EQT Partners lines up $1 billion CitiusTech exit
EQT Partners hopes to sell its 40% stake in CitiusTech for $1 billion.
Palomar Health, UC Pact Outlined
A Joint Powers Authority arrangement between Palomar Health and UC San Diego Health will give Palomar clinicians access to UC’s Epic system.
Clinical trial software and services vendor Paradigm Health acquires Flatiron Health’s tech-enabled clinical research solutions.
Sometimes it’s hard to keep up with everything that is going on in healthcare IT. Regardless of how many unread newsletters and blog notifications are in my inbox, I know I can count on HIStalk to deliver the curated content that helps me identify the topics that I need to dig into and those that I can let slide for a while.
This week, I appreciated Mr. H posting a link to an article about the strategy that the Department of Health and Human Services (HHS) plans to use as it expands the role of AI in healthcare. The document is 20 pages long and reads like an ode to the wonders of AI, with less attention to the documented risks and benefits.
As someone who has spent a good chunk of her career doing process improvement work, where evidence and outcomes are key, and who is squarely under the influence of evidence-based practice where patients are concerned, I’m all about the details. It isn’t enough to just say that you have a cool technology that’s going to be revolutionary. We had enough of that with Theranos and the pharma bros. Now we are in an era where people want to see results and understand fully how care might be impacted and how patients will be protected.
There are five key pillars in the document: creating a governance structure that manages risk, designing a suite of AI resources for use across the department, empowering employees to use AI tools, funding programs to set standards for the use of AI in research and development, and incorporating AI in public health and patient care.
It sounds like the “empowering employees to use AI tools” piece is well underway since HHS has made ChatGPT available to all its employees. Based on my own experiences, I initially hoped that they were not using it to look up health-related content, because I’ve seen some wild inaccuracies over the last year even with non-controversial queries, such as asking it to summarize a movie plot.
Unfortunately, plenty of media reports say that HHS leaders are planning to use it to “deliver personalized, context-aware health guidance to patients by securely accessing and interpreting their medical records in real time.” Unsurprisingly, that idea raises concerns about having third-party vendors accessing patient medical records and how that data might be protected.
HHS has already given the protected health information, including birth dates and Social Security numbers, of Medicaid enrollees to the Immigration and Customs Enforcement department, which is cringeworthy for those of us who have had to sit through decades of HIPAA training courses. Although it appears that HHS will prioritize risk mitigation, the clinical experts who I have spoken with have serious concerns about the organization’s ability to prioritize patient protection over political requests.
Those of us who are following the evolution of vaccine policy in the US have seen a disregard for the scientific method and the removal of world-renowned experts from the process. We have no reason to think that things will be different with AI. Given that we have decades of experience with vaccine efficacy and little experience with the impacts of AI, clinicians are understandably concerned.
A comment on the document noted that although safety measures are in place for individual patient information, no similar safeguards are listed for aggregated information that is being used by AI tools.
As I began to dig into it, I was surprised at how it differed from previous HHS publications over the last few decades. A glossy cover page was followed by a full-page photo of the secretary of Health and Human Services with a superimposed quote saying, “We are making HHS the template for the Utilization of AI.” When I’ve seen splashy graphics pages like that in the past, it’s been in the context of a major discovery or a noteworthy quote, but this just felt weird, for lack of a better word.
The document continues with introductory letters from the deputy secretary and the HHS chief AI officer. In the first letter, HHS Deputy Secretary Jim O’Neill notes that “By guiding innovation toward patient-focused outcomes, this administration has the potential to deliver historic wins for the public – wins that lead to longer healthier lives.”
What does he think that all of us healthcare and health tech people have been doing for the last two decades? We’ve been patient-focused and outcomes-driven for a long time. Maybe he thinks it’s something new or unique to this leadership.
My favorite statement is in the second letter. HHS Chief Information Officer and Acting Chief AI Officer Clark Minor, states, “This paradigm shift will unleash a new era of well-being for a healthier America.” I was reading this in a room with a dozen family physicians, so I asked them, “What one thing do you think will unleash a new era of well-being for a healthier America?” None of the answers included AI.
What they did include were concepts such as universal healthcare, eliminating healthcare inequity, increasing social services that directly impact health, mitigating the impact of food deserts, investing in preschool and early childhood education, strengthening nutrition education in the public schools, and increasing the primary care workforce through additional residency training spots and low-interest loans for those who pursue careers in primary care.
The ensuing discussion made me wonder how much the folks at HHS are actually talking to those who are on the front lines of public health and primary care. What do they need to help promote health and prevent disease? What are their pain points? Which solutions have they tried, and can they share an inventory of what worked and what failed?
I’m certainly not part of the policy-making apparatus in the US, but I know how I solve workflow hospitals in a hospital. It doesn’t involve putting all of my eggs in the AI basket. We use a rigorous methodology to analyze dysfunction and to propose solutions, and it actually works.
This idea of assuming that AI will solve all our problems and then taking action based on that hypothesis makes me feel like we’re all part of a giant unregulated experiment that wouldn’t pass the basic rigors of a middle school science fair, let alone the Institutional Review Board of a research institution.
I have to admit that I haven’t finished reading the document yet, largely because the level of rhetoric present was giving me a headache. I also have a time-consuming personal project that I’m trying to complete, so I decided to switch gears. I’m eager to hear from anyone who has read the whole thing.
What are your thoughts on how expanded AI at HHS will impact the greater US healthcare ecosystem? Do you think AI is going to be a major driver of change, or is it just another distraction from the difficult and often messy work that needs to be done to improve the health of a large and diverse population? Leave a comment or email me.
Email Dr. Jayne.
The Missing Clinical Voice in Healthcare IT
By Susan Grant, DNP, RN
Susan Grant, DNP, RN, is chief clinical officer at Symplr.
For years, the weight of healthcare technology decisions has fallen solely on IT teams, inadvertently leaving clinicians and IT operating in silos. Yet clinicians play a critical role in determining whether technology implementations succeed. Deloitte research shows that clinicians rate technology initiatives far more positively when we are actively involved, from design through implementation.
Despite this, only 38% of frontline clinicians report having been consulted on digital health workflows or new applications. We need to bring the clinical perspective into technology decisions earlier and more consistently. With physician use of AI already up 78% from 2023, clinicians both want and deserve a larger role in shaping these conversations.
The value of clinical input
Health systems must engage across departments, from IT to executives and clinical teams, to deliver successful technology implementations. Nurses alone make up the largest segment of the healthcare workforce. Because clinicians directly experience the problems that many solutions aim to solve, they offer essential insights that should guide decision-making.
Cross-functional communication is equally critical. Open discussions about technology challenges and workflow pain points help to align around the shared goal of streamlining work so that providers can focus on patient care. These conversations also allow IT professionals to demonstrate the benefits of new tools early, reducing resistance and building confidence that the technology reflects clinicians’ needs.
Historically, clinicians have too often been excluded from these conversations, leading to painful rollouts, misaligned expectations, and limited influence over tools designed for them. Bringing the clinical voice to the table can change all of that.
Clinicians want to be more involved
Clinicians want to play a bigger role in healthcare technology decisions. Our 2025 Compass Survey shows that 85% of clinicians want more influence over software purchasing decisions, up from 72% last year and 51% in 2022. This trend shows that care teams no longer view technology and innovation as strictly an IT responsibility. They recognize the value technology brings to their daily work and to delivering optimal care.
IT and operations professionals also acknowledge the advantage that clinicians bring to these decisions. Both groups show increased interest in clinician involvement. This year’s survey found that 77% of operations leaders and 76% of IT teams actively seek clinician participation.
What’s next?
Organizations are seeking to implement technology that improves care delivery, including AI and scheduling tools. Ensuring that clinicians participate throughout the full implementation process prevents problematic deployments and increases ROI. As a former nursing leader at large health systems, I’ve seen the direct positive impact digital tools can have on clinicians, saving time, reducing stress, and ultimately improving the healthcare experience for patients.
We are in the midst of a clinical shortage, with the National Council of State Boards of Nursing reporting that 40% of RNs intend to leave the field in the next five years. Ensuring that clinical voices guide technology decisions can improve daily life for this workforce.
Strengthen alignment and communication
Healthcare leaders can take several approaches to address this issue. Teams should begin by aligning on central priorities across clinical and IT groups to foster communication and gain a better understanding of each other’s goals. While they may have different priorities, both sides share the guiding objective of improving patient care.
Leadership should demonstrate the value of technology upfront to strengthen clinicians’ trust. After facing so many initiatives that have not helped, clinicians need concrete examples of how new tools can make their jobs easier.
To increase clarity and confidence in new tools, leadership should also provide comprehensive training and education for the healthcare workers who will use them. This approach offers transparency and addresses change fatigue, helping differentiate new technology rollouts from earlier efforts that left clinicians burned out.
Opening the lines of communication in a continuous and intentional way can transform how systems operate. When leaders gather clinical input before decisions and continue the conversation post-rollout, they increase collaboration, elevate clinician voices, and improve the success of each initiative.
Learn from past experiences
To share a personal example, in a previous role I saw nurses become frustrated with a new AI tool because incoming messages disrupted their communication with other providers. A simple conversation could have revealed this problem sooner. But because consideration of ongoing feedback was not a part of the post-implementation plan, no one realized that the tool designed to help them was instead creating more work.
When healthcare organizations use these strategies and place greater value on the clinical experience, they create a culture of innovation and collaboration that increases enthusiasm for change and avoids overpromising and underdelivering.
ECU Health partners with Artisight to bring Smart Hospital technology to eastern North Carolina
ECU Health will implement Artisight’s smart hospital platform, initially focusing on telehealth services for neurology and intensive care across five hospitals.
Nova Scotia Health’s IWK Health Centre becomes the province’s first facility to go live on what will become an enterprise roll out of Oracle Health.
The FDA launches a pilot that creates a risk-based regulatory pathway for chronic disease digital health devices, giving manufacturers enforcement discretion while they gather and publish real-world performance data.
HHS plans to expand its use of AI, primarily to improve administrative efficiency, and also to deliver real-time patient guidance by analyzing medical records.
Three-fourths of poll respondents consult a research-only firm when making buying decisions, most often KLAS.
New poll to your right or here: Will health systems meaningfully benefit from adding an C-suite AI job, such as chief AI officer?
Reader donations and matching funds provided Ms. M’s NC-based student-run school news program with audio and video equipment. She reports, “This is such a blessing to our student news team! They are so excited to bring the school news to our school, but we are struggling to make it work with limited technology. These items, such as the microphones, will be SO helpful so that we are able to be heard around the building! We have such ambitious, funny, bright students who are excite to bring something school wide.”
Welcome to new HIStalk Gold Sponsor FinThrive. The Plano, TX-based company helps 3,200 healthcare organizations increase revenue, reduce costs, improve patients financial experience, and ensure regulatory compliance across their entire revenue cycle continuum. Its SaaS-based RCM Platform delivers the industry’s widest breadth of capabilities, including integrated workflows supporting patient access, revenue integrity, claims management, contract management, and collections management teams within a centralized work environment. The company helps its customers bring modern digital experiences to their patients, including self-scheduling, virtual check-in, price estimations, patient payments and payment plans, and ongoing SMS-based secure communications. – with no app downloads required. Its platform also leverages machine learning, robotic process automation, end-to-end RCM analytics, and billing and coding education resources to increase efficiency and drive sustained ROI. Thanks to FinThrive for supporting HIStalk.
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Lightbeam Health Solutions acquires Syntax Health, whose platform supports value-based care contracting.
Nova Scotia’s IWK Health goes live on Oracle Health, the first hospital to do so under the province’s One Person One Record project.
India-based Healthify expects to add more GLP-1 drug makers to its patient support program, which offers metrics tracking and coaching, following its new contract with Novo Nordisk. The company says that it has 45 million global users.
OpenEvidence releases a free dialer program that allows physicians to contact their patients without exposing their personal phone number. It integrates with the Visits portion of the company’s app to allow users to automatically create a clinical note from the call.
The FDA launches a pilot that creates a risk-based regulatory pathway for chronic disease digital health devices, giving manufacturers enforcement discretion while they gather and publish real-world performance data.
BJC HealthCare calls out a “misleading” social media post that claims that the health system revokes parental access to their children’s records. It clarifies that its MyChart portal changes parental access from full to limited access when their child turns 12, but parents can still obtain records through its release process, all of which complies with federal and state privacy laws.
A US Embassy official assures Kenyans that their identifiable health records will not be shared with the US government under a new $150 million security agreement between the countries. A Kenya-based whistleblower claims that the deal grants full US government access to patient records, calls for sharing data with drug companies, and places Kenya’s data rights at risk by putting the agreement under US law.
An Asheville, NC-based news site says that the soaring share price of hospital operator HCA Healthcare has boosted the net worth of co-founder and major shareholder Thomas Frist, Jr., MD to $42 billion, with the $15 billion jump so far this year making him the 47th richest person in the world.
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VA staff flag dangerous errors ahead of new health records expansion
Media outlets report that the VA remains on track to expand its Oracle Health EHR rollout to 13 more medical centers in 2026 despite problems reported by clinicians at all six go-live sites.
Population health management company Lightbeam Health Solutions acquires Syntax Health, which offers value-based care contracting software.
US health department unveils strategy to expand its adoption of AI technology
HHS develops a strategy to coordinate the use of AI across its divisions, enhance employee efficiency, and innovate in the areas of public health and patient care.
The Spokesman-Review and The Washington Post say that the VA remains on track to expand its Oracle Health EHR rollout to 13 more medical centers in 2026 despite the problems that clinicians reported at all six go-live sites.
None scheduled soon. Contact Lorre to have your resource listed.
Healthcare AI agent developer Artera raises $65 million in growth investment.
AdvancedMD hires Nupura Kolwalkar-Rana, MS, MA (DNAnexus) as chief product and technology officer.
LiveData promotes Jeff Forbes, MBA to VP of commercial healthcare sales.
Medical kiosk maker OnMed will implement its CareStation clinic-in-a-box at 30 charter schools in a pilot project with 22Beacon, which provides real estate development, financing, and advisory services to charter schools. OnMed announced in October 2025 that it plans to go public via a SPAC merger.
Aetna lists the milestones it has achieved in its strategy to simplify healthcare experiences for providers and patients, which include combining prior authorizations for prescriptions and procedures into a single clinical review, introducing collaborative care models for Medicare Advantage members, and rolling out conversational AI solutions.
A new KLAS and Arch Collaborative report on clinician turnover finds that problems with organizational leadership top the list of causes, often triggered by a bad EHR experience. One clinician says that IT leadership pay should be pegged to patient satisfaction just as theirs is, while another says that IT protects its fiefdom and shows little interest in clinician needs.
Kaiser Permanente’s health plan will pay $46 million to settle a class action lawsuit that involves its 2024 use of web tracking technology.
I ran across the Substack of Helen Lu, RN, MSN, clinical director of informatics and analytics at Community Health System, who is also a family nurse practitioner, insightful health tech analyst, and AI fan. She questions on LinkedIn why she can stream Netflix in 4K, yet downloading a diagnostic quality image takes 30 minutes. She says that the technology exists, but hasn’t been adopted:
A BMJ article says that social media influencers shape public perception of medical guidance by promoting oversimplified or misleading advice that often conflicts with evidence-based recommendations. Influencers often lack expertise, are motivated by financial conflicts, and overgeneralize their personal beliefs. The authors add that official statements and fact-checking aren’t effective at countering misinformation because they lack the immediacy, appeal, and reach of influencers. They outline possible countermeasures, but say that no single approach is likely to work.
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This week’s encounter with Big Health System brought additional frustrations, along with a profound desire to sell them consulting services.
My appointment was scheduled with a nurse practitioner. It was supposed to be set up with a link to an imaging service. The plan was to see the provider first, then have the imaging, then go back to the provider.
When I stepped off the elevator, I had my choice of two check-in desks, one for the provider and one for the imaging department. Since my appointment was with the provider, I went there first. I was told that I needed to go to the imaging desk, where they checked me in and then sent me back to my original stop.
I had to check in again even though I had already done an online check-in. They sent me to a high-tech waiting room that has an electronic board that displays the names of providers who are in clinic that day.
I thought it was odd that my provider wasn’t on the board, but I’ve seen an electronic glitch or two in my career, so I didn’t give it much thought. I realized when I was taken back to the care area that they were going to take my vital signs in a centralized vital station that was right across from the checkout desk and also adjacent to the door. Everyone can see what is going on with everyone else.
Many of us Midwesterners dress in layers because of snow. I was glad that I was wearing a short-sleeved T-shirt under my sweater instead of a long-sleeved version. Otherwise, I guess I would have been wrestling half my body out of my shirt for all the world to see. At no point did the medical assistant ask if I had a suitable garment underneath before asking me to expose my arm, which would have been considerate from a patient experience standpoint.
Medication reconciliation was performed in the open in front of two other patients. That is a patient dissatisfier in my book.
I was taken back to an exam room. I was told to gown up and that “the physician assistant will be right in.” I asked if they had the right provider on the chart since I was scheduled to see a nurse practitioner who I had seen previously. They told me that she wasn’t there that day.
You can bet that as soon as the assistant stepped out, I checked the patient portal. Sure enough, the appointment was still listed as being with the nurse practitioner.
When the physician assistant arrived, she didn’t mention the scheduling change. She seemed surprised to hear that I was scheduled to see someone else. Knowing what I know about electronic health records, this shouldn’t have been a mystery to anyone, because schedules don’t just spontaneously morph. Regardless, with a day off work and a long commute to the center, we forged ahead.
Afterward, I was told to go to a check-out desk, where no one was present. I could see through a pass-through to the other side, where a staffer had her back to me. She didn’t acknowledge me when she finished with her patient. I walked through, only to find three people in a line that I couldn’t see from where I was told to wait.
I didn’t know if they were ahead of me or behind me in line, so I headed to the back. That side of the office was a mirror-image layout of where my intake occurred. Everyone could see and hear everyone else’s business as patients were brought in, had vitals taken and medication reconciliation performed, and were checked out.
One bright spot in the visit was that while I was waiting, one of the medical assistants walking by said, “Is that you Dr. J?” She turned out to be a former member of my team from the urgent care trenches. I enjoyed seeing the photos of her children that she had on the back of her badge and catching up while I waited.
Ultimately I made it to the check-out desk. The staffer was hidden behind dual monitors with no ability to make eye contact with the patient. She proceeded to schedule follow-up appointments without confirming whether or not they worked for my schedule. I suppose they assume everyone just drops everything for an appointment at that esteemed institution.
She also let me know that they were in the process of implementing “ticket scheduling” via the EHR. She said that I would receive a notice to schedule follow-up imaging, but advised me to ignore it because it would be automatically scheduled as a linked visit with my next provider appointment.
My read on that is that the EHR team doesn’t quite have everything as buttoned up as it needs to be. Or, whoever designed the scheduling protocol doesn’t understand that some clinics have linked imaging needs that aren’t suitable for patient self-scheduling.
I have multiple EHR certifications, I am knowledgeable about ticket scheduling, and I understood the context of being told to ignore the notice. Otherwise, I likely would have been confused to see the scheduling request in my patient portal, which I checked in the elevator to confirm the dates for the follow up.
Another bright spot occurred as I logged in. A popup asked me to set a communication preference about seeing my results before they are reviewed by the care team. I hadn’t seen that before, and it’s a great patient experience feature.
From there, I was off to the parking garage. One of the two exit gates was malfunctioning, causing dangerous reverse maneuvers and a total traffic jam that was preventing anyone from exiting their spaces.The clinic that I was in sees up to 100 patients a day, each floor has multiple clinics, and the building has multiple floors. I’m thinking that the parking situation might be a little undersized.
After driving home in a general state of frustration, I was glad to see a notification that my visit note was ready for review. Although I’m an avid reader and enjoy a good work of fiction, I don’t enjoy it when that fiction is masquerading as a medical record note. The list of errors included:
A note in the chart said that the contents of the visit were dictated using voice recognition software, but didn’t include any indication of AI usage. Actually, an ambient documentation solution might have yielded a better result since it probably wouldn’t hallucinate as many elements as the provider did.
It is possible that I have entered my curmudgeon era, but I simply don’t believe that this kind of provider behavior is appropriate. I also don’t think that patients deserve to be treated this way. When I hear people say that the US has the best healthcare system, I always think of situations like this and it makes my blood boil. What’s worse is that these things didn’t happen at a rural or underserved facility, but at a major academic medical center that has a top reputation.
While I was in the patient portal, I saw a message for a relative for whom I’m a proxy. It recommended that she have a mammogram despite being 97 years old and having had a mastectomy. I was happy to clear it out before she saw it, because she would have been incensed. Given the configurability of EHRs and individualization of care gaps, we shouldn’t be seeing things like that. Given that day’s experience, it was just one more layer of icing on the proverbial cake.
I know that healthcare providers are constantly being asked to do more with less. I live that situation on the regular. Plenty of corners can be cut when people are just trying to get through the day, but I draw the line at putting fraudulent documentation in a patient chart, or doing a bait-and-switch with providers who serve a vulnerable patient population.
I’ll be sending excerpts of this write-up to the powers that be, but I’m not at all confident that they will care.
Do you see these kinds of occurrences at your institution? If so, what are the solutions? Leave a comment or email me.
Email Dr. Jayne.
Artera Secures $65M Growth Investment and Reaches $100M CARR
Healthcare AI agent developer Artera raises a $65 million growth investment and expects to reach $100 million in contracted annual recurring revenue by the end of the year.
Cerbo and OptiMantra Announce Merger Under New CEO Jeff Hindman
Cerbo and OptiMantra, both vendors of EHR and practice management software for healthcare and wellness practices, merge and hire a new CEO.
People are Uploading Their Medical Records to AI Chatbots
The New York Times reports that people are downloading their medical records from provider patient portals and then uploading them to ChatGPT and other online AI tools seeking medical advice and interpretation.
Surveyed provider executives expect the chief AI innovation officer to become the most important new C-suite role, and most say that the chief AI officer and the CIO / CTO positions are rising fastest in strategic importance.
The American Hospital Association asks the FDA to adopt flexible, risk-based methods to measure and evaluate AI-enabled medical device performance, align new standards with existing frameworks, and minimize burden while protecting privacy and patient safety. It also requests that FDA streamline the 510k clearance process that has been used by 96% of AI-enabled medical devices to earn its clearance. It recommends developing post-market evaluation standards to help vendors identify accuracy and validity issues.
CogStack, an open-source AI tool that was created by King’s College London, UCL, and several NHS trusts, extracts meaning from structured and unstructured health-record data to improve patient care, safety, and population health research. Providers recouped their investment within two years by using the open-source system for trial recruitment, faster medication reviews, better coding, and identifying missing records.
LCMC Health will implement Nabla’s ambient documentation technology.
Google.org donates $5 million to launch an EU health initiative that will allow frontline clinicians to build and test their own AI solutions.
The founder of Yara AI and his clinical psychologist co-founder shut down their mental health chatbot after concluding that AI poses unacceptable risks for vulnerable users, citing unclear safety boundaries, mounting evidence of harmful behavior in large language models, new legal restrictions, and the inability of small startups to manage crisis-level interactions responsibly. Joe Braidwood says the team struggled to distinguish routine stress from trauma or serious mental illness, making it difficult to know when to support users and when to direct them to a professional, especially since many people are unaware of their own mental state and can become emotionally fragile at any time.
Healthcare AI agent developer Artera raises a $65 million growth investment and expects to reach $100 million in contracted annual recurring revenue by the end of the year.
A study finds that the Queen of Hearts AI-based ECG platform outperformed standard ED triage in identifying ST-elevation myocardial infarction.
The New York Times reports that people are downloading their medical records from provider patient portals and then uploading them to ChatGPT and other online AI tools seeking medical advice and interpretation. Experts warn of unreliable results and the possibility that ongoing AI training might allow a chatbot to leak sensitive information.
A hospital in Canada says that the widely reported heartwarming story of one of its parking attendant volunteers reserving parking spaces for families in need is not factual. The post appeared on a Facebook page called Astonishing, which freely admits that it makes up stories for inspiration and entertainment and enhances them with AI-generated photos.
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Igniting Smart Strategy: Rationalizing Your Application Portfolio
By Amy Penning
Amy Penning is senior application analyst with CereCore.
The complexity of managing clinical, administrative, and operational applications in healthcare organizations continues to grow. While many large hospital systems have invested in robust programs to streamline their application portfolios, any health system that has undergone ownership changes, faced prolonged under resourcing, or shifted priorities grapples with technical debt and legacy systems that quietly drain resources and introduce risk.
Application rationalization is not just a cleanup task. It’s a strategy that can yield measurable operational and financial benefits, even without a large team to execute it.
Application portfolios in healthcare environments tend to grow over time as new needs emerge and priorities shift. Legacy systems, departmental tools, and redundant applications can quietly accumulate, while consolidation becomes more complex from mergers and acquisitions, creating technical debt and operational inefficiencies.
One regional health system uncovered over 700 applications, nearly triple their initial estimate, after a thorough inventory. The result? $17 million in savings in the first year and $72 million over five years, all without a massive team or predefined playbook.
While cost reduction is a compelling driver, the return on investment from AppRat extends far beyond the balance sheet. Healthcare leaders often delay AppRat due to competing priorities, perceived disruption, or lack of internal expertise, including rationalizing legacy systems that aren’t understood by anyone on the current team.
Rationalization efforts have led to a 30% reduction in IT support tickets, 20–25% improvements in clinical workflow efficiency, and enhanced data interoperability. These operational gains translate into better clinician experiences, faster decision-making, and ultimately, improved patient care.
The challenge often lies in knowing where to begin. Many organizations believe that they have a handle on their application inventory until they start digging and discover hidden redundancies, unsupported systems, data silos, and cybersecurity risks. Begin with a simple inventory and build from there, tailoring the approach to each organization’s unique bandwidth and priorities.
A phased assessment approach, starting with inventory validation and business function mapping, can uncover opportunities to reduce licensing costs, simplify workflows, and improve data governance.
Decommissioning a single application can bring significant savings and risk reduction. But application rationalization isn’t just an IT exercise; it supports the most strategic organizational goals. By consolidating systems and eliminating outdated platforms, healthcare providers can improve clinician experience, reduce login fatigue, and streamline training. Standardization enhances interoperability, supports regulatory compliance, and strengthens cybersecurity posture by reducing exposure to vulnerabilities in legacy systems. These improvements contribute to better patient care and operational resilience.
Importantly, the return on investment extends beyond direct cost savings. Rationalization efforts often lead to reductions in IT support tickets, improved onboarding processes, and enhanced clinical workflow efficiency. These outcomes translate into cost avoidance and increased capacity for innovation. Organizations can redirect resources toward strategic initiatives such as AI adoption, cloud migration, or digital transformation.
Success does not require an army. It requires a thoughtful, repeatable process. Engaging stakeholders across IT, clinical, finance, and compliance teams ensures that decisions are informed and aligned with organizational priorities. Leveraging existing tools and frameworks can accelerate progress and reduce the burden on internal staff. Whether starting with a simple assessment or building a full application lifecycle management program, the key is to embed rationalization into the fabric of IT operations.
For organizations without the bandwidth or specialized expertise to manage this work, partnering with a team that can both assess and execute is critical. That team can help health systems identify opportunities through structured assessments and then manage the legacy turndown process, reducing risk, freeing resources, and creating a faster path to ROI so that teams can focus on strategic priorities like digital transformation and innovation.
ACCESS Model expands access to technology-supported care in Original Medicare
A new, 10-year CMS model called ACCESS will test whether an outcome-aligned payment approach can expand access to technology-enabled chronic care management in Original Medicare starting in July 2026.
Avandra, which is developing a federated network for medical imaging and clinical data for pharma and AI innovation, acquires DatCard Systems, which offers DICOM distribution solutions, and Sorna Corporation, whose technology supports automated medical data distribution.
Tech-enabled infusion therapy provider Uptiv Health will use new funding to enhance its digital platform, incorporate AI into its workflows, and expand into new markets.
A new, 10-year CMS model called ACCESS will test whether an outcome-aligned payment approach can expand access to technology-enabled chronic care management in Original Medicare starting in July 2026.
CMS says that telehealth, wearables, lifestyle coaching apps, and FDA-authorized devices can support clinical consultations, lifestyle support, counseling, patient education, medication management, ordering and interpreting tests and imaging.
The program will focus on four tracks:
Some LinkedIn comments from Christian Pean, MD, MS, executive director of AI and IT innovation at Duke Orthopedic Surgery:
Value-based care just got more real for orthopedics. I’ve sat through countless meetings about the shift from volume to value. It often feels abstract. But the CMS ACCESS Model (launching July 2026) is one of the most tangible signals I’ve seen that the ground is shifting below our feet. For those of us in orthopedic surgery and health tech, CMS says this is a playbook for the next decade. Instead of just paying us to intervene, CMS wants to pay us to manage patients longitudinally. The model introduces Outcome-Aligned Payments, recurring revenue that is contingent on the patient actually getting better … You cannot succeed in this model with a clipboard and a phone call. To manage outcomes at scale, we need AI-enabled Integrated Practice Units (IPUs). We need remote monitoring that feels invisible to the patient but gives the clinical team actionable data.
From Nasty Parts: “Re: Accuity. I’m hearing that it was acquired by [publicly traded vendor name omitted]. Not announced, but integration is underway.” Unverified. I’ve omitted the rumored acquirer’s name since they are publicly traded.
From Ray: “Re: TEFCA. I agree that comparisons between TEFCA and CMS Aligned Networks is confusing. This document may help clarify.” Thanks to Ray Duncan, MD, who has more experience in interoperability and technology than just about anybody, for creating and sending this document.
A reader’s generous donation, matched with funds from organizations and my Anonymous Vendor Executive, fully funded these Donors Choose teacher grant requests from historically underfunded schools:
None scheduled soon. Contact Lorre to have your resource listed.
Hospital-at-home company Inbound Health shuts down, citing regulatory uncertainty around reimbursement for its services. It was spun out of Allina Health in 2022 to help health systems develop tech-enabled, home-based care programs and had raised $50 million.
West Virginia University Health System will spend $80 million to roll out Epic across Independence Health System (PA) facilities, which will become a part of WVU’s system next fall.
Avandra, which is developing a federated network for medical imaging and clinical data for pharma and AI innovation, acquires DatCard Systems, which offers DICOM distribution solutions, and Sorna Corporation, whose technology supports automated medical data distribution.
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Owensboro Health (KY) promotes Bridget Burshears, MD to CMIO.
Darrell Keeling, PhD, MBA (Parkview Health) joins Bronson Healthcare as CTO and VP of IT infrastructure and cybersecurity operations.
HealthEx promotes Jeremy Schwarz to chief commercial officer.
Queen Victoria Hospital NHS Foundation Trust launches Altera Digital Health’s Sunrise EHR.
Tampa General Hospital (FL) implements Hyro’s voice AI agents within its call center workflows.
In Kansas, Gove County Medical Center will transition to Meditech through a new affiliation with HaysMed.
The New York State Nurses Association accuses hospitals of deploying AI without their involvement, specifically the Sofiya AI assistant that is being used in Mount Sinai’s cardiac catheterization lab.
CGH Medical Center (IL) goes live on Epic.
KLAS finds that despite better access to external records due to EHR vendor improvements, clinicians remain frustrated because duplicate data, inconsistent formats, and weak mapping limit actionability. The report notes that more APIs do not translate to more data or value, and that mistrust among providers and payers is a bigger barrier to sharing than the technology itself.
House lawmakers pass the Hospital Inpatient Services Modernization Act, which if signed into law, would extend federal reimbursement for hospital-at-home programs through 2030. Funding for such programs was cut off during the federal government shutdown.
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Virtual care company MiCare Path announces new funding and the acquisition of Compwell, which offers care management and virtual assessment services.
Inside Inbound Health’s sudden shutdown
Hospital-at-home company Inbound Health, which was spun out of Allina Health three years ago, shuts down amidst regulatory uncertainty.
Aledade Secures $500 Million Credit Facility from Ares to Support Growth
Value-based primary care management company Aledade announces a $500 million credit facility to support its continued growth.
LA-based medical billing company to relocate HQ to CT, add 150 jobs; gets tax rebate deal
Gebbs Healthcare Solutions will relocate its headquarters to Connecticut and hire 150 additional employees over the next seven years.
It’s been a bumpy couple of weeks. I have spent more time than I generally prefer in the patient, family, and caregiver role.
I hate to say that I saw mostly the bad and the ugly of the processes I have encountered, with barely any of the good. A solution is available for each of these issues, but when organizations fail to see problems with their processes, it’s unlikely that patients will see any change.
The first situation I ran into was with an elderly family member who was having an upcoming procedure. I’m essentially her healthcare proxy and receive her written communications. I also manage her phone calls because of her hearing impairment.
I received a voice mail a week prior to her procedure. It said that they had sent a financial responsibility letter and just wanted to make sure that I received it. The message went on to say that if I had indeed received it and didn’t have any questions, I didn’t need to call the office.
Although I hadn’t seen the letter yet, I looked at my Informed Delivery digest from the US Postal Service and saw that it would be in that day’s mail. I read the letter and had no questions, so I did as instructed and didn’t call back. I thought that was the end of it.
I had received written materials about the procedure six weeks before it was scheduled. They stated that I would receive a pre-registration call three days before the procedure. The call arrived as scheduled, but I was seeing patients, so I called back as soon as possible. I then learned that the department manages pre-registrations only between 1:00 p.m. and 4:00 p.m. and was now closed.
I called back the next day at 1:00 p.m. I was given the option to leave a voice mail, which wasn’t going to work because I was again seeing patients. I dutifully hit 0 to speak to an operator, who told me that the nurses are “still tied up with today’s patients because we’re running behind” and to “call back in a half hour or so.”
I gave it a full hour just to be safe. I was directed to voice mail again and was asked to leave a number where I could be reached from 1:00 to 3:00 p.m. I did so and didn’t hear back, so I called back at 3:45 since I knew that they close at 4:00. I was told “If they don’t reach you, they will just do her pre-registration when she gets here. But that’s not ideal, so we really need a number where we can reach you and have you answer.”
I received a call at 4:15 p.m. I just about broke my ankle trying to answer it, only to find that it was the financial office calling to see if I had any questions about the financial letter since they hadn’t heard from me. I let them know that the original message said not to call unless I had questions. The representative acted like she had no idea why the original message contained that information.
By this point, my read on the procedure center was that they have zero respect for people who have work or life situations where they can’t just drop everything and take a phone call during a narrow window of time. Also, that they don’t have their act together in making sure that the messages they leave are accurate. It didn’t make me feel respected as a potential patient or a caregiver.
I wasn’t seeing patients the day before the procedure, so I called in at 1:30 p.m. and finally reached a nurse. She went down a list of questions asking for information that was already on the chart. None of the questions was a curveball or tricky, so all of them could have been managed through an electronic check-in via the patient portal or through a secure messaging platform.
The nurse then read me all the pre-procedure instructions that had been mailed. That explains why the registration process takes so long and why the nurses aren’t easily available when patients call in as instructed.
In addition, the nurse paused periodically during our conversation to say goodbye to people in the office who were leaving. That seems unprofessional.
On procedure day, we arrived to find that the guarantor name on the insurance that was correct in the pre-registration conversation was now wrong. The check-in person also failed to collect the patient co-pay, which meant having an elderly person with a walker get up and down a couple of times rather than just once. The check-in desk was tall and didn’t have the option for a patient to sit, which was also a negative in my book.
The nurse was trying to ask rooming questions while we were walking to the dressing room. That isn’t ideal for an elderly person who is hard of hearing and who is focused on using her walker. I had to ask the nurse to stop asking questions until we were in a situation where she could directly address the patient without distractions.
Fortunately, the procedure went without a hitch. I returned her to her home and another family member tagged in.
Meanwhile, the second situation found me waiting for my own important test results. Their arrival was dragging into the holiday weekend. Physicians don’t always make the best patients, We are as anxious as anyone when we’re waiting to learn what is going on with our health.
I had been waiting a couple of days when I received a text telling me that a message was available in the patient portal. I was driving at the time, so I psyched myself up as I returned home and woke up my laptop so I could learn my fate.
It was a blast message from the surgeon’s office to let me know their office hours for the Thanksgiving holiday. Also, to remind me to call 911 if I had an immediate medical emergency.
I initially questioned whether this is a limitation of the patient portal. A quick chat with one of my favorite experts reassured me that the practice isn’t using the tool as designed. They could have used other options to convey the information that wouldn’t potentially trigger the hundreds of patients who are awaiting pathology results.
I know the EHR leaders at the institution in question. I wonder if they are aware how various departments are using the available tools and how deviation from published best practices can have a negative impact on their patients. This is the same practice that failed to notify patients that the office had moved, which caused quite a bit of hardship for patients. This workflow adds insult to injury.
Does your organization consider patient preferences and impact when creating patient-facing workflows? Do you leverage patient and family advisors to help you review new features? Leave a comment or email me.
Email Dr. Jayne.
Best Buy (BBY) Q3 2026 Earnings Call Transcript
Best Buy blames Medicaid and Medicare Advantage payments for exiting Best Buy Health with a $192 million impairment charge.
Accelerating Science with Human+AI Review
NEJM AI tests a fast-track manuscript review process that involves both AI and humans.
RI Doctor Claims AI Medical Firm Fired Him After Raising Concerns About FDA and HIPAA Compliance
A Brown University Health doctor sues Sully.AI, claiming that the company failed to pay him and terminated him for warning about making unsupported claims about HIPAA and FDA compliance.
NSW’ $969m single digital patient record at risk of cost overruns
An auditor’s report finds that New South Wales left key costs out of its $650 million USD Epic project.
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Traditionally Professional Courtesy is something that physicians gave each other - but we had to be careful with it when…