up 4%, EPS $0.18 vs. $0.14, meeting Wall Street’s expectations for revenue and exceeding those for earnings.
I recently had the opportunity to spend some time with a computer engineering student who was looking to learn about healthcare information technology. Specifically, he was curious about the role that clinicians play in the field.
We had some great conversations and the experience was very enjoyable, in large part because few of the discussions centered on AI. He has a particular interest in cybersecurity, so our initial conversations had some fairly deep coverage of the topic. He was interested in learning more about how hospitals and health systems handle the backup and recovery process, particularly when a security incident might have occurred. Based on a couple of his comments, I think I surprised him by being able to provide a deeper discussion of the topic than he expected to hear from a physician.
It was a good opportunity to explain the field of clinical informatics and how many types of roles we fill. I’m unusual in how much experience I’ve had with infrastructure, architecture, and the nuts and bolts of interoperability. I’ve been fortunate to work with some great engineering and development teams throughout my career, picking up some interesting and unique knowledge along the way. I never thought I’d be able to have conversations about Citrix load balancing or be able to explain the role of transaction log shipping as part of a disaster recovery solution, but you never know where your career is going to take you.
In large part, I learned about those things not because I necessarily wanted to, but because I had to. The first EHR project I was involved in did not go well. A lot of IT folks were techsplaining, which didn’t help me solve the problems that were interfering with my ability to deliver high-quality care.
Although I think that many of them were just talking in their everyday language — similar to how physicians talk among themselves, without trying to leave me out of the conversation — I experienced more than one situation where an IT staff member was treating me in a way that was equivalent to patting me on the head and saying, “Don’t worry about this, little lady.”
After one of those encounters, I decided that I would need to hold my own, so I started doing a lot of reading. I figured if I could learn biochemistry and the complexities of the human nervous system I could certainly learn some of this new language and how all the technology was supposed to be working compared to how it was actually performing in the field.
Thinking about how information access has changed, learning about those domains would be a lot easier now than back in the days when only 5% of physicians were using electronic health records. You couldn’t just pop into your web browser and find articles about implementing systems in hospitals, because we were just getting started. Meaningful Use wasn’t yet a thing, and those of us that were trying to bring up systems were doing it because we thought we could revolutionize patient care, not because someone was making us do it.
Hospitals had electronic laboratory and monitoring systems and of course billing, but computerized order entry wasn’t even on the radar of physicians. Heck, we couldn’t even print patient labels from the computer system at one of my hospitals. They were still using Addressograph cards to add patient information to the paper used for writing daily progress notes.
We went down the internet rabbit hole as I was trying to explain that piece of equipment to my student. I wish I had a picture of the look on his face when I explained how a similar technology was once used to process credit cards at businesses. Apparently you can buy a vintage credit card imprinter machine via various online resale sites, for those of you who miss the very specific noise made when the charge card was pressed under the carbon paper.
That led to a good conversation around the idea that 40 years ago, we had no frame of reference for the technologies that we would be using today. No one would have guessed that we could simply tap our credit cards on a machine to pay, let alone load that credit card information into a palm-sized phone and use it to pay as well. I can’t even imagine how things will work in 40 years, and I hope that when he’s later in his career, he will have the experience of being able to share stories of how things used to be with someone who is just starting out.
We also had some interesting conversations about healthcare in general, and particularly around healthcare finance and how the revenue cycle works. In my opinion, it’s one of the messier aspects of the US healthcare system, and opportunities exist to make it better.
We had a good conversation around how claim adjudication works and why it’s rare in our area to see an organization that is doing real-time claims adjudication. Some of the practices that I go to don’t even collect your co-pay during the office visit, so I can’t imagine what a big shock it would be to use a system like that.
I also ended up teaching him how to read an Explanation of Benefits statement, which I think was an eye-opener, especially for someone who doesn’t have a lot of patient-side experience in his relatively brief adulthood.
I enjoyed learning about some of the non-healthcare work that the engineering student has done as he works towards his degree. Also, the supplemental activities that are available to students that didn’t exist when I was in school. His school has competitive rocketry, drone, and Mars rover teams where students can apply what they’re learning as early as the first semester. We had to wait until our junior year to really have experiential learning opportunities and they certainly weren’t as cool as any of those.
Although I tried to bring healthcare and healthcare technology to life, I’m not sure it’s going to be as cool as some of the other career options that will undoubtedly be available to him, especially if he’s leaning towards cybersecurity and cryptography. He’ll be back next week, and I plan to cover topics including robotics, prosthetics, and human-computer interaction. I might still be able to convince him that healthcare can be cool.
What do you think are the coolest technologies we’re using in healthcare, beyond AI? Leave a comment or email me.
Email Dr. Jayne.
Self-Service in Health IT: More than a Fancy Kiosk
By Sriram Devarakonda
Sriram Devarakonda, MSEE is CTO at Cardamom.
Self-service first emerged in the consumer space, where it was designed to offer a frictionless, user-controlled experience. Whether buying a soda from a vending machine, ordering a burger at a kiosk, or depositing a check via mobile app, self-service is no longer a novelty — it’s an expectation.
The goal? Empower customers with speed and convenience, while still providing the right guardrails.
In health IT, self-service started gaining traction in the early 1990s, as support demand quickly outpaced available resources. Early implementations focused on handling low-complexity tasks like password resets, login issues, and access to knowledge articles.
Today, self-service goes far beyond troubleshooting. Users expect more sophisticated, cognitive tasks, such as exploring data, generating ad-hoc reports, and deriving meaningful insights, all without having to file a ticket. Yet despite the strategic focus placed on self-service across industries, sustainable, impactful adoption in healthcare remains rare.
What separates organizations that succeed with self-service from those that struggle?
Let’s go back to the burger analogy. Why might a customer avoid using a self-service kiosk?
Now, apply that thinking to self-service reporting in healthcare. The stakes are higher, and the choices are rarely as simple as picking from a preset menu. Success requires more than just implementing a tool. It demands the right mix of people, processes, and technologies to ensure that the information that is being served is accurate, actionable, and tailored to the user.
Here’s what that takes:
A deep understanding of users and use cases.
A care manager may need a quick list of patients for outreach. An ED director may be focused on real-time throughput. These are vastly different needs, both in purpose and in technical complexity. And that’s just two personas. Most healthcare systems support dozens more, each with their own complexities and needs.
Strong data governance
Certified, approved definitions help avoid inconsistent or misleading data. It’s the difference between ordering a Big Mac and ending up with a plain hamburger.
Rigorous validation processes
Just as restaurants test new menu items before launch, healthcare solutions should be reviewed by cross-functional teams — including clinical, technical, and operational experts — to ensure accuracy and trust.
A long-term mindset
Self-service is not a one-and-done implementation. It’s a journey that evolves with user maturity, system capabilities, and data maturity.
Robust user enablement
Even the best tools fall flat without support. Users need training, ongoing coaching, and a clear path for feedback and escalation.
Clear, meaningful measurement
Success should be tracked through real adoption, demonstrated value, and a measurable reduction in support tickets for routine issues.
Accessible, intuitive technology
The best self-service tools are invisible — seamless, simple, and always available when users need them.
When executed effectively, self-service doesn’t just reduce dependency on IT teams. It empowers frontline users to make faster, more informed decisions. It builds trust. It turns skeptics into advocates.
But success isn’t a matter of flashy platforms. It requires a service-oriented mindset, one that is grounded in empathy, clarity, and commitment to getting it right.
4D Medical secures $10m strategic investment from Pro Medicus
Visage Imaging parent company Pro Medicus invests $10 million in lung function technology vendor 4DMedical.
ASTP/ONC releases the HTI-4 final rule for certified EHRs, which includes updated criteria for electronic prior authorization, electronic prescribing, and real-time prescription benefit information.
Ultromics Lands $55M Series C to Tackle Undiagnosed Heart Failure at Scale
AI-enhanced heart failure detection company Ultromics raises $55 million from a group of investors that include UPMC Enterprises and UCM Ventures.
Digital physical therapy vendor Sword Health launches an AI division.
Sword Intelligence will have its own dedicated team and go-to-market strategy in operating outside of the company’s care delivery business. It will sell solutions to health systems, governments, and payers.
Sword Health’s June 2025 funding event valued the company at $4 billion.
From Doc Martin: “Re: Sol Health rebrand. I thought this email notice was a joke at first. At least they named themselves after the most frequent response to mental healthcare needs nowadays.” The company renamed itself Sol Mental Health in 2023 as a reference to the sun. A hyped up rebrand evangelist decided it would be much cooler to shout it out in ALL CAPS, which turned the solar-themed company name into a version that starts with a vulgarity and ends with “out of luck.” HIStalk don’t play that — I capitalize the first letter even if the company doesn’t (Athenahealth), excise gimmicky symbols (M*Modal), and lowercase everything but the first letter unless it’s a clear initialism (KONZA Network is fine, SOL Health is not). Pedantic grammar note: an initialism is an abbreviation where each letter is pronounced (EHR), while an acronym is pronounced as a word (FHIR). Long-timers will recall the annual conference when HIMSS told its staff to turn the name into an initialism, forcing them to perform lingual gymnastics to sound it out as H-I-M-S-S to justifiably puzzled looks.
From Yardbird: “Re: LLMs. They might encourage generalists to manage specific conditions instead of sending the patient to a specialist if judgment rather than a procedure is involved.” That could happen and fits the cognitive displacement theory in which LLMs will replace people whose jobs involve recalling obscure facts, following a checklist, or reformatting information into a desired format such as a legal brief or a prescription. You could argue that non-procedural specialists often rely on pattern recognition to make a blink diagnosis that an LLM could replicate, with a generalist present to meet legal requirements or apply minimal judgment. Medicine changes so fast that the most valuable thing a specialist might offer is the focused-factory advantage of volume-bred expertise.
About half of health system IT leaders expect their next budget to be less than the current one.
New poll to your right or here: How much will HHS’s “Make Health Tech Great Again” voluntary campaign improve healthcare?
I got some $10 AirPod knockoffs from Temu that are surprisingly good. Similar-looking versions go for as little as $5. I rarely use earbuds, so I was startled by the clarity and volume when I queued up some R.E.M. I’m sure the Apple product is fine, but not worth $200 to me.
I’m using Substack to create a solo hobby-style newsletter-website. It’s free unless you charge subscribers (that’s why I’m using it instead of the not-free Beehiiv) and definitely worth $100 or so to hire a Fiverr freelancer to tweak the CSS for formatting changes that the Substack UI doesn’t allow.
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Waystar reports Q2 results: revenue up 15%, EPS $0.36 versus $0.26, beating analyst expectations for both. WAY shares are up 72% since their June 2024 IPO, valuing the company at $6.2 billion.
Visage Imaging’s parent company Pro Medicus invests $10 million in lung function technology vendor 4DMedical.
I was surprised to see NantHealth as a participant in HHS’s “Make Health Tech Great Again” event. I’m actually even more surprised that the company remains in business — shares are down 99.99% to just over a penny since the company’s much-touted IPO in June 2016, its market cap has been flat for years at less than $500,000, and the company’s top institutional shareholder owns less than $1 worth. It’s one of 11 Nant-named companies that were spawned off by billionaire Patrick Soon-Shiong, MD under the NantWorks label.
A study finds that most ED patients who had a high mortality risk did not have their advance directive and treatment goals recorded in their EHR. The authors checked for healthcare proxy, power of attorney, living will, advance care plans, and physician orders for life-sustaining treatment.
Epic consulting firm Anura Connect posts on LinkedIn that some third-party EHR consultants are quietly double-dipping by working two full-time jobs at once and being paid by multiple health systems. The company says it’s easier to pull off now with loosely supervised remote work and a lack of vetting when hiring. It warns consulting firms that their reputation and long-term relationships could suffer when a client finds out, while the consultant themself could be blacklisted, at least until the next desperate recruiter calls.
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Cybersecurity startup Axonius acquires medical device security technology vendor Cynerio for $100 million.
JotPsych, a developer of AI scribe software for behavioral health providers, raises $5 million in seed funding.
Digital physical therapy company Sword Health launches an AI division specializing in modular AI care managers.
Waystar Reports Second Quarter 2025 Results
Waystar reports Q2 revenue of $270.7 million, beating analyst expectations for both revenue and earnings per share.
Several dozen health tech companies pledge at a White House-sponsored HHS event Wednesday titled “Make Health Tech Great Again,” to collaborate on interoperability and develop consumer-facing health tools in a patient-centric ecosystem. Thirty companies will build apps, 11 provider organizations will support adoption, and seven EHR vendors will promote data sharing and help “kill the clipboard” by reducing paper intake forms.
CMS says it will launch a digital health app library on Medicare.gov. It also outlined several related efforts:
The goals of the CMS Interoperability Framework include giving patients access to their medical and payer information using digital credentials and allowing providers to use their choice of technologies to obtain treatment access. It sets a July 4, 2026 date for participating networks to offer FHIR API access to chart notes, clinical documents, and encounter notifications.
Welcome to new HIStalk Platinum Sponsor LiveData. Hospitals and ASCs come to LiveData for tools that improve surgical revenue, margin, and patient safety. Its PeriOp Manager is a modular, real-time “system of engagement” integrated across the complete patient journey – pre-op case scheduling, block optimization, day-of awareness, OR safety, and retrospective analytics. It serves the perioperative suite and services procedure service lines as well. The company’s OR-Dashboard with Active Time Out module was recognized as a Joint Commission Leading Practice, thanks to its impact on improving safe surgery checklist compliance. The PeriOp Planner module has been shown on average to increase block utilization by 34%, decrease cancellations by 54%, and increase case volume by 4-6%. Surgery departments using LiveData modules have documented other improvements in KPIs like case scheduling accuracy, first-case-on-time-starts, and OR turnover speed. LiveData helps its clients realize fast financial and strategic gains in competitive environments. Thanks to LiveData for supporting HIStalk.
Here’s a LiveData explainer video.
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Blackstone will acquire revenue cycle management firm AGS Health for $1.1 billion. Blackstone was rumored to be the leading bidder in late May.
Cybersecurity startup Axonius acquires medical device security technology vendor Cynerio for $100 million.
Clinisys acquires lab system competitor Orchard Software from Francisco Partners, which acquired the company in 2019.
Highmark Health hires Alistair Erskine, MD, MBA (Emory Healthcare) as chief information and digital officer.
Jared Allen, MBA (Premier) joins Sonifi Health as SVP of healthcare sales.
Medical University of South Carolina names Amar Nagaram (Indiana University Health) as enterprise CIO.
England’s NHS pilots an AI-powered virtual physical therapy clinic, using Flok Health, which offers same-day automated video visits. Cambridgeshire and Peterborough NHS Foundation Trust reduced waiting times by 44%.
CVS-owned Aetna enhances its app with Aetna Care Paths, which gives members a personalized view of their benefits and provides AI-supported personalized health and wellness programs.
Clearwater launches an Enterprise Cyber Risk Management solution.
ASTP/ONC submits a prescription drug cost transparency rule that addresses using EHRs to submit prior authorizations, choose drugs that are consistent with the patient’s insurance, and exchange prescription information electronically with pharmacies and insurers.
An editorial in Radiology recommends separating the roles of radiologists and AI in diagnostic workflows, challenging the prevailing view that they should collaborate directly. It proposes that AI systems first generate a clinical summary from patient data, which radiologists then use to interpret images and produce the final report. The authors say that this division allows radiologists to focus on critical thinking and image interpretation while leveraging AI’s strengths in pattern recognition and data synthesis.
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There was some good discussion around the virtual physician lounge this week as one of my colleagues shared a recent article in Nature Scientific Reports about using AI to diagnose autism spectrum disorder and attention-deficit / hyperactivity disorder in children and adolescents.
Diagnosing these conditions can be challenging for primary care physicians who have limited time with patients and for parents who might wait months for their child to receive an appropriate assessment. In my city, the wait for a non-urgent assessment by a child and adolescent psychiatrist can be up to a year. Delayed diagnosis leads to delays in care.
The study still needs refinement, but preliminary results show that a sensor-based tool can suggest a diagnosis in under 15 minutes with up to 70% accuracy. The researchers began with a hypothesis that diagnostic clues can be identified in patients’ movements that are not perceptible to human observers, but can be detected by high-definition sensors. The authors catalogued movement among neurotypical subjects and those with neurodevelopmental disorders to inform a deep learning model. The movements were tracked by having the subjects wear a sensor-embedded glove while interacting with a target on a touch screen. The sensors collected movement variables such as pitch, yaw, and roll as well as linear acceleration and angular velocity.
I admit I was having flashbacks to some of my physics coursework as I read the paper, but it still kept my attention. The authors plan to continue validating the model in other settings, such as schools and clinics, and to validate it over time. The study has some limitations, namely its size. It had only 109 participants and some of those had to be excluded from the final analysis for reasons including inability to complete the exercise, motor disabilities, or problems with the sensors.
The participants were also a bit older than the typical age when diagnosis occurs, which could limit its broad applicability. Still, the ability to detect condition-related markers in an objective way, as opposed to having to use behavioral observations, would be a big step forward, especially if the study can be powered to significantly increase the sensitivity and specificity of the model.
Quite a bit of conversation occurred around a recent meta-analysis that looked at the number of steps adults should take in a day. Most of the patient-facing clinicians I know don’t have trouble getting their steps in on regular workdays, although some specialties have a fair amount of seated time, such as anesthesiology and pathology. A couple of folks I know are obsessed with getting a minimum of 10,000 steps each day, however, which is less important according to the recent article.
The authors looked at studies published since 2014 and concluded that individuals who got between 5,000 and 7,000 steps per day had a significant risk reduction for cardiovascular disease, dementia, and falls as well as all-cause mortality.
That’s not to say there’s a downside to getting 10,000 steps a day, but no clear evidence supports that specific number across the board. That’s good news for those of us on the IT side of the house who might spend less time ambulating than we’d like.
While we’re at it with our virtual Journal Club, another study that caught my eye this week looked at the benefits of the four-day work week. The authors looked at 141 companies that allowed employees to reduce workdays without a corresponding change in pay and found that the practice decreased employee fatigue, reduced burnout, increased job satisfaction, and improved efficiency compared to 12 control companies.
The process wasn’t as simple as just trimming days, however. Companies had to commit to some level of reorganization beforehand, focusing on efforts to build efficiency and collaboration prior to embarking on the six-month trial. There were 2,896 employees involved across companies in the US, UK, Australia, Canada, Ireland, and New Zealand.
I’ve worked with a couple of vendors who have instituted this practice. Their employees seem to be satisfied with the practice. I enjoyed living vicariously through the account reps who used their long weekends for camping and backpacking.
One of the companies sold a patient-facing technology with 24×7 support, so extra coordination was involved to ensure that those workers had adequate days off even though the rest of the company was closed on Fridays. I’ve also seen some healthcare organizations do this with their management teams, although it doesn’t seem that big of a stretch when the organizations already had hundreds of workers whose routine schedules involved three 12-hour shifts and leaders were already used to providing management coverage 24×7.
From Yes, Chef: “Re: this week’s Morbidity and Mortality Weekly Report. I would have loved to have been part of the public health informatics team crunching that data.” The report details an incident that involved a pizza restaurant not far from Madison, WI last October. Apparently 85 people experienced THC intoxication after eating from the restaurant, which shared kitchen space with a state-licensed vendor that produces THC edibles. When the pizza makers ran out of oil, they used some from the shared kitchen, unknowingly putting some “special sauce” into their dough. Public health informatics is one of my favorite subdisciplines of clinical informatics, so here’s a shout-out to all the disease detectives out there who solve mysteries like this one every day.
I’m trying to slow the volume of emails hitting my inbox, and HLTH seems to be one of the biggest offenders. The organization has been averaging three emails a day over the last month and attempting to manage my preferences hasn’t seemed to make a difference. Before clicking delete, I looked at the registration options for this year’s conference. It looks like it’s $2,995 and goes up to $4,100 next week.
I get that it’s an all-inclusive registration and includes two meals on most days, but it’s still a large amount to ask companies to spend on top of travel and lodging. For the average consulting CMIO, unless I can get some good meetings scheduled, the price isn’t worth it. Of course, media and influencers can apply to attend for free, but that’s hard to do when one is an anonymous blogger.
If you’re experiencing an overloaded inbox, who is the biggest offender? Have you found unsubscribing helpful or do you have other strategies to share? Leave a comment or email me.
Email Dr. Jayne.
Blackstone Acquires Healthcare Tech Firm AGS for $1.1 Billion
Blackstone will acquire RCM vendor AGS Health for $1.1 billion.
C8 Health, which specializes in delivering care standards and protocols at the point of care, announces $12 million in Series A funding.
White House, Tech Leaders Commit to Create Patient-Centric Healthcare Ecosystem
Dozens of companies pledge to support new federal data-sharing projects that include a public-private interoperability initiative and a digital health aggregation effort designed to help Medicare patients more easily track and access their own data.
Cedars-Sinai says that its CS Connect chatbot has been used in 42,000 telehealth visits. The system, which was built by integrating K Health’s technology with Epic, collects symptom information from the patient at the start of their scheduled or on-demand visit, then provides the physician with a summary and recommends treatment for their approval. Cedars-Sinai plans to expand CS Connect to support remote patient monitoring and link in-person urgent care visits with virtual care. K Health offers its own unlimited primary and urgent care virtual visits for $49 per month or $73 for a single visit.
OpenAI CEO Sam Altman warns that the company can’t guarantee privacy when someone shares personal or medical information with ChatGPT. He says that unlike therapists, doctors, or lawyers, OpenAI has no legal confidentiality obligation and could be forced to disclose user conversations in a lawsuit.
Stanford Medicine creates a virtual lab of AI “scientists” that communicate, debate, and collaborate under the guidance of a human principal investigator. Humans perform just 1% of the work, Stanford says. In a demo, the AI team designed an improved COVID vaccine candidate in just a few days.
Mayo Clinic deploys high-end Nvidia hardware to support AI work in pathomics, drug discovery, and precision medicine.
University of Colorado Anschutz Medical Campus researchers find that free, open-source AI tools can analyze medical images and reports as well as commercial systems like GPT-4, with the added benefit of keeping patient data within hospital infrastructure.
Smart fitness company Amp adds a predictive AI coach to its $1,800 exercise machine that uses computer vision to track movement and adjust workouts in real time. The company strongly recommends spending the extra $23 per month for app membership since “it’s what turns Amp from a piece of equipment into your complete strength suite.”
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David Howard, MPH, MBA is founder and CEO of TeamBuilder.
Tell me about yourself and the company.
We started TeamBuilder in 2021. It grew out of almost 20 years of healthcare consulting. Much of that involved performance improvement, hospital and health system strategy, and the growth of health system employed physician practices.
Over the past 10 to 15 years, small private practices grew into large medical groups that health systems acquired. A lot of our work was focused around supporting that growth. The early stage of the TeamBuilder concept was studying how staff and staff management within those groups drive cost-effective access to care.
The reality then, as it is now, is that staff scheduling for these health system medical groups and smaller standalone groups is generally done on paper and spreadsheets. TeamBuilder was born out of that prior work to digitize the schedule process through a digital staff schedule that’s built for that care setting. We also apply data science to patient visit volume to align the team by hour and by day to drive cost effective access to care.
As for me, I spent 20 years in healthcare consulting in various aspects, from financial distress to performance improvement.
What challenges of paper scheduling can technology improve?
The scheduling of staff, and even providers, is more complicated than it seems. Dr. Smith might work Monday through Thursday, while Dr. Jones might work Tuesday to Friday. But when you’re talking about the staff – clinical, non-clinical, nurses, and front desk workers — every day is different, because different providers are in the office different days. Each provider sees a different number of patients for an array of reasons, such as the type of their patient panel and how busy their practice panel is. Monday to Tuesday to Wednesday to Thursday can be very different, and very different each week.
There’s a lot of turnover and callouts. A lot of mental gymnastics goes into setting the schedule a month or a couple of weeks out. I’ve got these callouts in the morning. My only front desk person called out. How I find the right person to backfill?
Schedules seem static and stable to an outsider, but a lot goes into it. If it’s a static piece of paper or spreadsheet, it’s hard to make changes and send them back out. Nobody has the right system of record or source of truth for what that schedule is on that given day.
Second is that provider practices, independent or not, don’t have a good way to understand the work that is needed to support that care. It involves a lot of heuristics. A rule of thumb might say that I need two nurses per doctor, but any benchmarks that are out there aren’t grounded in fact. How long does it take to check patients in, check patients out, room them, and come back in and give the injection or support a procedure in the office? It can be eye-opening for what is actually needed versus what managers, providers, physicians, and executives think might be needed .
TeamBuilder does both of those things.
What does your market look like?
When you think about the world of staff and staff scheduling, minds go towards existing legacy scheduling providers. Some great great solutions are out there, such as UKG Kronos, Symplr, Smart Square, and ShiftWizard. They focus on inpatient nurse scheduling solutions and provide the highest value there. It’s very different from the outpatient side of clinical practice and operations.
The outpatient ambulatory side of the house has been neglected over the years. That’s often surprising to people when we talk about TeamBuilder. Many health system executives don’t recognize the differences of staffing across the two.
What variables can be used to prevent overstaffing?
A lot of this is driven by visit volume by hour and by day for the office. In many cases, folks are just thinking, we’ll do 70 visits on this day, so I’ll need this number of people to work these shifts. But what does that look like over the course of the day? Is it 70 visits from eight until noon, and then nobody comes in from noon until 4:00? Folks often anchor by staff or provider, but we believe it needs to anchor on the visit volume and the visit volume throughout the day, not just in total. That is hugely important.
The other variable is how work occurs by specialty. We work with clients to understand their workflow. We have significant client cohorts, so we can say that within neurology, here’s how work is done and here’s how that team can be best aligned.
Do most organizations track productivity and staffing levels using external benchmarks, their own history, or nothing at all?
Some benchmark sets are out there, but the sample sizes are quite low and the questions are simple. The accuracy of the respondents to these benchmark surveys is not very high. The benchmarks that prevail most are the number of staff, which could be clinical or non-clinical, as a function of the number of providers. That becomes a problem, because providers could see 10 patients a day or they could see 35 patients a day. Why would you allocate staff the same if that’s the case?
Another common one is the number of staff per 10,000 RVUs. Relative Value Units is a metric that quantifies the amount of work effort. But it’s a billing designation that becomes a function of the acuity of the visit, how long it took and the complexity of the medical decision-making. But you don’t know any of these when scheduling a patient. So while it’s nice to be able to quantify using RVUs, it’s Monday morning quarterbacking. You won’t know the level of work effort until after it happens.
We anchor on visits. That’s what’s on the schedule and that’s what you need to set the schedule in the future.
What are the employee benefits of efficient scheduling?
It’s important to be able to quickly see your schedule on mobile or web. If the manager is putting out a paper schedule every other week that I take a picture of , what if it changes? Jenny calls out and now you don’t have an accurate view. That’s understanding your schedule, but it’s also important to be able to call out from your shift automatically so your manager doesn’t forget that you told her two weeks ago that you can’t come in.
People in all industries are looking for more flexible schedules. There’s remote work, or I want to be able to pick up a shift on my day off when someone calls out. Trying to manage a dynamic, flexible workforce is hard if you’re doing it on paper and spreadsheets.
Staff love the ability to see open shifts, pick up shift requests, and live in a more dynamic world. A lot of organizations are thinking about, should I pay a premium if I ask Joey to drive in from an hour away? If you pick up a shift inside of 24 hours, do I give you a little bit of a kicker? Staff are excited about these things.
Can that help to reduce the cost of contracted workers, such as traveling nurses?
We often first think of managing the fixed workforce. You are hired to work Monday to Friday, 9:00 to 5:00, 40 hours.
How do I make sure that you’re providing that effort that you’re contracted for in the right place? Have I hired float pool or flex resources who I can tell where to report at a given time? Do I have per diem staff, either a little per diem group that is managed by the health system itself or engaged from nurse per diem companies to backfill shifts that I can’t fill from the first group? How do I get my best fit resource for the lowest expense and proper skill level alignment?
Does AI have a potential role in your product?
It definitely does. We are constantly thinking about how to use AI behind the scenes, such as validating code or looking at user experience analytics. We use AI in a variety of ways today.
As we move forward, though, it’s important for our data science and analytics and recommendations to be well understood. Leaders and physicians and managers should be able to quickly understand why that recommendation was made, why this might be a better schedule, and how I should act on it.
At TeamBuilder, we are further clarifying what we do as an operational intelligence platform. We think of it as this intersection of intelligence, which could include AI, and a practical reality that is well understood and explainable. The right answer can’t come from a black box, where nobody knows why the right answer today is 1.27 nurses.
I haven’t seen many CEOs and investors who have earned an MPH, which looks at how society can improve the health of the largest number of people rather than treating healthcare as a business. How do you see that intersection of healthcare and business?
I started in healthcare consulting out of business school after my MBA. I fell into it and grew to love it. Being able to drive business change inside of a clinical environment has been rewarding. When I was younger, I never foresaw myself getting into healthcare. I was doing turnarounds, distressed work, and strategy for health systems and growth. There becomes a time where you’re only looking at it through the business principles. I did not have as much exposure to the broader public health delivery ecosystem.
Going through the executive MPH program at Columbia rounded out that perspective. How is care delivered? Where does it need to be delivered? How is it done cost-effectively to provide value to community need?
There absolutely can be the intersection between running a business in an organization, but doing it in a way that benefits patients and providers optimally. The two are often at odds with each other, but don’t need to be. The backgrounds of the folks on our team let them live at this intersection between provider experience – which could be clinical or non-clinical – and business experience to be able to translate that.
What factors will be important to the company over the next three or four years?
The care delivery environment continues to change. The mix of in-person, remote, inpatient, outpatient ambulatory surgery, and in-home care will need to be supported with flexible dynamism. The ways to support those settings are not well understood. A lot of our focus is to be nimble in helping organizations proactively recruit and retain talent and align it to drive care in different care settings.
Innovating the Consumer Experience Beyond the EMR with Open Standards
By Robin Monks
Robin Monks is EVP of technology at Praia Health
Patients – and potential patients — expect seamless digital experiences. They’re getting them every day from their social media, retail, and banking apps. The difference in user experience between viewing a credit card statement and a healthcare bill is obvious – and shocking. At the same time, the costs of fragmented, proprietary systems for health systems are becoming unsustainable.
While we’ve seen progress in allowing patients access to more of their data, we’re just scratching the surface on data access and have yet to make inroads into data actionability. The lack of open standard adoption inflates integration costs, stifles innovation, and limits the true potential of digital health.
This challenge was the focus of our recent HIStalk webinar, “Innovating the Consumer Experience Beyond the EMR with Open Standards,” where fellow industry leaders and I explored the transformative power of open standards in healthcare. I was joined by Ryan Howells, principal at Leavitt Partners and program manager of The CARIN Alliance; David LaBine, vice president of software engineering at Providence 4SITE; and Kristen Valdes, CEO of b.well Connected Health.
We emphasized that open standards — such as OIDC (OpenID Connect) and HL7 FHIR (Fast Healthcare Interoperability Resources) — along with broader open technology requirements are creating dramatic ROI where they’ve been deployed. They are strategic enablers that can dramatically reduce the burdens associated with integrations, data migrations, and workflow adjustments across the healthcare ecosystem.
These standards offer more than just future flexibility. They deliver immediate ROI by accelerating development timelines, minimizing rework, and significantly lowering long-term maintenance expenses. Every closed integration implemented today represents a missed opportunity to operate with greater speed, intelligence, and efficiency.
A key takeaway from our discussion was the critical role of open standards in fostering a truly patient-centric approach. The current landscape often forces individuals to navigate a labyrinth of disparate patient portals, each with its own login and limited data access. This creates significant friction and can even impede access to life-saving information, particularly for those managing complex or rare diseases. By adopting open standards for identity and data exchange, health systems can streamline patient access, improve engagement, and build stronger, more trusting relationships.
Our conversation also delved into the tangible business case for open standards, moving beyond mere compliance. By standardizing data exchange and identity management, organizations can reduce technology costs, automate manual tasks, and unlock entirely new business models. Examples shared included double-digit increases in lab completion rates and cash collection for health systems that have embraced open identity solutions. The ability to connect disparate data sources, from clinical notes to wearable device data, allows for a more holistic view of the patient that enables proactive care and improved outcomes.
We underscored the importance of leveraging established global standards from other industries. The financial sector, for instance, has long utilized open standards for seamless and secure transactions, demonstrating that these are solved problems that healthcare can readily adopt. This approach avoids the costly and inefficient creation of bespoke solutions, allowing resources to be redirected towards actual patient care and innovation.
For healthcare executives and developers who are looking to initiate this transition, the advice is clear. Identify areas where fragmented patient experiences and data silos create friction and cost. Assess how many applications are isolated due to proprietary identity systems.
The potential for double-digit increases in patient engagement and operational efficiency makes a compelling argument for investment. Advocates for this shift are often found among chief digital officers and transformation leaders who recognize the need for a broader, integrated ecosystem of applications.
A practical roadmap for open standards implementation involves a strategic, incremental approach. This includes auditing systems to understand existing data flows and identity challenges, developing a clear vision for interoperability, and creating cross-functional teams dedicated to this transformation.
Open standards are available for immediate adoption. Organizations do not need to wait for mandates or rely on proprietary vendor roadmaps. But adoption requires that vendors be held to open standards when evaluating solutions and during each renewal cycle. By actively engaging with collaborative initiatives and embracing these open frameworks, healthcare stakeholders can collectively drive innovation, enhance patient loyalty, and build a more efficient and effective system for everyone.
The time to act is now. The industry must move from business-to-business data exchange to truly individual-centered care.
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