Picture This: Improved Access, Exchange, and Use of Diagnostic Images
An ASTP/ONC RFI seeks input on image exchange for possible rulemaking.
Premise Health and Crossover Health sign an agreement to create one unified company
Premise Health and Crossover Health, which offer primary care and occupational health services, will merge.
A Tribute to A. Neil Pappalardo
Meditech founder, chairman, and former CEO Neil Pappalardo died Tuesday at 83.
Sword Health acquires Germany-based digital MSK and pulmonary care company Kaia Health for $285 million. Sword will sunset Kaia’s MSK product in the US in favor of its own platform.
Sword plans to raise $500 million in Q1 for expansion and acquisitions.
Reader donations funded the Donors Choose teacher grant request of Mr. S, who teaches high school in Greenwood, DE and asked for help buying chemistry lab supplies and learning tools. He reports, “My students and I were able to experience chemical reactions like never before with a hands on approach rather than watch a video of someone on the internet … This experience allowed me to see the spark for learning that my classroom has been missing. By me engaging the students in the classroom this one time might create the next great chemist or inventor, and for that I cannot thank you enough.”
Amazon will lay off 16,000 employees while “reducing layers, increasing ownership, and removing bureaucracy,” which translates to firing rank-and-filers because of an org chart that executives built, tolerated, and now blame. How about starting with the belatedly enlightened suits who created those layers and bureaucracy in the first place? Our industry is littered with “Now we get it” announcements in which so-called rightsizing that somehow always spares the people who did the wrongsizing. Pro tip: ignore anyone quoted in statements like these who has been with the company for two or more years and thus helped create the mess that we are now supposed to believe they have magically fixed by jettisoning worker bees. It is a useful reminder that feel-good Kumbaya capitalism about being a family and valuing associates is performative BS that is touted when times are good and then dumped emotionlessly when knee-jerk cost cutting is required to line the pockets of investors and executives.
Live Webinar: February 18 (Wednesday) 2 ET. “From Blind Spots to Insights: Gaining Real-Time Visibility into Healthcare Risk.” Sponsor: CloudWave. Presenters: Jacob Wheeler, MBA, director of sales engineering, CloudWave; Mike Donahue, chief operating officer, CloudWave. Resilience starts with the ability to see clearly, across every endpoint, cloud workload, user, and clinical system. Join CloudWave’s cybersecurity leaders for an in-depth session on how real-time visibility transforms your ability to detect threats early, respond decisively, and strengthen resilience across the care ecosystem. Attendees will learn the practical steps that hospitals can take to move from reactive defense to resilient action.
Publication: HIStalk’s Guide to ViVE 2026 lists the activities of sponsors at the conference.
Contact Lorre to have your resource listed.
Virtual OCD provider NOCD acquires trauma self-help platform vendor Rebound Health and renames itself to Noto.
Premise Health and Crossover Health, which offer primary care and occupational health services, will merge. Crossover was co-founded in 2010 by ED physician Scott Shreeve, MD, who had co-founded Medsphere and will remain with the merged organization.
An investment firm speculates that Oracle may undertake mass layoffs and sell its Oracle Health business unit to fund the $156 billion in capital that it needs to build data centers for OpenAi.
Woman’s Hospital hires Glynis Cowart, MPA (Montefiore St. Luke’s Cornwall) as SVP/CIO.
CloudWave promotes Brian Pruitt to CTO.
Clearwater announces the hiring of Davis Chaffin, MBA (Load One) as CFO and Krissy Safi, MBA (Protiviti) as SVP of consulting services, and the promotion of Dave Bailey, MBA to VP of consulting solutions and strategy.
Meditech founder, chairman, and former CEO Neil Pappalardo died Tuesday. He was 83. Pappalardo and four MIT-educated co-founders launched Meditech in 1969 to create hospital software using the MUMPS program language that he and fellow founder Curt Marble developed at Massachusetts General Hospital.
Humana’s healthcare services business CenterWell goes live on Athenahealth’s AthenaOne at 350 senior primary care locations in 15 states.
Virtual primary care and healthcare navigation company Included Health creates a health plan and provider network that it will offer to employers.
AEYE Health, which offers fully autonomous AI-based diabetic eye exams, integrates its product with Epic.
EMurmur earns FDA clearance for its telehealth-capable heart murmur detection software for digital stethoscopes. Companies can integrate the technology with their own software and hardware without requiring additional FDA clearance.
A UK study reports that use of Eko’s AI stethoscope failed to improve detection of heart failure, atrial fibrillation, or valvular heart disease in primary care as adoption fell steadily, with 40% of practices dropping it within a year despite its effectiveness because of workflow friction that was driven by poor EHR integration. The AI stethoscopes whose use physicians resisted increased detection of heart failure by 2.3 times, atrial fibrillation 3.5 times, and VHD 1.9 times.
The VA will spend $1 billion in FY2026 to maintain its EHRs and to prepare for implementing Oracle Health in new facilities.
ASTP/ONC posts an RFI that seeks public input on accessing and exchanging diagnostic images to inform possible rulemaking.
DataBreaches.net reports that “digital helper” AI care coordination vendor Lena Health stored audio recordings that contain patient information, most of it from Houston Methodist, on unsecured web servers. A security group that is working with law firms to coordinate a class action lawsuit summarizes:
Listening to these confused patients talking to Lena, this company’s “digital helper,” about their private medical issues is a deeply disturbing and uncanny experience. They repeatedly ask Lena what’s wrong with her, why she sounds so weird, but even worse somehow are the patients who do not seem to notice they are not speaking with a human. It is deeply dehumanizing, and profoundly depressing to hear these elderly people … discussing their most personal medical issues with what they think is a compassionate human coordinator, but is actually an LLM trained to extract information so a hospital can save a few pennies on hiring a real human.
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The Journal of the American Medical Association published a research letter this week that looks at how authors are disclosing their use of AI when preparing submissions to professional journals. The JAMA Network has required such disclosures since August 2023. The authors reviewed the data to better understand how AI is being used and disclosed.
Papers in which AI use was declared increased from 1.7% to 6%. Common uses were creating drafts, searching the literature, editing language, developing statistical models, and evaluating data. AI use was more likely in Viewpoints and Letters to the Editor submissions than in Original Investigations.
The paper concludes that without a standard for confirming AI use, it’s difficult to know if authors are underreporting. They add that the results may show a greater need for journals to confirm how authors are using AI and whether it’s appropriate and accurate.
Clinician burnout continues to be a major focus for care delivery and professional organizations. One of the top symptoms that I hear about from colleagues is their inability to disconnect in the digital age. Physicians feel that they need to check their inboxes for patient results and respond to portal messages during off hours to avoid having them piling up.
A new article in the Journal of Medical Systems describes a randomized controlled trial around Reducing Work-Related Screen-Time in Healthcare Workers During Leisure Time (REDUCE SCREEN). Researchers used a straightforward intervention to examine whether a link exists between clinician wellbeing and the use of work-related apps on personal devices. A cohort of 800 physicians, residents, and nurses was divided into a control group and one whose members were instructed to take specific steps to reduce after-hours work, such as using out-of-office notifications and removing work apps from personal devices.
They found that after a scheduled weekend off, those in the intervention group had double the reported reduction in stress compared to those who weren’t instructed to make changes in device use. The intervention group also had an overall reduction in screen time compared to the control group. The study was limited by the fact that one-third of participants failed to complete the post-weekend assessment.
The authors plan additional research to look at interventions that force disengagement from work during non-scheduled hours to see if they are linked not only to less stress, but to improved productivity during working hours.
From Home Care: “Re: AI solutions. My daughter’s college is working on AI solutions that could help individuals with cognitive decline live independently longer. This seems like a much better use of AI than some of the options currently out there.”
The article covers a project that brought computer scientists together with occupational therapists to create an AI assistant to help solve this problem. The team captured videos of patients with and without cognitive decline performing a specific task, then created models to identify cognitive sequencing errors during task completion. The system is cheekily named CHEF (Cognitive Human Error Detection Framework) as it looked at the executive functions needed to prepare oatmeal on a stove.
While a camera captured the subject’s movements, occupational therapy students also provided cues about safety concerns or other errors. The system’s vision-language model integrates videos along with text and images to identify both obvious errors and those that are difficult to detect. The team states, “This is an excellent example of applying the cutting-edge AI to a vital health problem with tremendous public health impact.”
As a family physician who has had many difficult conversations about aging patients who are struggling to remain independent, this is some of the most exciting AI-related work that I’ve seen in recent memory. I hope these types of solutions are a reality by the time I might need them.
HIMSS has announced that the keynote speaker for the upcoming meeting will be actor Jeremy Renner. The announcement promises “a thoughtful look at the intersection of determination, care, and innovation and the impact they can have when people come together in moments that matter most.” Those who register before Friday, January 30 have a chance to win an opportunity to meet him personally.
I did something that I haven’t done in a very long time today. I wrote a paper check to pay for a medical bill. The entire process was frustrating. I received a patient portal message that told me that I had a bill, but I wasn’t able to log in. I thought it was an expired password, but I could access the portal from a different link.
It turns out that the practice operates as two separate entities. They use the same EHR, but each practice has its own patient portal. Going back to the portal that I could access, I saw the billing statement with the header for the other entity.
Clicking the payment link took me to a “page not found” error, so I typed the link manually, with the same outcome. I repeated this process the next day, thinking that maybe it was a site outage, and had the same result.
I called the number on the bill. They told me that they can’t take payments over the phone, so I was off to find the checkbook. If providers want to be paid in a timely manner, they need to make sure that their systems are working to make it easy for patients to pay.
I received two separate mailings from that practice today. The first was a check, which I assume was mailed by their billing service, that refunded me for an overage for the patient co-insurance portion of a procedure that I had last month. The second was a letter from the practice of the physician who performed the procedure featuring red “Second Notice” stickers to remind me that I was overdue to have the procedure and that they would make no further attempts to schedule it. This right here is US healthcare at its finest.
The American Academy of Pediatrics released its own childhood vaccination schedule this week, breaking with the Centers for Disease Control and Prevention on vaccine guidance. States are also issuing their own guidance or joining coalitions to discuss common recommendations.
The EHR where I practice most often continues to display legacy recommendations, and I haven’t heard of any plans to update them. I’m not sure if that’s because the work to do so wasn’t slotted into the IT build budget or if facility leadership is making a statement. Some days it’s refreshing to be outside the circle of decision- making, after having done it for so long.
How is your organization approaching the task of updating vaccine recommendations in your EHR? Leave a comment or email me.
Email Dr. Jayne.
Cleveland Clinic to expand, modernize main campus, CEO says
Cleveland Clinic plans to expand and modernize its main campus in Ohio while it continues to enhance system-wide adoption of AI tools, sepsis-prediction software, workflow automation, virtual nursing, and EHR-integrated digital whiteboards.
VA to invest all-time high of nearly $5B to improve health care infrastructure
The VA plans to spend $1 billion in 2026 on the maintenance and modernization of its Oracle Health-based EHR, which will go live at 13 facilities this year.
Sword Health acquires Kaia Health expanding reach to 100M people
Digital musculoskeletal care provider Sword Health acquires German competitor Kaia Health in a $285 million deal.
Wisp Acquires TBD Health, Launching Enterprise and Hybrid Care Offerings
Women’s telehealth company Wisp acquires sexual health-focused provider TBD Health.
OpenAI introduces Prism, a free ChatGPT-based workplace for scientists to write and collaborate on research.
A Louisiana news site reports that LCMC Health has removed its patient consent disclosure stating that it uses Nabla for ambient documentation. The organization’s compliance department determined that patient consent is not required for other types of note-taking and therefore is not needed for an AI scribe. Louisiana law requires only one-party consent for audio recording, which in this case would be the provider.
Testing finds that the latest version of ChatGPT cites sources that were themselves generated by other AI tools, including Elon Musk’s AI-created encyclopedia Grokipedia, which has been accused of promoting right-wing narratives on controversial topics. Experts question whether AI tools can be trained to ignore AI-generated content that may be incorrect, leading to recursively less accurate information. When asked by a news outlet about a fabricated quote that was attributed to the site, an XAI spokesperson responded, “Legacy media lies.”
The Guardian warns that Google’s AI Overviews could pose a public health risk because they summarize search results that may be inaccurate or low quality. A study of health-related queries found that AI Overviews rely heavily on content from Google’s YouTube that anyone can upload. Experts caution that users may accept the summaries at face value, and that even when summarizing medical literature, the tool can’t assess the quality of research.
A Wolters Kluwer survey finds that 58% of nurses use generative AI in their personal lives and 46% at work. Nearly half believe that AI could reduce nurse burnout by automating documentation, triaging patient questions, and streamlining workflows, while 62% say that using AI for onboarding and training can get new nurses onto the floor faster. Most report that their organizations lack formal AI policies or training.
A small UCSD Health study finds that clinicians generally view Epic’s EHR-integrated LLM chart review tool as useful for summarizing patient records, even though it frequently misses relevant details and occasionally hallucinates, requiring careful human verification. The authors conclude that such tools can augment workflows, but are not reliable enough to be used without clinician oversight.
Researchers believe that agentic AI systems could help hospitals prepare for extreme climate events that fall outside of emergency planning assumptions.
A study finds that of the 42% of US hospitals that use Epic, 62% have implemented ambient documentation. Adoption was significantly higher in metropolitan and government-operated hospitals and much higher in non-profit versus for-profit hospitals.
ChatGPT Health gives the Washington Post’s technology columnist an F for cardiac health after analyzing a decade of his Apple Watch data, a conclusion that his physician and Eric Topol, MD, say is wrong. When he repeated the test with Anthropic’s Claude for Healthcare, it assigned a C, although both tools changed their grades when he repeated the same question. He also notes that his resting heart rate reports a significantly different number each time he upgrades his Apple Watch. Topol concludes that, “You’d think that they would come up with something much more sophisticated, aligned with the practice of medicine and the knowledge base in medicine. Not something like this. This is very disappointing.”
Mr. H, Lorre, Jenn, Dr. Jayne.
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Killing the Clipboard: Cloud Fax is the Bridge to Patient-Centric Data Access
By Bevey Miner
Bevey Miner is a healthcare strategist at eFax, a Consensus Cloud Solutions brand.
The Trump Administration’s renewed focus on interoperability has reignited the long-standing calls for healthcare to “Kill the Clipboard.” This movement aims to eliminate the administrative burden and data silos that are caused by paper-based processes, allowing for near-instant access to searchable, actionable patient information.
The industry broadly supports modernization efforts, with patient access at the forefront. But we need to ensure that this digital transformation doesn’t leave small, rural, and under-resourced communities behind.
The paper problem: why change takes time
We cannot wait for every provider to achieve a perfect, fully digital state before we start delivering on the promise of interoperability. Patients must have access to their data now, even if parts of the industry are still using clipboards and paper fax.
With the federal initiative to bolster near-instant patient access to their health records, along with real-time patient data accessible for providers to dramatically speed care coordination, paper records that are transmitted over outdated fax machines don’t support and often impede the ability to reach this goal. The administration is leaning heavily on data networks and vendors to streamline the transmission of information between healthcare providers while modernizing standards with FHIR APIs.
Conceptually, the future we are all working towards is faster data access, searchable and actionable information to improve care, and seamless communication between care teams. This idealized future state fails to account for the practical limitations that are facing many foundational healthcare organizations.
Twenty-nine percent of providers report that they lack the financial resources that are needed to deploy the advanced digital infrastructures that are required by today’s interoperability vision.
Many organizations, like rural and smaller post-acute care settings, are still playing catch-up since they were excluded from incentives that accompanied the HITECH act of 2009. While some of these organizations may have an EHR, it may be outdated and not certified. Additionally, it’s not uncommon to find others working with scrappier, home-grown solutions, or even resorting to paper-based and manual processes.
But while these smaller organizations might not have million-dollar EHR platforms, they do have paper fax. In order for healthcare organizations of all sizes to participate in the move to “Kill the Clipboard,” they are turning to digital cloud fax.
Cloud fax: healthcare’s guilty pleasure
A recent survey found that 46% of healthcare facilities still use paper fax to send and receive patient data. If the healthcare industry is so dedicated to moving past paper, why do these archaic systems persist?
The simple answer is that, while we are attempting to replace the paper fax machine with a structured data format like FHIR, we still need the next level of communication maturity: cloud fax. Once a fax becomes digital, additional data-sharing capabilities become possible.
Cloud fax offers all the benefits of paper fax and is much more efficient. It is particularly easy to use and can be fully integrated into other applications via APIs. For decades, it has served as the standard method for document and digital data transmission in healthcare because it checks many boxes. It meets HIPAA and HITRUST standards and is universally compatible with other systems that operate in silos.
Simply put, cloud fax is the most common and accessible form of send and receive communication in our industry. Calls to prevent its ubiquitous use demonstrate a fundamental unawareness of current operational realities and the power of digital transformation to modernize and integrate cloud fax, rather than simply eliminate it.
Send, receive, find: AI-powered digital cloud fax goes the extra mile
Digital cloud fax provides robust send and receive capabilities, but to meet the CMS definition of interoperability, “find” is another key component. To find information, the data must be discoverable. New AI capabilities are helping fax go the extra mile, transforming traditionally unstructured, static documents into structured, actionable insights using intelligent data extraction. This is critical to advancing interoperability since as much as 80% of healthcare data remains unstructured.
Innovations in machine learning and LLMs enable unstructured data from digital faxes, scanned images, TIFFs, and other PDFs to be extracted from nearly any type of health document, including intake content, claims, handwritten forms, and more, and place it directly into a structured system like an EHR or a payer workflow. When these AI tools are built on digital cloud fax platforms to start, they are already leveraging a technology that most healthcare organizations have in place. Implementation is significantly easier and less time-consuming than adding an entirely new system to an organization’s already overloaded and fragmented tech stack.
Delivering superior reliability and security, intelligent digital cloud fax acts as a connector between various types of data files and formats, sharing both structured and unstructured data between healthcare organizations that span various levels of digital sophistication.
Time to face the fax
For many healthcare organizations, digital cloud fax isn’t a roadblock, but an accelerator, enabling them to keep up with more tech-savvy counterparts without the heavy investment in rip and replace technology. It also supports the ongoing FHIR mandates and regulatory changes impacting providers at every level.
By recognizing digital cloud fax as a necessary part of day-to-day operations, as it is at most healthcare organizations, we can better understand how this tool can help us reach interoperability faster, while facilitating the digital transformation of as many organizations as possible.
Healthcare’s reliance on digital cloud fax should not be treated as a guilty secret. Instead, it’s an equalizer and an opportunity. Once we realize its full potential, interoperability initiatives will be more achievable and successful than ever.
Health Gorilla Releases Statement in Response to Epic Lawsuit
Health Gorilla says that the lawsuit that Epic Systems and several health systems filed against it contains unfounded allegations about the company’s role in data exchange.
Anthropic closes latest funding round above $10 billion and could go higher, sources say
Claude for Healthcare parent company Anthropic raises additional funding, with sources putting this latest round at between $10 billion and $15 billion.
Healthcare revenue optimization company Kodiak Solutions acquires Besler, which specializes in hospital revenue cycle consulting and technology.
NOCD Buys Rebound Health, Creates Parent Company Noto to Expand Specialty Behavioral Health Services
Virtual OCD treatment provider NOCD acquires virtual trauma therapy company Rebound Health.
Bloomberg reports that the valuation of prior authorization technology vendor Tandem Technology has reached $1 billion, with an anticipated $100 million in new funding.
Tandem founder and CEO Sahir Jaggi was previously a director at insurance company Oscar Health.
It’s that time of year when LinkedIn is flooded with graphics posted by proud show-uppers. The HIMSS ones are also piling up. I’m only slightly annoyed at pitches by scheduled presenters who are trying to drum up attendance, but just being in the convention center is not newsworthy. It won’t be long before the “influencers” start posting their mandatory ViVE-fawning posts (three before, three during, three after) to pay for their free badge and accompanying sense of self-importance.
Live Webinar: February 18 (Wednesday) 2 ET. “From Blind Spots to Insights: Gaining Real-Time Visibility into Healthcare Risk.” Sponsor: CloudWave. Presenters: Jacob Wheeler, MBA, director of sales engineering, CloudWave; Mike Donahue, chief operating officer, CloudWave. Resilience starts with the ability to see clearly, across every endpoint, cloud workload, user, and clinical system. Join CloudWave’s cybersecurity leaders for an in-depth session on how real-time visibility transforms your ability to detect threats early, respond decisively, and strengthen resilience across the care ecosystem. Attendees will learn the practical steps that hospitals can take to move from reactive defense to resilient action.
Publication: HIStalk’s Guide to ViVE 2026 lists the activities of sponsors at the conference.
Contact Lorre to have your resource listed.
HURC names Kevin Coloton, MPT, MBA (Reveleer) CEO.
Elissa Baker, RN (American Telemedicine Association) joins Nesa as president and chief clinical officer.
MedeAnalytics names David Figueredo (Experian) chief innovation officer.
Nicholas Testa, MD (CommonSpirit Health) joins Sentact as chief clinical officer.
Sevaro Health names Carl Dugart (Medically Home) CTO and Vineet Agrawal, MBA (DocSpera) head of growth.
Artera promotes Tom McIntyre, MS, MBA to president, Michael Jensen to CFO, Zach Wood, MBA to chief product and strategy officer, and Emily Coy to VP of communications and integrated marketing.
Dartmouth Health hires Randa Perkins, MD, MBA (Moffitt Cancer Center) as CHIO.
Qure.ai secures a multi-million dollar Gates Foundation grant to develop AI-powered point-of-care ultrasound tools that are aimed at detecting tuberculosis and pneumonia in low-resource settings. The project also includes building an open, multimodal data platform to support global lung health research and deployment at scale. The company’s products are being used by 4,800 sites in 105 countries.
Health Gorilla says that the lawsuit that Epic Systems and several health systems filed against it contains unfounded allegations about the company’s role in data exchange. Health Gorilla says that it suspended the disputed connections of some of its clients and accuses Epic of using litigation to stifle competition in interoperability. Health Gorilla says that it operates in conformance with all laws and requirements and accuses Epic of using litigation as a weapon so it can “monetize clinical data exchanges for their own benefit.” An Epic spokesperson provided this statement:
Health Gorilla enabled their customers to sell identifiable patient medical records to class-action law firms without patients’ consent or health systems’ knowledge. They had an obligation to protect patients’ intimate health information. Instead, they violated the privacy of hundreds of thousands of people. Epic and health systems together filed this lawsuit to hold Health Gorilla and other bad actors accountable and to stop further abuse and misuse of patients’ sensitive information.
Midwives at some NHS hospitals that use Epic are given the option to record the gender identity, sexual orientation, and pronouns of newborns, but according to a midwife quoted in The Times, lack a dedicated field to record biological sex in the same workflow. An executive of a sex rights charity criticized the configuration, saying, “The concept of babies having a gender identity is farcical, whereas a baby’s sex is essential medical information,” and argued that some trusts have prioritized ideological preferences over clinical clarity. A spokesperson for the One Devon Electronic Patient Record project says that any claims that Epic requires information about the gender identity or sexual orientation of newborns are incorrect, and the only mandatory entries are date of birth and legal sex. Epic has not publicly commented on the article.
The VA Office of Inspector General’s annual report lists information systems and innovation among the top five management and performance challenges facing the department, particularly highlighting its beleaguered EHR modernization efforts. The Oracle Health-based program will restart this April at four sites in Michigan.
The Connecticut College of Emergency Physicians develops a public dashboard that displays ER boarding trends across hospitals throughout the state to gain insight into ED overcrowding. State lawmakers passed a law in 2023 that requires hospitals to annually report their boarding data through 2029.
Nassau University Medical Center sues seven former executives, including its CIO, alleging that they received $1 million in improper payouts when they resigned in May and later refused to give the money back. Many of the hospital’s executives quit after the state took over the financially struggling hospital’s board. The hospital filed a $10 million lawsuit against the former hospital CEO who authorized the payouts. Her name is Meg Ryan, should you have a surplus of “When Harry Met Sally” Katz’s Delicatessen scene bon mots.
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AI-for-Prescriptions Startup Tandem Lands $1 Billion Valuation
Bloomberg reports that automated medication access startup Tandem Technology has achieved a $1 billion valuation with an anticipated $100 million in new funding.
Care coordination company Pair Team acquires competitor Town Square.
CT launches country’s first public dashboard to track and fix emergency room overcrowding
The Connecticut College of Emergency Physicians develops a public dashboard that displays emergency department boarding trends across hospitals throughout the state.
Significant portions of the US are experiencing arctic temperatures and significant snowfall this weekend. As the storm approached my area, I touched base with nursing staff at several hospitals to see how they were ensuring adequate staffing despite deteriorating road conditions.
They generally offered options for staff to sleep on campus, but approached the situation in drastically different ways. One hospital enticed nurses to sleep on campus to guarantee attendance, paid a retention bonus for the time between shifts, and provided meals Another sent a text message that was less than welcoming, treating those who planned to stay at the hospital as a burden by telling them to bring their own bed linens and towels. I’m betting that employee satisfaction differs between those facilities.
Speaking of things that didn’t resonate well during the storm, the marketing folks at Starbucks should reconsider their tactics during winter storms. While the National Weather Service was issuing advisories and our city and state public safety officials were urging people to stay off the roads, Starbucks was blowing up my phone with discount drink offers.
It seems like it would be easy to suppress those promotions in area codes where people shouldn’t be on the roads, whether they’re customers or employees. People who have storm-belt area codes might live elsewhere in the US, but I would guess that they are in the minority. Better yet, come up with a promo code that people can enable that becomes active in three or four days, when they start to tunnel out and are looking for a treat. My city is still focusing on clearing interstates and critical roads, so I will be staying put for a while.
We became skilled at pivoting to virtual meetings during the COVID pandemic, so I was surprised to see some meetings cancel off of my schedule even though they could have been held as web meetings or even as old-school conference calls. I could understand this for small organizations that might have let their virtual meeting subscriptions lapse, but these cancellations involve larger organizations that routinely have at least one or two people on video due to travel constraints.
Childcare issues could be at play due to school closures, but one of the only bright spots of the pandemic was getting to virtually meet the families and pets of my co-workers.
In last week’s Healthcare AI News, Mr. H mentioned the growing concerns that we are on the cusp of seeing AI-related malpractice lawsuits. Frankly, I’m surprised that we’re not already there, given how I see some of my colleagues using AI tools.
Quite a few knowledgeable clinicians, including clinical informaticists and AI researchers, understand the limits of AI. But large numbers of people are overly trusting of the content they see coming out of LLMs.
I’ve seen people cut and paste content containing obvious errors directly from a non-clinical AI tool into the EHR. I’ve also seen people operate wildly outside their scope of practice based on the ability to quickly access information that may or may not be accurate. Unfortunately, these are the situations where people don’t know what they don’t know, and LLMs can be extremely convincing even when they are wrong.
As an example, I recently saw a patient who was accompanied by a physician family member. The family member had a predetermined outcome that they wanted to achieve during the visit. They apparently thought that paying an $80 co-pay entitled them to see a physician who would suspend their professional knowledge and judgment and do the electronic equivalent of whipping out a prescription pad and ordering what they wanted.
I explained the clinical situation, the evidence-based recommendations, what I saw on the patient’s exam, what I had gathered from their history, and why I believed that the requested medication wasn’t appropriate in that scenario. The family member began arguing with me and was showing me his phone with his previous searches on the topic as a way to prove his point. Especially given that his specialty training wasn’t even close to the body system in question, he wasn’t aware that the articles being cited were only tangentially related to the diagnosis.
Fortunately, I’ve spent the last couple of decades working with patients who bring their internet research to the visit. I’m pretty good at educating while arriving at a plan of care that is mutually acceptable. However, I don’t have a lot of experience arguing with a peer who is putting blind trust in the output of a generative AI tool, so it was new territory.
I used my emergency department-mandated de-escalation training, so we managed to make it through the visit once one of the other family members in the room made the physician family member leave. With situations like this on the daily, it’s no wonder that clinicians have lost the joy in medicine. Having to argue with AI-generated errors when a patient’s health is at stake is something that none of us signed up for.
Mr. H also mentioned ECRI’s annual list of technology hazards, and I was gratified to see one of my soapbox issues in the number two position. “Unpreparedness for a ‘Digital Darkness’ Event” is a fancy way to say that an organization isn’t ready for an unplanned downtime. Maybe making it sound more exciting will convince people that they need to do something to get ready.
We should all know that cyberattacks are a “when” situation rather than an “if” these days, and that network or vendor outages are entirely possible. For clinicians who have always been dependent on the tools and safeguards that are built into the EHR, having to work without those can be frightening. It’s one thing to not have calculators or references at your disposal, but not being able to see the overall picture of what’s going on in the intensive care unit at full capacity is something else entirely.
Those of us who practiced in the olden days remember the large paper ICU progress notes that were the size of a poster board, but could fold up to fit in a standard medical chart. With just a glance, we could quickly figure out what was going on with a patient and formulate the best questions to ask during shift change.
The availability of electronic dashboards and monitoring suites has rewired those parts of my brain, but I bet that mental model is still in there somewhere and I could access it in a pinch. We need to remember that soon there will be more clinicians who have never seen that kind of paper documentation than those who have, and adjust our downtime preparations accordingly.
Are you prepared for a digital darkness event? Have you experienced any outages due to snowmageddon? Is your hospital treating staff who have to stay overnight in the facility like a blessing or a burden? Leave a comment or email me.
Email Dr. Jayne.
Engineering Prior Authorization for WISeR: Six Ways Providers Can Prepare for AI-Assisted Prior Authorization Under the WISeR Model
By Ryan Redman, JD
Ryan Redman, JD is product manager at Onspring.
The Wasteful and Inappropriate Service Reduction (WISeR) model introduces AI-assisted reviews into Medicare Fee-for-Service (FFS) prior authorization across six pilot states is now live, as of January 2026. That may expedite cost control, but it also raises high-stakes governance questions that are already being discussed in public debate.
Some critics have warned of an “AI death panel” dynamic in payer decisions, a fear that is now echoing into Medicare’s orbit as automation expands. For providers participating in original Medicare, the operating problem changes. Decisions must be made quickly, consistently, and defensibly, with evidence trails that withstand audits and appeals.
While the program is framed around reducing waste, it creates immediate governance, risk, and compliance challenges for providers who are deciding whether and how to submit services through the WISeR prior authorization pathway.
What changes most under WISeR is not clinical care, but the expectation that decisions are traceable, reviewable, and defensible as they move through provider ordering, scheduling, and revenue cycle workflows and into AI-assisted review on the payer side.
How should providers respond? The focus should be on preparing ordering, intake, and revenue cycle workflows first, then tuning for throughput.
Where the friction really is for providers
Before designing solutions, providers must understand where WISeR introduces operational and governance risk into existing workflows. Providers will still deliver care and submit claims, but WISeR introduces new intermediaries, AI technology vendors, between the provider and the Medicare Administrative Contractor.
With tech vendors now in the mix, incentives to curb waste cannot influence clinical judgment. Provider documentation and workflow controls must support medical necessity without introducing financial bias into clinical decision-making.
Teams will have to juggle prior authorization and pre-payment reviews. If a provider chooses not to submit a required prior authorization, the claim will be scrutinized pre-payment, delaying reimbursement by 45 days or more and potentially affecting cash flow. If prior authorization is skipped, post-service reviews can stall cash and increase appeals, so routing, timers, and evidence capture must be precise.
The baseline requirement: transparency is non-negotiable. Prior authorization status, approval and denial patterns, turnaround times, and appeals must be visible across provider clinical, scheduling, and revenue cycle teams, not in stitched spreadsheets, with human review and audit trails for any AI-assisted step.
Build a WISeR-ready architecture
With the friction points defined, the build becomes clearer. From a provider perspective, a WISeR-capable pipeline consists of six moving parts that function as a single system and support governance, risk monitoring, and compliance reporting.
Controls that make speed defensible
Role-based access should determine who can view PHI, who can finalize a determination, and who can modify provider-controlled workflow rules and documentation requirements. When those rules or configurations change, record who reviewed them and maintain a versioned history of the changes. Logs should be append-only and time-stamped, with retention aligned to records schedules. Controls should also prevent WISeR-targeted claims from being submitted without a prior authorization number on file.
Because AI-supported reviews occur on the WISeR technical vendor side, providers are not tuning models, but monitoring outcomes. Pattern and variance checks should run continuously, monitoring approval and denial rates by category and population slices, tracking overturns on appeal, and flagging outliers for the governance group. Provider compliance, legal, security, and operations teams should review findings together to protect both reimbursement and regulatory posture.
Proving it with metrics and turning plans into operations
Where providers use AI internally, such as limited adoption of AI-enabled claims review or denial prediction, those tools should be governed as part of existing clinical and revenue cycle controls rather than treated as core to the WISeR model itself.
Treat WISeR as an engineering problem: set up the core path, prove it on one service line, and then extend it with guardrails. Four phases keep providers moving without losing control.
WISeR raises the bar on speed, transparency, and defensibility. For providers, success depends on preparing workflows and documentation before claims are submitted. Done well, this approach protects reimbursement, limits disruption, and may support future eligibility for CMS “Gold Card” exemptions as performance is evaluated during the pilot, ensuring that provider organizations can participate in WISeR without unnecessary risk. Getting data, documentation, and workflows right now puts providers in a position to earn flexibility later.
Wolters Kluwer survey finds broad presence of unsanctioned AI tools in hospitals and health systems
A Wolters Kluwer Health survey finds that use of “shadow” AI is widespread in health systems, mostly by users who want to speed up workflows.
VA watchdog lists EHR modernization as a major management challenge
The VA Office of Inspector General’s annual report lists EHR modernization among the top five management and performance challenges facing the department.
Announcing our $4.4m Seed Round
Claim Health, which offers AI-powered revenue cycle solutions for home-based care, raises $4.4 million in seed funding.
Healthcare technology services vendor Healthcare Triangle will acquire Spain-based Teyame AI, which offers AI-powered contact center solutions, for a reported $50 million.
Epic and 63 health systems ask The Sequoia Project to centralize vetting and ongoing monitoring of organizations that exchange medical records via Carequality and TEFCA. The letter recommends the following changes:
Most poll respondents say that Kaiser Permanente’s affiliates, like many health systems, were playing the Medicare Advantage game within the rules as designed.
New poll to your right or here: How has your use of AI improved your job performance? You’ll see a “comments” link after voting, which you can click to tell us more about your answer. I’m especially curious about AI use that has increased your effectiveness by 50% or more, which is likely a unicorn but still worth asking.
If you are socked in by snow or ice, cheer yourself up with a photo of Ms. O’s kindergarten class in Hayward, CA working with the STEM magnetic building sets that were fully funded by reader donations to Donors Choose, along with matching funds from my Anonymous Vendor Executive and outside groups. She reports, “This project has been so important because giving students a strong foundation in math and literacy in their first year of school makes a big difference by giving them a good start in their academic careers.”
Live Webinar: February 18 (Wednesday) 2 ET. “From Blind Spots to Insights: Gaining Real-Time Visibility into Healthcare Risk.” Sponsor: CloudWave. Presenters: Jacob Wheeler, MBA, director of sales engineering, CloudWave; Mike Donahue, chief operating officer, CloudWave. Resilience starts with the ability to see clearly, across every endpoint, cloud workload, user, and clinical system. Join CloudWave’s cybersecurity leaders for an in-depth session on how real-time visibility transforms your ability to detect threats early, respond decisively, and strengthen resilience across the care ecosystem. Attendees will learn the practical steps that hospitals can take to move from reactive defense to resilient action.
Publication: HIStalk’s Guide to ViVE 2026 lists the activities of sponsors at the conference.
Contact Lorre to have your resource listed.
Medical records and coding vendor Rapid Care acquires DeepDoc, whose AI-driven system summarizes unstructured medical records for law firms and insurers.
Healthcare technology services vendor Healthcare Triangle will acquire Spain-based Teyame AI, which offers AI-powered contact center solutions, for a reported $50 million. HCTI shares have lost 99.9% over the past 12 months, valuing the company at $3 million.
CTG promotes Tom Niehaus to CEO.
State-owned UNC Health will acquire independently operated UNC Campus Health Services, likely moving Campus Health from EClinicalWorks to Epic.
A Wolters Kluwer Health survey finds that use of “shadow” AI is widespread in health systems, mostly by users who want to speed up workflows. Half of the respondents say they frequently use AI tools or rely on them for their work.
Mark Cuban warns that insurers will find new ways to make money as their pharmacy benefit management companies, the top three of which fill 80% of US prescriptions, come under increasing scrutiny.
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Rapid Care Acquires DeepDoc to Expand AI-Powered Medical Record Intelligence
Clinical documentation, records review, and revenue cycle management company Rapid Care acquires DeepDoc, which offers AI-powered medical record insights and summaries.
UNC Health-Campus Health merger holds potential for efficient care, leaves employees with questions
UNC Campus Health Services will likely transition from EClinicalWorks to Epic when it merges with UNC Health this fall.
Slingshot pulls therapy chatbot Ash out of UK over regulatory concerns
In England, Slingshot AI takes its therapy chatbot down over uncertainty about its compliance with medical device regulations.
ECRI publishes its “Top 10 Health Technology Hazards for 2026,” with misuse of chatbots topping the list.
ECRI says that unregulated chatbots give users expert-sounding responses, but have offered incorrect diagnoses, recommended unnecessary tests, promoted questionable supplies, and based answers on body parts they made up.
Companies exhibiting at ViVE and/or HIMSS, you are about to spend a small fortune on a well-lit, carpeted rectangle that you will occupy for a few exhausting hours while handing out geegaws. For a tiny fraction of that spend, you can claim a different rectangle, this one virtual and this one lasting 365 days, on HIStalk. It is read obsessively by the people who buy, influence, complain about, and occasionally approve health IT purchases. Black Book Research, in a health tech media analysis that found this amateurish and cynical site to be #1 for industry trust and influence, puts it this way: “HIStalk stands out for its influence, independence, and continued relevance to the decision-makers shaping the future of health IT.” Contact Lorre, who has a soft spot for new sponsors that sometimes leads her to offer perks that she glosses over when telling me.
Listening: Porcupine Tree, a 40-year-old English progressive rock band whose “In Absentia” popped up at me.
Live Webinar: February 18 (Wednesday) 2 ET. “From Blind Spots to Insights: Gaining Real-Time Visibility into Healthcare Risk.” Sponsor: CloudWave. Presenters: Jacob Wheeler, MBA, director of sales engineering, CloudWave; Mike Donahue, chief operating officer, CloudWave. Resilience starts with the ability to see clearly, across every endpoint, cloud workload, user, and clinical system. Join CloudWave’s cybersecurity leaders for an in-depth session on how real-time visibility transforms your ability to detect threats early, respond decisively, and strengthen resilience across the care ecosystem. Attendees will learn the practical steps that hospitals can take to move from reactive defense to resilient action.
Publication: HIStalk’s Guide to ViVE 2026 lists the activities of sponsors at the conference.
Contact Lorre to have your resource listed.
Harmony Healthcare IT acquires Meditech solutions provider Blue Elm.
OpenEvidence confirms earlier reports that it recently raised $250 million in a Series D funding round that values the company at $12 billion. The company says that physicians used its system to treat 100 million patients last year and requested 18 million clinical consultations in December 2025 alone.
Health data management platform vendor Health Chain names Eric Rosow, MS (Conduce Health) as CEO and Reed Perry, MBA (Availity) as chief commercial officer.
Valerie Mondelli, RPh, MBA (Iodine Software) joins DrFirst as chief commercial officer.
VectorCare launches Smart on FHIR as a Service, which incudes a no-code workflow builder and developer tools for building and deploying EHR-embedded applications.
The Washington Post covers Epic’s lawsuit that alleges that Health Gorilla knowingly provided treatment access to patient records by law firms that were looking for malpractice plaintiffs.
In England, Slingshot AI takes its therapy chatbot down over uncertainty about its compliance with medical device regulations. The company launched the therapy bot Ash in mid-2025.
The federal government’s Health Information Technology Advisory Committee (HITAC) will resume its meetings on February 19 following a year-long hiatus that was imposed by the White House. Both co-chairs of HITAC, which advises ASTP/ONC, resigned last week. The committee is scheduled to meet four times in 2026.
Epic files an answer to a Texas lawsuit that alleges that the company is a monopoly and violates Texas laws by blocking parents’ access to their child’s Epic medical records. In its response:
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The American Board of Preventive Medicine is notifying candidates that they have successfully passed the Clinical Informatics board certification exam. The certifications are retroactive to January 1, 2026. Congratulations to all the new Diplomates, and welcome to yet another continuing certification process that will have you asking yourself why you decided to become double-boarded.
From Straight A Student: “Re: online registration form for a training course that I completed recently. Prompts were in a ‘are there any’ format that asked about mobility restrictions or food allergies. A dropdown choice list appeared to be pre-populated with ‘none.’ My answer was ‘none’ for all of them, so I tried to just submit the form, which popped me back to the top with no feedback. The course vendor responded to my help desk ticket to say that the dropdown requires choosing ‘none’ and people miss that all the time.”
These sorts of Process Improvement 101 issues drive end users batty. The time wasted by users and the help desk adds up.
I wonder if user acceptance testing was done, since it should have been caught. Sometimes teams give the users detailed testing instructions outside of the application, such as “click here, then choose that,” which makes it impossible to determine how they will interact with the workflow. I also wonder if they are analyzing call volume to to identify ongoing issues. Then, has the help desk team reported the issue to development and asked for an update?
It feels like it would be more efficient to change the default to “please select from the list” or “choose a response.” Or, to add a page instruction telling users what to do.
I have been in countless conversations about the safety of healthcare AI solutions. I’m always interested in how the risks and benefits are portrayed to patients and other non-clinical, non-tech individuals. Mr. H mentioned a preliminary report by the VA Office of Inspector General that found that the Veterans Health Administration had some gaps in AI chatbot oversight. The story was also picked up by military-focused Task & Purpose, which ran its own version.
Risks that were highlighted for the general audience included “producing misinformation, privacy violations, and bias, and that the systems had been put in place without review by the VA’s own patient safety experts.” I didn’t see mention of concerns that were noted by other publications, such as whether lags exist in providing current information for the LLMs to use.
An article commenter shared their physician assistant’s thoughts that “the AI is egregiously wrong 90% of the time, so he doesn’t bother with it.” Based on my own experiences with clinical-focused and consumer-focused AI solutions, that’s probably a significant exaggeration. I wonder if the user would benefit from additional education on prompt construction or effective use of AI tools.
The VA providers who I’ve talked to locally are happy with the AI solutions that are available to them. They are looking forward to continued expansion of their capabilities, such as helping craft more readable medical information for patients. If you’re a VA user, feel free to chime in. We can keep your comments anonymous.
I’m still in my New Year’s inbox cleanup extravaganza, and found an article about Hackensack Meridian Health’s canine-powered cancer detection program. The health system partnered with startup SpotitEarly for a clinical trial that examines the ability of trained dogs to detect cancer via patients’ breath samples. The goal is to validate the technique as a noninvasive cancer detection approach that might be more attractive to patients who are unwilling or unable to complete traditional screening recommendations.
The test is conducted by having patients breathe into a mask-like device for several minutes, followed by the dogs sniffing the devices. The dogs are trained to recognize odor signatures in the exhaled volatile organic compounds that can be associated with cancer. The dogs indicate detection by sitting next to a sample.
We know AI has to be involved somehow, and indeed it is. The company is using AI tools to document and analyze the behaviors of the dogs based on behavioral and physiological data.
SpotitEarly has been in the US market since May 2025, although it was founded in 2020. Previous studies of the technique found that the test was 94% accurate for detecting lung, colorectal, breast, and prostate cancers. If any readers are involved in the study, I’d love to hear about the “best boys” and “good girls” that are doing the sniffing and whether they prefer belly scratches or having their ears rubbed. My medical school had some public-facing research animals and they were the most amazing companions when they retired, resulting in a years-long waitlist for adoption opportunities.
Based on some of the other email traffic in my inbox, quite a few physicians made a New Year’s resolution to look for different employment. Several of them seem to think that informatics is something that you can just jump into because you are “techy” without any formal training or experience.
Some startups will hire clinicians in this situation, but I always encourage people to consider formal coursework to better understand the informatics landscape. I’m a big fan of the courses offered by the American Medical Informatics Association. The virtual courses are convenient, and the in-person ones are great for networking with colleagues working in the field.
A number of highly qualified clinical informatics physicians have recently been displaced from EHR vendors and health systems, so it seems that as long as mergers continue, the job market will remain challenging.
Are you looking to make a career change in 2026, and if so, how are you approaching it? Leave a comment or email me.
Email Dr. Jayne.
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In fairness to the person on the thread the other day: Now THIS is politics on the blog. :)