Blackstone emerges as lead contender for mega $1.1 bn-$1.3 bn buyout of EQT-promoted AGS Health
Sources say that private equity firm Blackstone is the frontrunner in acquisition offers for revenue cycle company AGS Health.
Cyberattack brings down Kettering Health phone lines, MyChart patient portal access
Kettering Health (OH) reverts to downtime operations, canceling all elective procedures and diverting ambulances in the wake of a ransomware attack discovered Tuesday morning.
Abridge in Talks to Raise at $5 Billion Valuation as AI Health Startups Draw Investors
AI-powered documentation company Abridge is reportedly looking to raise new funding that would put its valuation at $5 billion, double its value earlier this year when it announced $250 million in Series D funding.
Regeneron Pharmaceuticals acquires 23andMe’s Personal Genome Service, Total Health and Research Services businesses, and Biobank and related assets for $256 million at bankruptcy auction, beating out a bid from co-founder and former CEO Anne Wojcicki.
23andMe retains its Lemonaid Health telemedicine business, though it, too, may be sold off at a later date.
Regeneron has stressed that it will ensure the security of its newly acquired consumer genetics data.
From Tom B. William: “Re: Epic’s latest courtroom win. The company has scored recent wins against patent troll GreatGigz and Decapolis, with the latter win on behalf of a customer. I’d love to know how much money is annually budgeted by Epic for such matters.” Readers, feel free to weigh in with your best guess. I can only assume that the sum is more than some health IT companies spend on line items like sales and marketing. As I mentioned in 2022 after Epic triumphed over GreatGigz in a suit involving Christus Health, “Epic has historically been one of few companies willing to do whatever it takes to defend itself, and in this case, the involvement of one of its customers is likely to unleash its legal dogs.”
Live Webinar: June 18 (Wednesday) noon ET. “Fireside Chat: Closing the Gaps in Medication Adherence.” Sponsor: DrFirst. Presenters: Ben G. Long, MD, director of hospital medicine, Magnolia Regional Health Center; Wes Blakeslee, PhD, vice president of clinical data strategies, DrFirst; Colin Banas, MD, MHA, chief medical officer, DrFirst. Magnolia Regional Health Center will describe how its Nurse Navigator program used real-time prescription fill data from DrFirst to identify therapy gaps and engage patients through timely, personalized outreach. The effort led to a 19% increase in prescription fills and a 6% drop in 30-day readmissions among participating patients. Attendees will learn why prescribing price transparency is key to adherence, how real-time data helps care teams support patients between visits, and how Magnolia aligned its approach with value-based care and population health goals.
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New Mountain Capital combines portfolio RCM companies SmarterDx, Thoughtful.ai, and Access Healthcare to create AI-powered healthcare revenue management company Smarter Technologies. New Mountain Executive Advisor and industry veteran Jeremy Delinsky will serve as CEO of the new business.
Inovalon promotes Karly Rowe to president of its provider business unit.
Valerie Mondelli, MBA (RevSpring) joins Iodine Software as chief commercial officer.
Glooko promotes Mark Clements, MD, PhD to chief medical and strategy officer.
TruBridge adds Microsoft’s Dragon Copilot AI-powered clinical workflow assistant to its EHR.
Dayton Children’s Hospital (OH) implements Abridge’s ambient documentation software.
VA EHR Modernization Program Executive Director Neil Evans, MD explains that next year’s slate of 13 implementations will occur in waves of facilities chosen for their pre-existing relationships, with many patients receiving primary care at one facility and specialty care at another. Go lives will occur next year at sites in Michigan, Ohio, Indiana, and Alaska.
Kettering Health (OH) reverts to downtime operations, canceling all elective procedures and diverting ambulances in the wake of a ransomware attack discovered Tuesday morning. Hackers have threatened to publish patient data on the dark web if the health system doesn’t meet their demands within 72 hours.
Researchers at the the Regenstrief Institute and Indiana University School of Dentistry develop an app that connects dentists to health information exchanges so that they can more easily access a patient’s medical history.
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New Mountain Capital combines portfolio companies SmarterDx, Thoughtful.ai, and Access Healthcare to create healthcare administrative and revenue management company Smarter Technologies.
Medical and dental practice technology, services, and solutions company Henry Schein announces a $250 million strategic investment from KKR.
Regeneron Pharmaceuticals will acquire 23andMe’s Personal Genome Service, Total Health and Research Services businesses, and Biobank and related assets for $256 million.
One of the hospitals where I am on staff has decided to take a dip into the waters of virtual nursing, at least according to a buzzword-filled newsletter that came out last week. Apparently, the project is going to be transformative, innovative, and cooperative, although having all those words in the same opening paragraph made me wonder if hospital administration was having fun with a thesaurus app while writing it. They left out some of the adjectives that we sometimes associate with technology projects, including disruptive, aggressive, and intrusive.
At no point in the newsletter did they actually explain what type of virtual nursing workflows they planned to implement, or what the timeline might look like. I’ve done plenty of work in this space and know that if you’ve seen a virtual nursing project at one organization you’ve seen one project and that rarely do two of them look alike. There are so many variables, including which EHR will be incorporated, what kind of equipment will be used, and which of the many problems the organization is trying to solve with the solution. There was also no mention of the timeline, the holding of stakeholder sessions, or any contact information about the project other than to contact the director of nursing for questions. I don’t envy the volume that her inbox is likely to see with all the questions I heard thrown about in the physician lounge.
I thought the timing of the newsletter was particularly interesting, since we just had our quarterly medical staff meeting last week and that would have been a fantastic opportunity for socializing the concept with the majority of physicians who are on staff at our facility. Of course, that begs the question of whether administrators actually want to have a dialogue about the project, leading my more conspiracy-minded colleagues to think the lack of information was part of a well-orchestrated plan to cut physicians out of the process. Having watched a number of technology projects unfold here, I’m not sure that I would give some of our leaders credit for being organized enough to intentionally alienate us. More likely than not, it’s just the usual confusion and lack of communication and coordination that we see most of the time.
One of my colleagues asked me what I thought about virtual nursing and which variety of the solution we should adopt. In thinking through current needs and what I hear from the floors, I think a quick win would be to adopt a solution that enables virtual sitters. Right now, the hospital is so short staffed for sitters that they’re floating registered nurses to do the job, which creates an incredible cost burden every time a physician orders a sitter for their patient’s safety. There’s a lot of pushback when the order is placed, which isn’t a good look for any healthcare facility. It’s also a dissatisfier to the nurses who are floated, since they end up working far below the level of their licenses. Although implementing a virtual sitter program would create some operational savings, it’s a huge capital investment, as it would require adding cameras and technical infrastructure throughout the facility.
Having that kind of technology in patient rooms could also be used as a stepping stone to implementation of AI-powered fall prevention programs, which I think are going to be increasingly important as the average age of hospitalized patients continues to increase. Due to the technology lift, organizations that employ these kinds of solutions usually do so on a unit-by-unit basis, which makes sense to reduce disruption. Still, I could see the neurology unit duking it out with orthopedics and the general medical service to see who gets to go first. I suppose if hospital leaders wanted to get creative they could throw in some teambuilding and elements of competition and turn it into a formal challenge to see who can earn the right to go first. Personally, I think it would be more entertaining than the usual teambuilding they try to do, which usually leads to worsening resentment by the lunch break, if not before.
While we were talking about it, someone asked whether I thought it would be better for the staff of such a program to be employed by the hospital or by a third party. There are certainly pros and cons with either approach. Making the virtual sitters part of our hospital would have the potential to build collegiality and trust, and might allow us to tap a larger candidate pool due to the virtual nature of the work. On the other hand, having them work for a third party might lead to culture issues if there is a perception of difference as to how those sitters are treated versus in-person employees. It certainly changes the appearance of the balance sheet, which is more important to some administrative types than others.
When it comes to virtual nursing of the registered nursing variety, I think it’s critically important that the nurses be employed by the hospital so that there is a single cohesive nursing workforce. Virtual nursing has enormous potential when it comes to creating longevity in the staffing pool – allowing nurses to float to virtual roles when they need to because of illness, injury, or disability. There’s potential for hybrid roles where nurses work both virtually and in person, which helps keep skill sets sharp for future role changes. Such an arrangement also prevents the feelings of “us versus them” that I’ve seen in other virtual projects, where the virtual staffers may be in another state or otherwise never set foot within the facility.
I’ve seen so many different kinds of projects, though; I think it would be challenging to figure out where to start first in our facility. Would we want to have virtual nurses primarily for admission, discharge, or both? Or would we use a more hybrid model where several less experienced bedside nurses might be paired with a more experienced virtual nurse who serves as a supportive mentor to the group? Of course, one of the first things we should be doing is having conversations with our stakeholders, which don’t seem to have happened yet based on how the newsletter sounds.
For the projects on which I’ve worked, usually I become involved after the decisions are made and I’m working on implementation and training, so it would be great to understand the thought process of organizations who have tried the different solutions in different combinations. Is there one way that’s more foolproof than others to implement in a mid-tier community hospital as compared to the academic medical centers that many vendors seem to have worked with? Is there enough consistent experience in the field that pitfalls have been identified for organizations to avoid?
What are your thoughts with virtual sitters or virtual nursing? Did it do all that you expected or did the efforts fall flat? Leave a comment or email me.
Email Dr. Jayne.
Private equity giant Bain mulls bid for London-listed software firm Craneware
Shares of Scotland-based Craneware jump on reports that Bain Capital is considering acquiring the company, which sells health system financial software.
Doximity Stock Drops 20% After Outlook Disappoints
Doximity shares drop 20% after the telehealth and medical networking company issues full-year guidance below analyst expectations.
Fresno hospital kickback scheme was fueled by wine, cigars and Vegas strip clubs
The Department of Justice settles a False Claims Act whistleblower lawsuit against Fresno, CA-based Community Regional Medical Center and its for-profit technology subsidiary Physician Network Advantage for $31.5 million.
Shares of Scotland-based Craneware jump on reports that Bain Capital is considering acquiring the company.
Bain Capital confirmed that Bain Capital Funds is assessing a possible offer, but it has not involved Craneware’s board.
The company, which sells health system financial software, reported 800 employees and $189 million in sales last year. Its market capitalization is nearly $1 billion.
From Japonais: “Re: CureIS versus Epic. What points does Epic need to dispute to prevail?” Unlike Particle Health’s lawsuit against Epic, CureIS makes no claim that Epic created an illegal monopoly, which carries a high burden of proof that is unlikely to prove successful. The CureIS complaint lists these specific items:
Respondents for last week’s poll passed along some advice to those who are planning, or should be planning, their future.
New poll to your right or here: Should Epic and other EHR vendors be required to provide data access to competing applications if their shared customer approves?
Live Webinar: June 18 (Wednesday) noon ET. “Fireside Chat: Closing the Gaps in Medication Adherence.” Sponsor: DrFirst. Presenters: Ben G. Long, MD, director of hospital medicine, Magnolia Regional Health Center; Wes Blakeslee, PhD, vice president of clinical data strategies, DrFirst; Colin Banas, MD, MHA, chief medical officer, DrFirst. Magnolia Regional Health Center will describe how its Nurse Navigator program used real-time prescription fill data from DrFirst to identify therapy gaps and engage patients through timely, personalized outreach. The effort led to a 19% increase in prescription fills and a 6% drop in 30-day readmissions among participating patients. Attendees will learn why prescribing price transparency is key to adherence, how real-time data helps care teams support patients between visits, and how Magnolia aligned its approach with value-based care and population health goals.
Oracle Health, Cleveland Clinic, and Emirates-based AI company G42 will develop an AI-based healthcare delivery platform that will combine Oracle Health applications, Oracle Cloud Infrastructure, and Oracle AI Data Platform. The system will continually analyze population and public health data and provide real-world data for life sciences to enhance diagnostics, personalize treatments, optimize outcomes, and decrease costs.
The VA plans to implement Oracle Health at 13 facilities in 2026, followed by 20 to 25 additional go-lives in 2027. VA Secretary Doug Collins says that the agency will address the lack of standardization that stalled the project.
The Department of Justice settles a False Claims Act whistleblower lawsuit against Fresno, CA-based Community Regional Medical Center and its for-profit technology subsidiary Physician Network Advantage for $31.5 million. The hospital was accused of bribing doctors with cash, wine, strip club visits, and trips in return for using the hospital’s $75 million Epic EHR to refer their patients to its facilities. Michael Terpening, the whistleblower and former PNA controller, says that CMC provided the Epic system under the Community Connect model at no charge in return for referrals. Details from the lawsuit:
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Blake Walker is co-founder and CEO of Inbox Health.
Tell me about yourself and the company.
Inbox Health is a software platform that fully automates patient billing, payment collection, and patient support for medical practices and billing companies. We try to make bills clear, help them get to patients faster, and make them more convenient and affordable for patients to pay. Alongside that, and an important part of that process, is to make sure that patients get fast and empathetic support via phone, text, and real-time chat to get their questions about their bills answered while we’re doing that.
I started in the healthcare space right out of college. I worked on a patient financing startup and quickly learned how problematic the patient AR problem was becoming for medical practices, especially smaller medical practices. I then spent a couple of years working on another patient billing startup and then ultimately founded Inbox Health 11 years ago. I have been with the company ever since, growing it from zero to where it is today, with about 3,500 medical practices using the platform nationwide.
How does the patient’s payment experience influence their satisfaction with the provider?
It’s a huge factor. It’s so intertwined today, the way the clinical experience then carries over into the billing experience. The patient can leave that visit feeling good about the clinical care, but then have such a bad billing experience that their entire perception of that provider is dragged down.
If there are mistakes in the way their insurance was billed, the provider may end up getting into an argument with them on the phone after the fact. Or even worse, it’s not even the provider, it’s the provider’s billing service provider. The patient may feel that the clinician provided a worse clinical experience because of how the billing went.
Having a great billing experience is critical to making sure that the entire clinical visit is perceived as positive. So much more frequently than ever, that billing experience is a negative one. Patients owe more money. High-deductible health plans are common now, and patients are surprised by the bills they get and are frustrated by them.
As providers, we owe it to the patients to do everything we possibly can to make sure that the billing is done accurately and clearly and that the experience that they have is convenient. Often it’s paper checks only and poor patient support to answer their questions. That will obviously leave the patient with a bad outcome.
How do practices prevent those awkward financial moments that can start or finish a visit, especially when the practice may not know what services the patient will need ahead of time?
Educating the patient about their coverage at the time of the visit, and how that visit is likely to be billed to the patient, is an important starting point. You don’t necessarily need to have it down to the dollar, just that the patient understands that a bill is likely. If they come in to a nutritionist’s office, their child is sick, and you see that they have a high-deductible plan, give them a sense of expectations, such as that it usually takes about two weeks for us to send bills out. Or after your insurance is adjudicated and we know that you’re on a high-deductible plan, I want to make sure to flag that for you. That’s realistic for most practices with just their standard processes for eligibility checks prior to visit and understanding a little bit about the patient’s insurance. The patient can fill in the rest.
Then, whatever you can do to get the bill to the patient as quickly as possible. You don’t want situations where it’s months and then the patient’s getting a bill 90 or 120 days after they came in to see you. I understand that there’s often trouble getting it through the adjudication process with insurance, but getting that timeline as fast as possible so that the patient is in that same frame of mind as when they came in to see the clinician in the first place. Having that be an easy, convenient digital-native experience as much as possible helps to streamline that whole experience.
How does the method and timing of presenting the bill to the patient affect getting paid?
Most patients want to have both the digital presentment and also the tactile patient statement in the mailbox to know that it’s legitimate. Sending a text message or an email captures their attention, but it doesn’t feel real to them. Once they get the statement in the mail, then it feels more real and they are more likely to pay from the email or text that follows up after the statement. It’s a combination of demographics and who’s more likely to pay from email or text message than a paper statement. But for most patients, email is the most likely way to drive payment.
No method on its own works particularly well. Everyone pays attention to text messages, but are hesitant to click on them and pay because texts are often used for scams. It has to be a holistic approach, where at least in our case, we’re using artificial intelligence to identify what will probably work best for most patients. It’s all dynamic. It has to be an omni-channel, holistic approach to trying to reach the patient in the way that will work best for them and meeting them where they are at any particular time through a process over several weeks and sometimes months.
How common is it for the patient to need or want to contact someone at the practice once they’ve received a bill?
About a quarter of the bills that go out create a question. That’s obviously a huge factor in terms of how you’re running a practice now. If you’re sending these bills out without anticipating and being prepared to answer those questions, it’s going to pull down your collection rates. It’s going to negatively impact the consumer experience with those bills. Most of us aren’t well prepared to do it, but it’s a high proportion that are coming back to the practice with questions.
A big factor is the amount of money owed. The average family has a $4,000 deductible and it’s not uncommon to end up with a $500 or $600 bill from a standard medical visit. That’s a huge number for most families. You shouldn’t expect that someone who gets a $500 or $600 bill will just blindly pay it from all of this wording that’s on the bill, and why it was billed that way. It’s unlikely that someone will just pay without asking a question.
What is the outcome of those billing calls to the practice? Are patients looking for reassurance that the number is correct or perhaps wanting more details that could have been provided on the bill initially?
I would say that about half could have been addressed upfront. Better setting expectations, providing better information on the bill itself, is often a root cause of the questions that come through. But a significant number of them are related to how the billing was done. It’s often somehow related to coordination of benefits, meaning what insurance was billed and in what order was it billed, particularly for patients who have multiple insurances like Medicare or Medicare Advantage plans or multiple commercial plans. A lot of those cases have legitimate issues that feed back to it, and ultimately, that could be prevented to some degree upstream just by collecting better information at the front desk.
I’m just isolating the patient billing itself. It’s a little difficult to control what problems land on the lap of your patient support team because something wasn’t done well up front.
How often does the patient get frustrated by trying to coordinate the practice’s billing, the insurance payment, and their own financial responsibility?
It’s frustrating for everyone. The provider obviously wants the procedures to be covered to whatever extent they possibly could be. The patient is stuck in this loop where they’re asking the provider questions, the providers are deferring to the payer, and the payer defers to the provider. All sides don’t have a full picture.
The patient is the one who’s left holding the bag with a bill that someone is demanding to be paid and the frustration of two parties that aren’t seeing eye to eye. It’s common for the provider’s answer to be “ask your payer” and for the payer’s answer to be “ask your provider.” The patient may finally give up and pay the bill or ignore it and see what happens. Patients are seeking that alternative more and more.
What are some best practices for reducing how long it takes to receive payment for patient responsibility?
Optimizing the number of touch points and the channels that you are able to reach a patient on in that first 15 days is critical. That’s the first thing.
Second is meeting patients, from an affordability perspective, where they are. Understanding where a patient’s threshold is for when they might need payment plan options and making those payment plans available to a patient readily. You don’t want the patient waiting 45 or 60 days, getting three bills from you, and then picking calling you and saying, “I know you keep asking, but I don’t have $1,500. I just don’t.” Then you tell them that you can take $50 a month and that’s fine. You need to be proactive about how you engage the patient, which channels you engage them on, and then offering the payment plans when it’s applicable to that particular patient.
We do predicted payment plan offers, where we’re looking at various data points about a patient, their bill, and their past history with the practice and then determining which ones to offer payment plans to and what kind to offer.
But if you can do those two things well, that will get you the best possible result. Some of this comes back to the more that you do at the front desk to educate the patient and collect cards on the file, the more you can accelerate that back end as well. But if you can’t influence that or change that for whatever reason, then obviously on the back side, that approach makes the most sense.
How are you using AI now and how will you use it in the next year or two?
AI has always played a role in how we manage the outgoing patient billing process. The biggest changes in how we’re using AI, and how AI will be used in the patient experience moving forward as it relates to patient billing, is on patient support. We are investing heavily in making the patient support experience better by training large language models to answer the patient questions that come back, feeding it data from the patient record to be able to help it answer patient questions, and letting it actually take action, such as the patient didn’t get a paper bill and wants one, so AI sends it. Or creating a payment plan.
Over the next two to three years, you will see a transformational change in how patient phone calls are answered and how patient chats are answered relative to where we were a couple of years ago, or a year ago. Or even right now, where most of that is either going to the practice staff in the office or it’s being outsourced to the Philippines or India to lower-cost resources. The quality of AI for patient support is rapidly improving and will play a cool role in improving the patient experience in many ways, but in particular, around patient billing.
What factors will drive the company’s strategy over the next three or four years?
Investing heavily in the role of artificial intelligence in the patient experience is a main focus for us over the next few years. And in general, partnering as closely as we can with the best-in-class EHRs and practice management systems to make the experience as seamless as possible for patients where their providers are using different EHR platforms is really important to us. Those are the areas we’re investing heavily in. We believe there’s a lot of opportunity to improve the front desk experience. That’s another area where we’re focused on trying to build technology to improve how the front desk experience connects back to the patient billing experience post-visit.
Health data company Datavant acquires Aetion, which offers a real-world evidence platform for drug companies.
Akido Labs Raises $60 Million for AI Assistant for Doctors
Healthcare AI and medical network company Akido Labs announces a $60 million Series B funding round.
VA hopes to use next year’s EHR rollouts to gain momentum for faster deployments
VA Secretary Doug Colins expects momentum gained during planned roll outs at 13 facilities in 2026 will enable the department to implement new EHR software at 20 to 25 sites in 2027.
Sprinter Health, which offers virtual and in-home preventive care, raises a $55 million Series B round.
Tucson-based CureIS Healthcare files suit against Epic, alleging that the company harmed its business by blocking access to billing data from Epic-using customers and falsely claiming that Epic’s products could replace those of CureIS. The complaint alleges these actions by Epic:
An Epic spokesperson provided this response: “Epic believes in free and fair competition, and we also believe our customers are in the best position to choose the right solutions to meet their needs — whether with Epic or by adopting other products and services. We are aware of the complaint filed by CureIS and we look forward to setting the record straight in court.”
From VTInquirer: “Re: [ambulatory EHR/PM vendor name omitted]. The CEO of a provider organization told me they are exploring alternatives because the vendor can’t certify as a compliant EHR until they release some kind of patch whose ETA is November 2025. Can anyone verify?” I’ve omitted the vendor’s name pending reader confirmation (I’m 100% sure the company won’t do so). Chime in if you know the company and the issue.
From Gin Diesel: “Re: your Epic report. I ran across this in a Google search and found it fascinating.” Thanks for stirring that memory since I totally forgot about “Epic: The Cold, Hard Facts” that I wrote way back in 2016 using custom research data from Peer60 (now Reaction). We received responses and comments from nearly 100 Epic-using health system CIOs, along with 39 CMOs, 22 CEOs, and dozens of CFOs and CNOs. My intro hinted at the sassiness to come:
Everybody in healthcare IT has a strong opinion about Epic. Most of the people who express those opinions confidently (and sometimes loudly) don’t have any first-hand experience with the company or its products. It’s like asking an armchair quarterback dribbling wing sauce onto his shirt how Peyton Manning should be reading the defense. On the “Epic is great” side are loyal customers who are financially vested in Epic’s success; consultants who make a great living riding on Epic’s coattails; and research firms who sell reports after talking to a few Epic-using hospital employees of unstated job titles. The “Epic is evil” contingent has a significant portion of people whose employer is losing business to Epic; experienced industry specialists who Epic won’t hire since they aren’t new graduates; and those naysayers who just don’t like Epic’s success. Also in the anti-Epic camp are critics of electronic health records who use Epic as an example of how technology has ruined medicine.
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Complement 1, which offers virtual lifestyle modification for coaching for cancer patients, raises $16 million in seed funding. India-based founder and CEO Karan Bajaj, MBA has an interesting background – brand manager for P&G, author of several novels, yoga teacher, executive of Discovery Networks, and founder of a company that applies technology to alleviating poverty in India.
Behavioral health and substance abuse operations software vendor Dazos raises $25 million in Series A funding.
Health data company Datavant acquires Aetion, which offers a real-world evidence platform for drug companies.
Sprinter Health, which offers virtual and in-home preventive care, raises a $55 million Series B round. Co-founder and CEO Max Cohen, MBA came from Google and Facebook.
Cohere Health, which offers prior authorization solutions, raises $90 million in Series C funding. Co-founder and CEO Siva Namasivayam, MS, MBA is an industry veteran who has held leadership roles at Gartner, Perot Systems, MphasiS, and SCIO Health Analytics.
Compensation for executives at Atrium Health, now part of Advocate Health, jumped 41% last year, with EVP/Chief Innovation and Commercial Officer Rasu Shrestha, MD, MBA earning $3.3 million and EVP/Chief Information and Analytics Officer Andy Crowder, MHA making $2.3 million.
Google-owned Fitbit Labs adds a Gemini-powered lab results summary creator, a symptom checker, and an alert for unusual trends to its app. The enhancements are being released for testing.
Two-thirds of 9,000 nurses who were surveyed by Black Book Research cited poor EHR usability and documentation burden as major sources of their job dissatisfaction. Among nurses under 40, two-thirds say that EHR experience ranks among their top three considerations when evaluating new employers. Just 11% believe that their EHR vendor or IT department takes frontline nurse impact into account when making changes.
AGS Health opens an office in Guadalajara, Mexico and will hire 150 employees to provide clinical administrative services.
The Department of Justice is reportedly conducting a Medicare fraud investigation of UnitedHealth Group’s Medicare Advantage business. Hard-hit UNH shares dropped sharply on the news. They have lost more than 50% in the past month, erasing $250 billion in market capitalization.
More than half of surveyed Swiss physicians say that their EHRs don’t improve patient safety, while two-thirds of hospital doctors cite EHR inefficiency as wasting their time. The authors conclude that IT configuration and support strongly influence user satisfaction related to the same EHR.
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I was at a neighborhood gathering the other night. One of my neighbors was talking about her health experiences, and in particular, with wearable devices. Just from what I could see, she had an Oura ring, an Apple watch, and a continuous glucose monitor sensor. Someone asked her if they were recommended by her physician, and her response was essentially that she was following various wellness influencers for recommendations.
One of my older and more curmudgeonly neighbors (who is of course my favorite) made a comment about “not wanting all those people spying on me,” which made me smile. He’s the kind of guy who can type up a binding contract in minutes and can explain the appropriate use of a comma at the drop of a hat, so I enjoyed hearing his thoughts on End User Licensing Agreements and how “the young people are just giving their rights away.” The comments shocked the neighbor with the wearables since she had no idea that her health data isn’t covered by HIPAA when using consumer devices.
I did a quick web search later that evening and discovered that only roughly 9% of users actually read the licensing agreement or terms and conditions that come with new devices, services, or subscriptions. That number actually seemed high to me considering the number of agreements we all run into on a given day. I know I haven’t read one in a very long time, and when I do look at them, I tend to only look at specific portions. I avoid wellness apps and services that touch my health data, so that’s one level of privacy defense right there.
Another search brought me a decade-old Atlantic article that said that if people read the agreements they encountered in a year, it would take 76 work days. Still, knowing the risks of having data shared makes you want to think twice before signing up for anything, and three times for anything involving sensitive information.
From Forest Fan: “Re: visit notes summary. What should the patient do when the documentation is not accurate? One of my doctors was doing a lot of copy-paste, not reviewing, etc. He had the meds all wrong. Medicare uses that documentation to decide whether to authorize his recommended treatments, so I started to think that I need to pay attention. An RN who did the Epic implementation for this organization recommended speaking up, but UGHH. How to do this? It doesn’t seem right to correct my physician.”
From the physician perspective, I’ve seen so many inaccurate notes over the years that nothing shocks me. Early in my career, many of them were errors in dictation and transcription. Most of them were when physicians didn’t read their notes after they returned from the transcription service, but instead simply signed them and sent them out the door. Generally they had an accurate physical exam, diagnosis, and plan content, so I could overlook the semantic issues.
As EHRs came onto the scene, we started to see templated physical exams that were entirely fanciful. My favorite was the one from an orthopedic surgeon who claimed to have performed an eye exam that included visualizing the fundus. I’ve never been in an orthopedic office where an ophthalmoscope was present, so either this was some kind of multispecialty clinic and the physician is a serious outlier or it was simply erroneous.
By this point, I was knee-deep in EHR deployments. I recognized it as either laziness or unwillingness for the provider to spend time customizing his exam template or inappropriately restrictive behavior by IT folks unwilling to support personalization due to fears of increasing their maintenance burden. Now, many of the consultation notes I see are so much gibberish that I end up talking more with the patient to understand what actually happened.
From the patient perspective, I can’t stand errors in my chart. It’s one thing if they’re in a narrative or free text box that isn’t discrete data. As the reader noted, these are seen by insurance folks when notes are sent as documentation of the need for a prior authorization or other approval, so they’re certainly problematic. However, when discrete data is wrong, that’s a different kind of problem since it could be used behind the scenes in various algorithms that form care recommendations and no one is aware that they’re incorrect.
Errors aren’t just a nuisance, but can keep you from getting the care you need and can prevent you from receiving recommendations for care you might not even know you needed. Still, because of the traditional power imbalance between physicians and patients, it’s hard to bring it up.
I’ve had to bring it up myself and have used different strategies depending on the level of the error. For minor errors, I’ve sent messages through the patient portal and asked the clinician to update the note. I think it’s important to have that written record. For more serious errors, I’ve addressed them in person at a subsequent visit and somewhat forced the correction or amendment to be done real time.
For major errors, I’ve invoked my rights under HIPAA and sent a formal communication to the physician and asked for them to modify the chart and send me a corrected copy of the documentation. HIPAA requires that patients submit these requests in writing, after which providers have to either make the changes or provide a written denial with explanation. I’ve also specifically requested that they reach out to downstream systems that may have consumed the erroneous data and address it there or notify me where their data is flowing so I can make the appropriate requests.
For the major errors, I’ve also sent letters to the higher-ups making sure that they know what is going on in their practices. At one, a clinician put inaccurate information into my chart three visits in a row, so I cited that as my reason for leaving the practice and removing them from my referral list as a physician. Shockingly, I’ve never received a response from any of those administrative communications, which I think is a reflection on how little people value accuracy or loyalty these days.
Have you had to correct your medical record, and how did you approach it? Leave a comment or email me.
Email Dr. Jayne.
Complement 1, which offers a digital lifestyle modification and personalized coaching app for cancer patients, launches with $16 million in seed funding.
Behavioral Health Software Provider Dazos Raises $25M Series A
Behavioral health CRM, billing, and business intelligence software company Dazos raises $25 million in Series A funding.
Prior authorization software vendor Cohere Health announces a $90 million Series C funding round, bringing its total raised to $200 million.
OpenAI launches HealthBench, a physician-developed benchmark that evaluates large language models on real-world medical decision-making. It uses 5,000 realistic clinical conversations to grade models on communication quality, instruction adherence, accuracy, context awareness, and completeness.
Google is expanding its Gemini AI assistant beyond smartphones to other Android devices such as smart watches, cars, TVs, and extended reality headsets.
AI answer engine Perplexity adds PayPal “buy now” buttons to its results, enabling in-app purchases as it promotes “conversation-driven commerce.”
Oracle Health launches its Clinical AI Agent in Canada, offering health systems automated note drafting and voice-enabled EHR navigation.
Patient-provider communication platform vendor OhMD launches Nia, an AI voice assistant that manages routine patient requests for scheduling and refills while routing sensitive requests to medical practice teams. OhMD co-founder and CEO Ethan Bechtel has executive industry experience with EMR Edge, Blueprint Health, and MBA HealthGroup.
The New York Post profiles Doctronic, a startup whose symptom-checking chatbot suggests potential diagnoses and then offers a $39 virtual physician visit to review. The company says its chatbot’s diagnosis and treatment plan match the doctor’s 70% of the time and that the platform serves 50,000 users weekly.
Australian researchers report that over 1,000 health-related GPTs in OpenAI’s GPT Store operate outside medical device regulations. Authors of two of the 10 most-used GPTs declined to provide details, while the remaining eight offered no evidence of safety or regulatory approval.
A House budget reconciliation bill would impose a 10-year moratorium on state and local regulation of AI.
A New York Times article notes that AI hasn’t displaced radiologists as some once predicted, highlighting that Mayo Clinic has grown its radiology staff by 55% over nine years and formed a 40-member AI team to build tools that support clinicians. Experts say that outsiders often misunderstand the role of radiologists, who in addition to reading images also advise physicians, review medical records, speak with patients, and contextualizing findings for a particular patient.
Mr. H, Lorre, Jenn, Dr. Jayne.
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Don Woodlock is head of global healthcare solutions at InterSystems.
Tell me about yourself and the company.
I’ve been in our industry for my whole career – 14 years at IDX, 15 years at GE Healthcare, and eight years here at InterSystems, where I run our healthcare solutions. These are the applications that we sell to the healthcare industry, which includes an EMR that we sell outside the US and an interoperability data product line called HealthShare that we sell around the world.
Otherwise, InterSystems is also a data platform company. Most famously, Epic is built on our technology, but about 1,000 other systems have been built on our technology as well. We’ve been in the industry a long time, specializing in data and interoperability, with special skills in healthcare.
How central is healthcare to the overall mission of the company, which has $1 billion in annual revenue and 2,000 employees?
We are primarily in healthcare, where we have a deep focus and experience base. It has been our longest business. Our technology is applicable to a few other industries, so we have built up financial services and supply chain product lines and teams, but our heart remains in healthcare.
We have been foundational, so everybody doesn’t necessarily know our name. We are behind other vendors as the interoperability or data platform for many customers. We’re not always out there with the front-end face of healthcare software, but we’re certainly in there on the heavy duty lifting, performance, and scalability of the healthcare data side.
What are the latest developments in the company’s technology?
We are not unusual in that we’ve been focused a lot on how Gen AI can make a big difference to our products and to our customers’ workflow. Each of our products has had exciting innovations, with new features and modules that are enabled by Gen AI. We are certainly in that AI era, a good AI era, and we’re a couple of years into it. We have a lot more years of innovation and hopefully making healthcare a lot better with this technology.
What parts of healthcare do you expect to see profoundly affected by AI, especially in quality, cost, and access?
At least the first few years, we’re focused on the user experience and having the use of technology like ours, like EMR, be a whole lot more fun, delightful, natural, and more human to use. We moved to graphical user interfaces 20 or 25 years ago. We thought that was a big shift, but it’s still hard to use. It’s still a lot of pointing and clicking, dropdowns, and tabs. It’s not a very natural experience.
With GenAI and approaches like ambient or natural chat user experiences, we will be able to create software that’s a whole lot easier to use, to get information out of, and have it pay attention to our instructions and do useful things for us. Historically, software has been kind of dumb. It follows the instructions of the user, stores the information that I type in, and then shows it back to me a few days later when I ask for it again. AI can allow us to build a lot smarter software that will be more helpful to us as users and hopefully will help transform the industry.
We first focus on the user experience. Down the road, we’ll start to move into other areas around clinical decision-making, workflow optimization, and a better patient experience. There’s a lot of places we could go with this technology.
You just announced IntelliCare, a next-generation, AI-centered EHR that is available only outside the US. What were the lessons learned in developing it?
We took a bet that worked out, which is that AI should be natively built in the EHR versus just a partnership with somebody else. That’s really working out. It’s enabling us to do closer integration of the technology into the workflows of the user instead of having it be an arm’s length relationship. That’s been good.
It takes more R&D to do that. We’ve had seven teams working on this across our EHR development teams. With enterprise EHRs versus best-of-breed departmental systems, enterprise has won out as the right strategy. I don’t think that AI is that different. You want to embed it into that enterprise feel versus having it be a best-of-breed type system. We made that decision early on that we would do this natively. That cost us more, but I think it’s going to pay off, and it is already paying off with some of our early adopter sites.
Other lessons learned with AI is that it’s important to work closely with our customers. There’s a lot of trust issues with AI. There’s a lot of education issues in terms of how these systems work, how we test and validate them, and how we get comfortable with the way that our data is handled by a cloud AI provider.
There’s a lot of new ground on the InterSystems side, but also on the customer side in terms of governance, legal, safety, and a comfort level with AI overall. We’ve had to spend more time than I would have guessed on the customer side, educating them and getting them comfortable with what we’re doing. Maybe part of my education push on AI was observing how much the market needed to learn about AI in order to adopt it well. We’ve just encountered a lot of that with our early sites.
How does traditional software development, maintenance, and support change when you add an AI component?
The good news is that all of these large language model vendors basically use the same APIs and the same way to call them. There’s not a lot of technical investment that you’re making in one road that’s not useful for another road if people continue to leapfrog each other and things change.
What is really tricky is the testing and validation process, because when you are dealing with generative AI and you ask the same question multiple times, you’re not going to get the same answer back. There’s a non-deterministic aspect to the way large language models work, even on the inbound side. If somebody’s asking a question about a patient chart or whether they have been seen for this condition before, there might be multiple ways that that clinician might ask essentially the same question. There’s non-deterministic aspects on the user side and then certainly non-deterministic aspects on the answer side.
We had to invent our automated testing process and our validation process from scratch. That is much different than our traditional process, where we want them to fill out these four dropdowns and get the answer “32” in the end. For this non-deterministic process, we’ve had to build up a completely different automated testing infrastructure and validation infrastructure. We have a lot more human validation with real physicians and nurses in the process. Testing, measuring accuracy, and then maintaining that accuracy as the model providers come up with new versions is a whole different design and architecture that we needed to build around this.
How are you using AI tools personally?
We provide our employees with OpenAI licenses with an enterprise agreement, where they can use it for company confidential stuff. We’re enabling our employees, myself included, to use and take advantage of the technology.
For me, I use it most for coding side projects. I do a lot of AI side projects just to keep current with the technology. These large language models are excellent at writing code, answering technology questions, debugging, and stuff like that. It’s remarkable how well these technologies work as maybe junior programmers or code developers along with you.
One way to view these AI technologies, at least for the next couple of years, is for empowering every human employee here with a co-marketer, co-developer, or a co-implementation person who can help them be better at their job, be more productive, debug problems faster, and that kind of thing.
The industry could use basic AI education to navigate the opportunities and risks with AI effectively. I’ve always enjoyed teaching, so I am doing five or 10-minute videos called “Code to Care” to explain AI concepts. I always have enough content because buzzwords are being thrown out that people don’t understand or that vendors overuse. I am enjoying putting together that AI education. It’s important. HIMSS, HLTH, and ViVE have a lot of sessions where educators don’t get into enough depth, or maybe they don’t know enough depth, to help you understand some of the newer topics and approaches.
I don’t know if it’s to the company’s benefit or not, but I certainly enjoy doing it. I enjoy hearing from people across the industry who have known me over the years who like my video content. It’s important that we navigate this AI wave effectively.
What has been the impact of moving to the cloud?
I’m finding that our customers are struggling with anything on-prem these days. Maintaining a data center and keeping hardware and storage current, updated, and patched for security vulnerabilities is a growing challenge. More and more of our existing customers are asking us to host their platforms or offer the same functionality as some kind of service or equivalent.
For our net new business, we almost do everything as a service. People within health systems and payers don’t want to be doing this anymore. It just doesn’t make sense economically. It’s the predominant model that we find to make software and technology available to customers. We do the heavy lifting, such as maintaining the staff, buying hardware if we’re doing it ourselves, or procuring it from one of our cloud partners. The industry is just kind of done with on-prem software and relying on their software vendors to manage it as a hosted or software-as-a-service platform.
Is interoperability a solved problem?
[Laughs]. No, no, no, no. I definitely think that the ball has moved, which is great. When I started in interoperability, the use case was a provider seeing a patient, let’s say in the ED, and wanting to know what happened with this patient outside of my health system. That is getting solved. National networks like CommonWell or vendor networks like Epic’s Care Everywhere have done a fabulous job with that use case, and the ball has moved.
But we’re trying to do new things. We are working hard on the payer-provider interaction, like electronic prior authorization, clinical data exchange, payer data exchange, and patient and member access to their information. Those are new exciting use cases that we’re working on as an industry.
The industry still struggles. We are in the middle of this with our technology and services with mapping data in one format and making it consumable and useful in another format. So it’s definitely not a solved problem. We are enjoying a great growth of FHIR as an approach and a set of standards, and that is helping with all of these new use cases.
Things are getting better. We’re moving on to slightly more advanced problems from an interoperability point of view, but it’s certainly not a solved problem at all.
What near-term trends will influence the industry and the company?
InterSystems has been around for 47 years. We have a slide that we talk about, which is the advent of micro-computing, PCs, the Internet, cloud computing, and now Gen AI. Each of these is maybe a 10-year-long transformation that has allowed us to do great new things. All of those significantly advance the impact that computers and software have had in healthcare. Gen AI is going to be either no different, or even better, than some of those prior transformations. That’s a terrific trend.
I also think that cooperation among payers, providers, public health, Medicare plans, and others within a community is getting stronger. It will make it easier as a patient and as a caregiver for your family to navigate the healthcare system. I hope that technology, interoperability and cooperation across communities will continue to improve. I certainly see it improving with customers that we work with.
UnitedHealth Group CEO Andrew Witty steps down, company suspends annual forecast
UnitedHealth Group announces that CEO Andrew Witty has resigned, and that it will suspend its 2025 financial forecasts due to rising medical costs in its Medicare Advantage business.
Epic Systems sued by CureIS Healthcare for alleged ‘scheme to destroy’ its business
CureIS Healthcare, a managed care services company focused on government programs, files a civil suit against Epic for anticompetitive practices.
OpenAI launches HealthBench, a physician-developed benchmark that evaluates large language models on real-world medical decision-making.
Hinge Health targets $3 billion valuation as IPO markets signal comeback
Digital musculoskeletal care company Hinge Health hopes to raise $437 million in its upcoming IPO for a valuation of $3 billion.
A federal court orders Commure to stop marketing and selling its Strongline Pro wearable panic button for staff safety based on the allegations of Canopy Works, the original developer of the technology.
UnitedHealth Group announces that CEO Andrew Witty has resigned for personal reasons and has been replaced by Chairman and former CEO Stephen Hemsley.
The company also announced that it will suspend its 2025 financial forecasts due to rising medical costs in its Medicare Advantage business.
UnitedHealth Group has recently struggled with the Change Healthcare cyberattack; the murder of Brian Thompson, the CEO of its insurance business; and consumer backlash over high costs and denied claims.
UNH shares dropped 18% Tuesday following the announcement.
None scheduled soon. Contact Lorre to have your resource listed.
Healthcare RCM and patient care software company TruBridge reports Q1 results: revenue up 3.7%; adjusted EPS $0.36 versus $0.19, beating revenue expectations but falling short on earnings.
Care coordination company Olio announces $11 million in Series B funding, bringing its total raised to $26.5 million.
OpenAI launches HealthBench, a physician-developed benchmark that evaluates large language models on real-world medical decision-making. It uses 5,000 realistic clinical conversations to grade models on communication quality, instruction adherence, accuracy, context awareness, and completeness.
A federal court orders Commure to stop marketing and selling its Strongline Pro wearable panic button for staff safety. Canopy Works, the original developer of the technology, alleges that Commure resold its system until their partnership ended in 2023, after which it accuses Commure of launching a similar product almost immediately.
Children’s Wisconsin names Benjamin Mansalis, MD (Indiana University Health) chief information and digital officer.
Epic integrates lifestyle medicine assessment tools from The American College of Lifestyle Medicine with its EHR. Tools include a short form-assessment, diet screener, and physical activity review.
Virtual healthcare company Ovatient launches the MyCare Anywhere patient engagement app using technology from League. Patients at MetroHealth (OH), which co-founded Ovatient in 2022 with MUSC Health (SC), will be among the first to use it.
Exalt Health implements WellSky’s Specialty Care EHR at its inpatient rehabilitation facility in Arizona. The company will soon roll out the software at three sites in additional states.
Sanford Health implements organ donor registration via Epic’s MyChart. The collaboration between Epic and Donate Life America streamlines registration with pre-populated information, adds the registrant to the National Donate Life Registry, and updates their medical record to ensure that donor preferences are accessible to care teams anywhere.
PsychNow launches Chapter, an AI co-pilot that captures a behavioral health patient’s history and assessment from their initial visit conversation.
CMS and ASTP issue an RFI titled “Health Technology Ecosystem” that seeks public input on digital health products in the Medicare population, with a focus on interoperability.
The US Navy’s Military Sealift Command is upgrading its IT infrastructure, including linking the US Naval Ship Mercy, a humanitarian and military vessel, to the federal MHS Genesis EHR. Hospital Ship Joint Task Director Mike Taylor says they are considering incorporating AI into the ship’s healthcare operations: “… I don’t want AI making decisions to shut off a network point, a port that goes to an IV infusion pump. We’re watching it carefully. We’re excited to implement some facets of AI, especially in the security arena, but we’re treading lightly at this point.”
AdventHealth will launch a hypertension management program this summer across 370 care sites that will incorporate remote patient monitoring devices and virtual visits.
Frustration with timely prior authorizations takes the top spot in payer-provider collaboration challenges, according to Black Book Research. An overwhelming majority of surveyed providers typically experience prior auth delays of more than five days, while just 29% of payers say that they have implemented electronic prior authorization tied to EHRs.
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