TTA’s August Ice Cream Run 2: Oracle talks layoffs (again) and VA extends EHRM contract; OpenAI sued for ‘doctoring’; big vendor data breach; med drone delivery; and a tart take on AI Copy Slop

August 14, 2026 | by | No Comments

14-17 August 2026

Still in the ‘dog days’ of August weather, despite the back to school and Halloween (!) stuff in the stores. We should enjoy our last days of ‘traditional’ summer (versus ‘local’ or ‘smart’ summer) but the merchers won’t let us. In other news, there was a lot of news around Oracle Health this week, from pending layoffs to the VA extending its contract to 2031. We also have our (likely first, but not last) lawsuit claiming OpenAI doctoring harmed a ‘patient’, meds and supplies delivered by drone, a big vendor data breach, affordable hearing assistance, and yet another likely spinoff. And on the hot subject of AI writing and AI Copy Slop, your Editor has more than a few thoughts after reading an excellent article by Alys Denby. Grab the cuppa for this one. Or you’ll faint like Pepper!

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

Why Readers can be assured that TTA is 100% Written by Humans

News potpourri: OpenAI sued for practicing unlicensed medicine”, Cleveland Clinic med drone delivery, Solventum separates out health info systems, Unlimited Technology RCM in 3.8M data breach, Samsung Galaxy Buds FDA cleared for hearing assist

VA moves to secure Oracle for its EHR Modernization through mid-2031 (More reasons beyond the obvious)

Breaking report: Oracle drawing up plans to lay off employees in “double digit percentages” by 1 September

Last week’s headlines

News roundup #2: Function Health’s jumbo $450M raise from General Catalyst, Hinge Health’s $105M Cylinder buy, and Throne Science’s $10M Series A

News roundup #1: AI governance ‘in’ with Feds, ATA; Centene’s shrinking but more profitable future; repositions and partnerships for DispatchHealth, WHOOP; Te Whatu Ora Health New Zealand modernization

Recent Headlines and Must Reads

Chutes & Ladders, Oracle Edition: Surprise! Project Jupiter data center build overages, “social costs” multiply. Pentagon inks $7B, 10 year deal for software.

Catching up to Masimo’s ‘unfinished’ business: Danaher completes $9.9B acquisition of Masimo. $634 million damages from Apple upheld, but Kiani lawsuits continue

This week’s Must Read: the dangerous financing of AI data center buildouts–and how they resemble the 2020 health tech boom (Remember the SPAC boom that cracked and left nearly all companies and billions in the dust?)

A gloomy view on Oracle going forward: debt, cash flow, and dependence on OpenAI

Vinegary Must Reads This Week: Silicon Valley’s ‘Cargo Culture’; the clinical query tool explosion between OpenEvidence and general AI

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Support not only a publication but also a well-informed international community.

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Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Why Readers can be assured that TTA is 100% Written by Humans

August 13, 2026 | by | No Comments

Most of you will assume that by the selectivity, the sheer dogged opinionatedness that you find here, with occasional rashes of sarcasm, it would be one heck of a bot writing this.

Unfortunately for my free time, that bot hasn’t been created yet.

So here’s my personal Eight-Point Writers Guide to How You Know TTA‘s Not AI Authored.

  1. Selectivity. I write extensively on topics that intrigue me and hopefully intrigue you. I give more emphasis to companies that have a) breakthroughs, b) deserve attention for a variety of reasons, c) by their business move markets, d) fit into a trend that I’ve spotted.
  2. If it’s lifted from a press release or another article, it generally is closely paraphrased with ‘according to’ or put into quotes. That used to be taught in writing courses.
  3. I do try to connect dots I see. Yes, I get it wrong, sometimes. But I don’t go into outer space, where AI goes.
  4. A tendency to be Cassandra. I’m too cynical to be a cheerleader anymore, having been a part of the Hype Curve of Health Tech from 2006. Also, Doom frankly makes for a good lede. Part of my desire to write here is to warn busy people in health tech of the many Scylla and Charybdis that populate healthcare and health tech today*. 
  5. The occasional busted grammar and misspelling. I do use tools that flag obvious misspellings. I’ve found Grammarly useful but intrusive, trying to flag and rewrite, sell me on paid, and turned it off as a result. Some of this comes out of re-editing what I wrote at 11pm the previous night. I try to clean up my obvious messes, subject-object agreement, and fractured phrases. 
  6. Since I’m American (if being from NJ counts), I write in American English, such that it is. I like certain British turns of phrase, though I don’t use ‘redundancies’ when people are laid off or fired. When I was writing my thesis for my university London Semester Way Back When, my advising professor** instructed me, when I asked the question, to stick to American English and to note source material quoted from UK sources. I also worked with many Brits, Irish, and Australians in my travel industry years (as well as Editor Emeritus Steve here), so some of it rubbed off.
  7. Real anecdotes that have an eventual point. If you see the occasional red MD-80 or 737-300 on these pages, I’m hearkening to my three-plus year  ‘graduate school’ as ad manager of New York Air. The ‘wild west’ of airline deregulation, the airlines that started up in that time, the larger than life founders, including their involvement with government regulation, have many lessons to teach to the founders of the new ‘wild west’ of AI companies as well as those attempting to serve or buy from them. Most of us in healthcare lived through other boom/busts: Dot.Com, the Hype Cycle of early telehealth and health tech, and the barely-past-us Crazy Covid Telehealth Money. Not learning from what we lived through leads to mistakes in the business present. Lord Acton phrased it better, though.
  8. AI Slop has no sense of humor. Even painful humor.

Now what got me all cranked up here was a far more succinct view of AI Slop Writing, sent to me by Editor Emeritus and Founder of this website, Steve Hards. An editor’s guide to spotting AI writing by Alys Denby is published on her Substack/website, CapX. We are drowning in it, especially if you like to hang out on YouTube for airliner/ATC and history videos. Her guide is simple, easy to follow…and once you see it,  it’s hard to unsee. Key points she brings out: rhythm, e.g. too even paragraph length; the overuse of short sentences; repetitiveness; too much passive tense; ambivalent constructions; ‘not this but this’ negative parallelism; too many transitional phrases; and a certain hollowness -‘banal generalizations’. I’d sum it up as the feeling that you’ve just read cotton candy.

Detection tools you can use: GPTZero, Pangram, and even Grammarly (paid). Just a few, not a recommendation. And yes, they are AI too. Kind of like white hat/black hat in cybersecurity.

Most of all, you can read and support authors who write their stuff in both news media and for your company. The use of AI for research is now common, but what’s essential is using the same critical review you’d use in any other research.

  • Use Real Human Writers for your company materials. Use real marketers for your planning who listen to sales and your customers. They can use AI to research, refine, and streamline production. Like any other tool.
  • Limit the amount of AI Slop Writing you use on social media. It’s filler. Cotton candy. It doesn’t present you well.
  • And use Real Graphics Designed by Real Graphic Designers.

And remember….even Pepper fainted from the stress! 

*Scylla and Charybdis are the mythological (?) monsters guarding the Strait of Messina between Sicily and Italy. Appropriate as my maternal ancestors were from that part of Sicily.

**Sir Patrick Duffy, Labour MP, Sheffield Attercliffe, Royal Navy veteran WWII, Brexiteer, RIP aged 105 in January. Had I but known.  Guardian obit

News potpourri: OpenAI sued for practicing unlicensed medicine”, Cleveland Clinic med drone delivery, Solventum separates out health info systems, Unlimited Technology RCM in 3.8M data breach, Samsung Galaxy Buds FDA cleared for hearing assist

August 13, 2026 | by | No Comments

OpenAI sued for ChatGPT “practicing medicine without a license” after “inaccurate medical guidance”–and may be the first of its type. The lawsuit filed in Superior Court of California, San Francisco, by pastor Scott Winters, claims that ChatGPT information served to the Florida pastor caused him to delay care for what turned out to be a pulmonary embolism. His filing claims that he was “brought to the brink of death” by ChatGPT’s information that mimicked a pastoral language style and minimized the importance of his symptoms, discouraging his seeking medical care. The account in Becker’s is distressing, with claims such as that ChatGPT told Pastor Winters that “early signs of his health problems were “not something dangerous” and discouraged him from seeking medical care, urging him instead to trust that “God did not design your body to endlessly fail.” After confining himself to a recliner and suffering recurring symptoms such as groin pain and dizzy spells over June and July 2025, he suffered a “massive pulmonary embolism due to multiple blood clots in both of his lungs that brought him to the brink of death, one that his doctors stated was likely brought on because of his immobility”. The lawsuit charges both OpenAI and CEO Sam Altman with negligence, unlicensed practice of medicine, defective product design and other claims. It seeks financial damages and for the court to compel OpenAI to implement “reasonable safeguards that protect other users from harm”. Pastor Winter is represented by Tech Justice Law and the Social Media Victims Law Center. BBC News

Cleveland Clinic premiers medication drone delivery with the promise of more. The catch for now is that the Zipline drones only operate for now within a five-mile radius of Cleveland Clinic’s Beachwood Administrative Campus and for patients already utilizing home delivery for select medications, excluding controlled substances. According to their Facebook post, “the drones use an innovative delivery method and do not land in patients’ yards. When a prescription is ready, a Cleveland Clinic pharmacy technician will place the package into a secure drop box. The electric drone then autonomously retrieves the order, and flies to its destination. Upon arrival, the drone stays up to 300 feet in the air while a pod containing the package descends to the ground on a tether.” This Editor wonders if the operator or the drone calls ahead to be on the lookout; these drones fly up to 70 mph! If successful, Cleveland Clinic plans to expand the drone delivery to other locations and for other items such as other medications, lab samples, medically tailored meals and supplies. Other healthcare organizations have been experimenting with drone delivery, such as Zipline with Walmart in Dallas-Fort Worth since 2020 for over-the-counter and select pharmacy products. Advocate Health next year will use Zipline for prescriptions, lab tests and medical supplies in Charlotte, North Carolina, then Chicago and Milwaukee. Zipline’s most interesting use of drone delivery will be a $150 million program in conjunction with the US State Department for delivery of blood and medical supplies to as many as 15,000 health facilities across African nations, including Côte d’Ivoire, Ghana, Kenya, Nigeria and Rwanda (State Department release). Healthcare IT News

Solventum to separate its health information systems business from their medtech. This is positioned as a concentration on their medical-surgical and dental solutions business. HIS generates about $1.4 billion in sales, including an ongoing contract with the Department of War for their MHS GENESIS clinical documentation and coding, a relationship that will end in July 2027 as functions are assumed by the Defense Health Agency [TTA 19 June]. The release does not give divorce details and there is a ton of ‘strategic’ boilerplate designed for investors. Apparently multiple alternatives are being evaluated with expected completion within 12 to 18 months. It concludes with “No decision has been made regarding the ultimate structure or timing of any potential transaction, and there can be no assurance that a separation will occur.” Puzzling.

Solventum was spun off from 3M in 2024 as a public company traded on the NYSE. 3M shareholders received one Solventum share for every four 3M shares.

Revenue cycle and financial management Federal/enterprise provider Unlimited Technology feels the unlimited sting of a hack. In the second largest healthcare breach reported this year, 3.8 million records were breached by an unauthorized user via a network server between 5-10 October 2025, according to a report on Health and Human Services (HHS)’s HIPAA Cases Currently Under Investigation page. According to a class action law firm release in July, UT’s breached records had the full gamut of PII, including names, Social Security numbers, dates of birth, email and mailing addresses, phone numbers, demographic information, and scanned documents such as copies of driver’s licenses or other government identification, insurance cards, and intake forms. PHI may potentially include insurance policy numbers, claims and benefits information, medical record numbers, dates of service, and diagnosis information. UT has no statement on its website other than confirming it was ransomware, nor has it identified any perpetrators. Affected patients were notified starting last month and offered identity monitoring services through Kroll.

Vendor breaches are on the rise. HHS has proposed tightening the HIPAA Security Rule’s requirements for vendor oversight, though that has not been done yet. And vendors like UT aren’t small. Per their website, UT serves US specialty healthcare providers in 4,500 clinics and 6,500 specialty healthcare providers, processing more than $70 billion in net healthcare charges annually.  Bleeping Computer, MedCityNews

Another affordable approach for assisting those with mild to moderate hearing loss via Samsung. Their Galaxy Buds Pro in-ear device just received FDA clearance for its Galaxy Buds Hearing Aid feature. The app is considered to be an over-the-counter (OTC) hearing aid functioning in conjunction with Galaxy Buds3 Pro and Galaxy Buds4 Pro. Users with the Buds must use them to do a self-assessment of their hearing via the Hearing Test feature. It uses pure-tone audiometry to assess hearing deficits, whether the user requires assistance and at what level. The Galaxy Buds Pro models run about $250 retail and the Hearing Aid feature debuts Q4 in the US.  Mobihealthnews

VA moves to secure Oracle for its EHR Modernization through mid-2031

August 12, 2026 | by | No Comments

It’s an extension that likely has a very good and smart reason behind it. This short article in a specialized Federal services publication, OrangeSlices PBC (public benefit corporation), that broke the story early AM today (12 Aug), has a few tidbits that anyone who is following the VA’s EHRM will find of interest. 

The first is the three-year extension of the current VA contract 36C10B18D5000, the Electronic Health Record Modernization Indefinite-Delivery/Indefinite-Quantity (IDIQ) contract with Oracle Health Government Services, the successor to Cerner Government Services. The proposed Modification P00008 to the IDIQ contract adds another three one-year optional periods, taking the duration out to May 2031.

Some history is in order here.

  • The contract originally had a base period of 10 years starting in May 2018 with a value of $10 billion, later revised upwards to $16 billion.
  • It was rewritten and renegotiated in early 2023 after the failure of the initial five-location rollout. The ten-year base period was halved to five years, ending in 2023, with a renewal instead of five successive one-year optional ordering periods ending in May 2028.
  • This renewal took place only after much debate, a hail of flak from both the House and Senate Veterans Affairs’ full committees and tech subcommittees, and calls to dump Oracle and start all over again. The contract redo was designed to bring Oracle to heel.  It subjected both Oracle and the VA to lengthy accountability metrics that culminated in multiple modifications and testing. [TTA 18 May 2023]
  • The EHRM rollout was radically modified by geography to VA Health Centers mostly within the same VA region, or VISN, then with additional implementations every two months. The rollout resumed in April 2026, with five more locations added in August and October to complete 13 for 2026 and another 27 in 2027. [TTA 8 Feb and the updated VA rollout schedule]

The three-year extension brings the contract to the projected final VA rollout and conclusion in 2031. According to the article, 36 sites are scheduled to go live between August 2026 and January 2028. Subtracting 2026 (5) and 2027 (27), that leaves four in 2028 before the contract’s original expiration. There are at least another 120 to be covered within VA’s existing VISNs.

The contract modification has an anticipated award date of on or about 17 August 2026. SAM.gov (published Tuesday 11 Aug)

The second is why this three-year extension is a very smart move on the VA EHRM team’s part.

  • The obvious one is that the VA EHRM rollout requires another three years from 2028 to 2031 to fully cover all locations. Apparently all is going smoothly but releasing the main single-source contractor three years prior to its finalization is not an intelligent move.
  • The other is protection. Now you won’t read this elsewhere. Since the late winter, Oracle was rumored to be interested in selling, wholly or in part, Oracle Health AI (OHAI). Oracle Health sale rumors were confirmed this summer. In the event of a sale, the buyer would be obligated to honor the VA contracts and its terms.
  • The other possibility is if something truly awful happens to Oracle as a result of their AI landlord strategy, such as bankruptcy, the VA has some contractual protection in a Federal court. 

Whether Oracle can even sell OHAI is an open question. But for VA to tighten the contract to confirm an obligation to continue the VA EHRM to the end (or near end) is commendably businesslike–to not leave the VA and our veterans who served in the lurch with their medical records, scheduling, research, and much more. That would be unacceptable.

Update: Just posted in NextGov/FCW and FedScoop. The last notes that the House-passed fiscal 2027 Military Construction and Veterans Affairs appropriations bill would give $3.4 million for EHRM.

Breaking report: Oracle drawing up plans to lay off employees in “double digit percentages” by 1 September

August 12, 2026 | by | No Comments

30,000 global layoffs (18%) in March were evidently not enough. Oracle’s transformation into an AI infrastructure landlord with the corresponding debt (closing FY26 at $100 billion, projected by an analyst to exceed $120 billion in their FY27) is coming at a huge cost. This afternoon (US Eastern Time), Business Insider broke the news that Oracle is planning another significant round of layoffs to reduce payrolls by 1 September. 

FTA: “The cuts could reach double-digit percentages on some teams, according to the document. The company has requested managers provide lists of affected employees, with the intention of reducing payroll by the time the second quarter begins on Sept. 1, according to one of the people with direct knowledge.” Note: the Oracle FY27 began on 1 June 2026, thus Q2 27 starts on 1 September.

The Business Insider writer claims to have seen an internal document confirming this. Considering that today is 12 August, there is not much time between now and 1 September. Oracle currently has around 141,000 employees. If there were, for instance, a 10% (double digit) overall layoff, that would be 14,000 people. No hard numbers are included in the BI article.

The BI article does not have information on whether this will affect only the US, North America, or global Oracle sites. The last round of layoffs were global in scope.  Oracle ran into expensive buzzsaws in countries such as Germany; many European countries have layoff notice and benefit requirements. In the last layoff, India was hard hit.

The scuttlebutt on The Layoff rumor board has other tidbits that may be true or sheer speculation:

  • The actual date may be 15 September. But historically Oracle layoffs happen around Labor Day (US 7 September). (Ed.–It could be both!)
  • Managers are preparing lists for upcoming layoffs. One poster scores his or her part time remote manager who remained after the last layoff round.
  • Nothing is showing up in Federal/state WARN notices yet. However, WARN does not cover remote, dispersed employees nor offshore employees.
  • There are about $300 million in restructuring costs included in the FY 27 SEC 10-K filing. This is a comparatively low amount that has to cover earlier layoff costs, which may indicate that this upcoming layoff will be lower than March’s.

The money continues to flow out, not in. Oracle’s high-profile data center buildouts, notably Project Jupiter, are being hit with increasing “social costs”. Despite initial permitting, local groups have been successful in mobilizing for changes. Redesigns in cooling and power draw are expensive. Data center locations and builds are one of the few US issues that cross political lines [TTA 29 July]. Unlike Microsoft, Oracle no longer has the cushion of free cash flow to pay the bills. Oracle also has crushing performance obligations to meet with OpenAI and Meta [TTA 16 July].

What’s the healthcare impact, other than AI?  For the business segments in the former Cerner, now is Oracle Health AI, the news has been dismal–and concerning to entities such as the Federal Government.

  • The Oracle EHR, bought in the palmy days of June 2022 for $28 billion, is now down to a ‘sloppy second’ versus Epic in the acute care (20%) and the health system (27%) segments. The EHR is not prospering as an alternative, as much as many in healthcare don’t care for Epic.
  • There is no one reportedly lining up to buy OHAI. In June, London-based investors Nelson Advisors confirmed the rumors that the division was up for sale. The ‘usual suspects’ all have regulatory and competitive road blocks. The alternative may be private equity purchase or investment, including the Federal Government. PE is not jumping up and down to lay the money down. In other words, OHAI is a hard-to-sell asset.
  • Even if an OHAI sale freed up anywhere near the purchase price, an unlikely outcome, it would make only a dent in the stunning amount of debt. Whether it would improve Oracle’s low credit rating is doubtful.

There are also ongoing and new Federal commitments to meet:

  • There are the EHRs managed by the Veterans Health Administration EHR Modernization (EHRM) and the Military Health System (MHS), two separate but mandatorily interoperable systems. MHS is rolled out but modifications continue, while VA’s EHRM is only getting started, with extensive Federal oversight and guardrails in place. That rollout is expected to continue into 2031. These are both hot potatoes that show no signs of cooling off.
  • In Oracle’s traditional software business, Oracle’s latest commitment is to the Department of War (a/k/a Department of Defense). In late July DoW announced a software contract with Oracle which could be worth up to $7 billion over ten years as part of the cross-agency Enterprise Software Initiative. 

The layoffs can only increase the perception of Oracle as losing the staff to meet their commitments, as unstable and in trouble. This is a developing story. A TTA ‘hat tip’ to an observer who wishes to remain anonymous.

TTA’s August Ice Cream Run: General Catalyst’s $ for Function Health, GI health is “IT” for Hinge and Throne, EO for AI, DispatchHealth repositions, Health NZ modernizes, Centene’s profit, more!

August 7, 2026 | by | No Comments

7-10 August 2026

August weather may be ‘dog days’ but in digital health it was an ice cream run, with more to come next week. There was an unusually large General Catalyst debt financing of Function Health’s DTC lab testing subscription model and a lot of ‘movement’ around gastrointestinal health. A Presidential Executive Order on AI governance/cybersec, ATA on the virtual health case, Centene’s cutbacks to profitability, DispatchHealth’s refresh, and health modernizes in the Land of the Kiwi.

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

News roundup #2: Function Health’s jumbo $450M raise from General Catalyst, Hinge Health’s $105M Cylinder buy, and Throne Science’s $10M Series A

News roundup #1: AI governance ‘in’ with Feds, ATA; Centene’s shrinking but more profitable future; repositions and partnerships for DispatchHealth, WHOOP; Te Whatu Ora Health New Zealand modernization

Last week’s headlines

The week that was in M&A, financings: Included Health buys Firefly, Candid’s $120M raise, DarioHealth’s $23M RDO, TytoCare’s $25M growth round + new execs, Aurenar’s $5.7M seed for ICU neuromodulation

Chutes & Ladders, Oracle Edition: Surprise! Project Jupiter data center build overages, “social costs” multiply. Pentagon inks $7B, 10 year deal for software.

Catching up to Masimo’s ‘unfinished’ business: Danaher completes $9.9B acquisition of Masimo. $634 million damages from Apple upheld, but Kiani lawsuits continue

Recent Headlines and Must Reads

This week’s Must Read: the dangerous financing of AI data center buildouts–and how they resemble the 2020 health tech boom (Remember the SPAC boom that cracked and left nearly all companies and billions in the dust?)

Chutes & Ladders: Data breach clouts Clover, OpenAI agent escapes sandbox to attack Hugging Face, Precision’s surface BCI achieves thought control, Tempus AI $1.5B Personalis buy, Karoo Health’s $16.2M Series A

News roundup: Withings Medical Group service launches, MPs urge cancellation of NHS/Palantir FDP contract, IKS closes TruBridge buy for $557M, ATA comments on prelim CMS PFS for telehealth, Philips’ AI-powered…toothbrush

A gloomy view on Oracle going forward: debt, cash flow, and dependence on OpenAI

Midjourney Medical audaciously promises a revolution in whole-body scanning, powered by Butterfly Network chips. Can the reality ever match the hype?

Vinegary Must Reads This Week: Silicon Valley’s ‘Cargo Culture’; the clinical query tool explosion between OpenEvidence and general AI

 * * *
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Support not only a publication but also a well-informed international community.

Contact Editor Donna for more information.

Help Spread the News

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Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

News roundup #2: Function Health’s jumbo $450M raise from General Catalyst, Hinge Health’s $105M Cylinder buy, and Throne Science’s $10M Series A

August 6, 2026 | by | No Comments

August is opening with a blood draw and a “flush” in two Financings and one substantial, additive GI Deal.

The much-ballyhooed Function Health raises another $450 million from General Catalyst. This debt financing adds to their war chest, now $804 million. Crunchbase The growth financing from General Catalyst, which makes news with its raises, follows on Function’s November 2025 Series B round of $298 million led by Redpoint.

Function provides direct-to-consumer 160+ lab tests in an annual self-pay subscription model ($365, HSA/FSA eligible). Their pitch is to enable you to “live 100 healthy years” by self-testing for conditions such as thyroid, cardiovascular, hormones, immune disorders, and early signs of fatty liver and cancer, plus two annual full-body scans. The tests are performed via Quest Diagnostics in 48 states (excluding Rhode Island, Hawaii, and the territory of Puerto Rico). Members also receive a physician-reviewed results and insights. Function also offers MRI and CT scans (for an additional cost below $1000). They acquired in the past two years Ezra AI (full-body MRI scans), Getlabs (at-home or office blood draw network), and SuppCo (supplements). Function members have performed over 100 million lab tests in the past three years.

According to their CEO Jonathan Swerdlin, their target is “anyone who wants to be healthy”, but drilling down, it is the worried well, those wanting to centralize their ongoing testing, and those managing chronic conditions. Having gone through (and will be going through) a battery of thyroid and related tests, those of us who don’t have a physician brother to write up testing (and now an endocrinologist) could find this very attractive indeed, especially those with HSA/FSA accounts. For Medicare beneficiaries, it’s strictly out of pocket but if you have a lot of testing to do, perhaps worth it. The next part of this, of course, is getting your labs to a specialist without going through a primary care provider.

Reaching out to sell memberships to a broad consumer audience via traditional and social media is going to be an expensive proposition. $365 is not a trifling sum and getting your labs done via procedures like blood draws isn’t wonderfully pleasant. It requires national marketing and promotion, with a value proposition that takes some of the sting out of that blood draw. We’ll see if this happens as a result of the debt financing this fall. Release, MedCityNews

Hinge Health expands into GI care with Cylinder Health. One-time MSK remote physical therapy specialist Hinge Health continues its specialty expansion with $105 million for gastrointestinal care management company Cylinder Health. The buy is all cash and expected to close during Q3, subject to the usual customary closing considerations.

Cylinder has already treated 150,000 people for gastrointestinal (GI) conditions and has a clinically validated ROI. From the release: “The acquisition will combine Cylinder’s clinical expertise and existing market footprint with Hinge Health’s AI-powered care model and technology platform to deliver support in a single app expected to launch in 2027. There is no mention of how the companies will go forward in management and workforce locations.

Hinge expanded from MSK therapy into pain relief via the Enso pulse wireless device, pelvic health, migraine care (Enso), and fall prevention. Interestingly, in the release the CEO quote from Daniel Perez, alludes to GI care being an unmet need.  “Many people we already serve for back, joint, pelvic, and migraine care also have chronic digestive conditions. After spending time with Terry Boch and the Cylinder team, it’s clear that Cylinder gives us a running start in a category with significant unmet need.” (If you, like this Editor, spend any time on YouTube, one is assailed with digestive health ads, often, as we said as teens but perfect here, ‘gross’.)

Hinge went public last year at $32/share [TTA 22 May 2025] and is currently trading at around $80/share, a gain of over 100%, so they are doing something right in a very competitive space against Omada Health and Sword Health. Mobihealthnews, Healthcare Dive

And while we are discussing things gastrointestinal, Throne Science raised a Series A of $10 million. It was led by Will Ventures with participation from Emerson Collective, Workshop, LEAD VC, Salt VC, Accomplice, Moxxie, Ventures Together, Symphony, Felix Capital, Cosmic Venture Partners, Offscript, V1.VC, and Morrison Seger. Throne Science has developed an AI-assisted toilet sensor for $399 (plus $5.99/month membership) that monitors for bathroom habits, specifically monitoring patterns around hydration and gut health. Last month, they launched the beta version of their Gut Health AI coach which allows users to query the app about their data. The fresh funds will be used for further R&D for the next generation of the device targeting early detection of colon and urinary tract cancers. Interestingly, one of the founders is John Capodilupo, formerly CTO at the previously mentioned WHOOP. Release, Mobihealthnews

Disclaimer: Throne Science has nothing to do with the British, or any other, Kings or Queens. 

News roundup #1: AI governance ‘in’ with Feds, ATA; Centene’s shrinking but more profitable future; repositions and partnerships for DispatchHealth, WHOOP; Te Whatu Ora Health New Zealand modernization

August 6, 2026 | by | No Comments

Besides data center worries, AI governance and cybersecurity are very near the top of AI concerns.

  • For the Feds, AI is being used to patch up cyber vulnerabilities at speed and scale. The Gold Eagle “Promoting Advanced Artificial Intelligence Innovation and Security” initiative established in Executive Order (EO) 14409 is designed to operate across agency lines, reduce bureaucracy, stimulate innovation, and utilize AI for security as well as develop internal, responsible AI practices. It also promotes cooperation between the private sector and government by being built out by open source software companies, The EO has three major parts: 
    1. Upgrading American Systems for Advanced AI–this sets a 30 day clock from 2 June for adoption across the Committee on National Security Systems, the Departments of War, Homeland Security, Treasury, OMB and others.
    2. Secure Frontier Model Deployment–setting benchmarking, frameworks, “covered frontier models” and partners within 60 days inclusive of confidentiality, cybersecurity, insider-risk, and intellectual-property protection.
    3. Protection Against Criminal Actors–tightening up existing US Code and criminal laws to penalize “anyone who utilizes AI to illegally access or damage a computer without authorization, or who utilizes AI while engaged in such illegal access to further any other crime”.

Healthcare IT News

The American Telemedicine Association (ATA) and its advocacy arm, ATA ACTION, are establishing three working groups to help shape AI governance policy affecting virtual care and telemedicine. The first is on state-level AI policy, the second and third groups are centered on Federal policy agendas, regulations, and how state and Federal governments approach AI in virtual care. The three groups will present their report outcomes in December at the ATA EDGE Policy Conference setting the direction for ATA ACTION’s advocacy priorities in 2027. ATA Release

As payers continue to shrink due to plan membership declines and closures/selloffs, Centene actually is notching some profit and having some sunnier days. Centene’s Q2 closed with a stunning $1.1 billion in profit, with H1 at $2.6 billion, reminiscent of the palmy Michael Neidorff days when the sky was the limit and what was on the ground with the operating plans/companies was a jungle. This was quite a contrast versus 2025’s Q2 $253 million loss and H1  $1.05 billion profit. Revenues were also up nicely with H1 this year at  $103.5 billion, compared to $95.4 billion last year. All exceeded Wall Street estimates and gave Centene the opportunity to boost its 2026 full year outlook to at least $4.80 in earnings per share and revenue to between $193.5 billion to $197.5 billion, a flat-to-boost from 2025’s ending $194.78 billion and $2.08 per share.

At this point, it’s apparent that despite shrinking memberships down to 25.9 million as of Q2, both their sizable Medicaid and ACA plan memberships shrinking sharply, Centene has wrestled that old devil, the Medical Loss Ratio (MLR) to 89.6%, down from 93%. Another bright spot has been their commercial plans which have notched growth and a 10 point less MLR. ACA memberships are down from 5.9 million to 3.5 million. The ACA premium tax credit subsidies expired at the end of 2025, effectively causing premiums to double for nearly everyone. Aetna exited this year and Cigna will be out in 2027.

Share price is also sunny side up. Since April, shares have gone from the $31/share bottom in April to the $60 plus range since June. Centene is reportedly working hard to improve their plan STAR (CMS) and HEDIS (NCQA) ratings.

What is not so sunny is the number of people being shed at Centene. They’ve reported a cut of about 1,200 people as of Q2. It’s unknown how many have accepted the voluntary separation plan (VSP) that was announced in June and deadlined on 27 July. TTA 18 June  Centene reported that they forecast H2 severance costs between roughly $315 million and $365 million. Many of these severances will hit between early September and December, although on the Centene page on The Layoff, some employees accepting the VSP have dates into late 2027.

The VSP is in addition to prior layoffs that took place in H1. Centene reported H1 severance and third-party vendor costs of $61 million, with $47 million hitting in Q2. (This Editor knows a former colleague who was laid off after 16 years in June.) There are also rumors of further layoffs in H2 not part of the VSP as memberships shrink. FierceHealthcare, Becker’s, Centene earnings release

This Editor will reiterate that rarely does shrinking to profitability work except as an interim strategy to stem losses or look better to shareholders. Even with AI tools, operating plans without people on a ‘bare bones’ basis gets plans into quality ratings trouble, the nature of the health plan ‘beast’. That’s even true of commercial plans where employers and third-party brokers shoulder part of the load.

(Disclosure: this Editor was briefly a Centene employee after the company she worked for, WellCare Health Plans, was bought by Centene. She is a holder of Centene stock converted from her prior company. The above is strictly her opinion and protected speech, and should not be used as investment advice.)

DispatchHealth brightly announced what they termed a ‘refined market focus’ and a new website. This terminology means that Dispatch, which was previously known for providing home medical care, recovery services, and hospital-level care at home, now is stating that they are focusing on their B2B health system customers, “offering solutions that empower health systems and risk-bearing providers to build and scale their at-home programs, under their own brands”. Translation: they are now white labeling their CESIA platform and services to health systems to turnkey complex care at home via their workforce. Dispatch merged with Medically Home in June [TTA 21 Mar]. Investment to date has been $733 million through seven rounds (Series E) through 2022, which means that they’ve been paying their own way for some time. Dispatch release

WHOOP continues to “it” up, inking a new partnership in increasingly popular women’s digital health. The Natural Cycles app, which tracks fertility via the menstrual cycle and overnight skin temperature, will integrate with WHOOP’s biometric data collected from their wearable. This past spring, WHOOP definitely whooped it up with a $575 million Series G (for Giant) funding in April and claims 2.5 million members internationally. Natural Cycles has also enjoyed strong funding, including $55 million in a Series C round in 2024,  Mobihealthnews

And flying off way down under to New Zealand, Te Whatu Ora/Health New Zealand has enlisted UCLPartners for tech  modernization. Te Whatu Ora is New Zealand’s largest employer and provides universal health care to 5 million Kiwis. The partnership is for deployment of technology and AI through their digital and AI innovation program, HealthX. In April, they announced that they were working on five initiatives: AI scribes, remote patient monitoring (RPM) for heart failure patients, AI-enabled skin lesion assessments, AI-enabled diagnostics, and CoPilot for leadership and digital services. Health Informatics NZ  UCLPartners is a health innovations developer in care pathways and innovations and workflows. London-based, it works extensively with the National Health Service (NHS). The company worked with Te Whatu Ora on the HealthX AI scribe rollout for horizon scanning work. Healthcare IT News

TTA’s July’s a Wrap: what’s up with Masimo and Danaher, Oracle’s new datacenter danger zone with overruns, Included buys Firefly in expansion, Candid raises $120M, TytoCare’s new CEO and $25M, more!

July 30, 2026 | by | No Comments

30 July-3 August 2026

A mixture this week of catchup–Masimo’s acquisition by Danaher and what that all means–and suddenly perking activity in M&A and diverse funding rounds from Series D to seed. But the week wouldn’t be complete with yet more on Oracle In Danger, this time from data center overruns–yet getting a tidy Federal contract worth several billions.

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

The week that was in M&A, financings: Included Health buys Firefly, Candid’s $120M raise, DarioHealth’s $23M RDO, TytoCare’s $25M growth round + new execs, Aurenar’s $5.7M seed for ICU neuromodulation

Chutes & Ladders, Oracle Edition: Surprise! Project Jupiter data center build overages, “social costs” multiply. Pentagon inks $7B, 10 year deal for software.

Catching up to Masimo’s ‘unfinished’ business: Danaher completes $9.9B acquisition of Masimo. $634 million damages from Apple upheld, but Kiani lawsuits continue

Last week’s headlines

This week’s Must Read: the dangerous financing of AI data center buildouts–and how they resemble the 2020 health tech boom (Remember the SPAC boom that cracked and left nearly all companies and billions in the dust?)

Chutes & Ladders: Data breach clouts Clover, OpenAI agent escapes sandbox to attack Hugging Face, Precision’s surface BCI achieves thought control, Tempus AI $1.5B Personalis buy, Karoo Health’s $16.2M Series A

Recent Headlines and Must Reads

News roundup: Withings Medical Group service launches, MPs urge cancellation of NHS/Palantir FDP contract, IKS closes TruBridge buy for $557M, ATA comments on prelim CMS PFS for telehealth, Philips’ AI-powered…toothbrush

A gloomy view on Oracle going forward: debt, cash flow, and dependence on OpenAI

Chutes & Ladders: Done Global principals sentenced on Adderall fraud, Oracle E-Biz Suite hacked, OpenAI’s 5% offer to US government, Meta considers cloud AI, Pearl’s $110M raise

Midjourney Medical audaciously promises a revolution in whole-body scanning, powered by Butterfly Network chips. Can the reality ever match the hype?

Vinegary Must Reads This Week: Silicon Valley’s ‘Cargo Culture’; the clinical query tool explosion between OpenEvidence and general AI

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The week that was in M&A, financings: Included Health buys Firefly, Candid’s $120M raise, DarioHealth’s $23M RDO, TytoCare’s $25M growth round + new execs, Aurenar’s $5.7M seed for ICU neuromodulation

July 30, 2026 | by | No Comments

Mr. Market woke up out of his summertime nap with some surprising end-of-July activity. What will August bring?

On the M&A front, virtual care mega Included Health is acquiring Firefly Health. This adds a virtual-first health plan and advanced primary care services to Included’s established telehealth and care navigation business. In February, Included quietly entered the health plan business with an Alternative Plan Design for employers that offers an alternative approach to health benefits. Firefly is classified as an Alternative Health Plan as Administrative Services Only (ASO), quoting a 15% savings in total cost of care and 90% member satisfaction. Interestingly, San Francisco-based Included’s acquisition cost of the Watertown, Massachusetts company is not disclosed nor are any management or service transitions. The deal is expected to close in Q3 2026 and is subject to regulatory review. Readers will recall that Included was formed from telehealth pioneers (2011-12) Grand Rounds and Doctor on Demand, with the small LGBTQ focused Included Health picked up in 2021, then rebranded with that name. It is solely focused on employers, health plans, public sector organizations, and unions.  Release, MedCityNews

Candid Health raised a $120 million Series D. Lead investor for this revenue cycle management (RCM) company is Sixth Street Growth, with participation from Oak HC/FT, 8VC, and Y Combinator. This follows a February $52.5 million Series C led by Oak HC/FT for a total raise of $220 million since 2020. TechCrunch Candid concentrates on provider financials, automating medical billing and health insurance claims to speed payments. Sixth Street release, MedCityNews

DarioHealth’s latest ‘rabbit out of hat’ is a $23.5 million RDO. As we’ve previously noted, DarioHealth started in MSK therapies and by 2023 branched out to clinically-based interventional care management solutions through apps and consults in cardiometabolic and behavioral health, including GLP-1 prescribing for weight management. DarioHealth’s latest is true to its form in creative financings as previously noted here and here. This bit of funding legerdemain is an RDO, a registered direct offering. From the SEC Form 8-K, DarioHealth is selling to institutional investors 2.4 million of their publicly traded stock at $6.80/share plus pre-funded warrants for over a million shares at $6.7999. This raises $23.5 million before deducting the offering expenses. The RDO  closed on 23 July. Mobihealthnews

Our old friends at TytoCare, notably quiet of late, added $25 million to their war chest and brought on some fresh horses. The growth/venture round brings their total financing to $231 million. The round for the remote physical exam tech company was led by Insight Partners, with participation from existing strategic investors OliveTree, HOOP, Qumra Capital, Qualcomm Ventures, OrbiMed and others. In the release, the lead repositions of the company as now a “AI-First Clinical Enablement Platform, Bringing FDA-Cleared AI-Powered Insights into Virtual Primary Care to Support Cardiopulmonary and Oncology Care” which doesn’t quite follow through on the website which focuses on their devices. Joining the company are Adam Pellegrini as CEO, replacing co-founder/CEO Dedi Gilad who moves to chairman. The other co-founder, Ofer Tzadik, remains with the operating company in NYC and Israel. Mr. Pellegrini is the former CEO of MSK/pulmonary management company Kaia Health, acquired last January by Sword Health for $285 million, and previously co-founder and former CEO of cancer support company Jasper Health out of Redesign Health. Also onboarding as COO is Greg Orr, former Walgreens VP Digital Health and COO of Jasper Health. One suspects some changes are in the offing. Mobihealthnews

Our last and most unusual company is Aurenar, which has developed a non-invasive neuromodulator for inflammation that stimulates the vagus nerve in the ear. The destined use is for ICUs to modulate the body’s secondary and toxic inflammatory responses to conditions such as subarachnoid hemorrhages and stroke. The V-Link vagus nerve stimulator gained FDA breakthrough device designation on 30 June. The oversubscribed seed round of $5.7 million was led by American Heart Association Ventures’ Go Red for Women Venture Fund and Solas BioVentures, with participation from BJC Health and Kaleida Capital. Initial validation has been through multiple pilot clinical trials at St. Louis-based Washington University, where Aurenar is located. The funding will be used for pivotal trials around stroke, including final device development, verification and validation testing, plus regulatory submissions to the FDA. Other uses will center on additional inflammatory conditions disproportionately affecting women. FierceHealthcare, MassDevice, Mobihealthnews

Chutes & Ladders, Oracle Edition: Surprise! Project Jupiter data center build overages, “social costs” multiply. Pentagon inks $7B, 10 year deal for software.

July 29, 2026 | by | No Comments

The Unexpected in the Terra Incognita of data centers whip up The Perfect Pricey Storm for Oracle. Oracle knows how to build software, not huge data center buildings. Buildings have messy things like power supply, coolant, and permitting at the local and state levels. There is also The Unexpected that any experienced builder will factor in even when unknown, whether it’s overruns for wiring, racks, chips, out of spec cement, etc., that delay Opening Revenue Day. The Unexpected increasingly includes what is termed “social costs” that start around genuine concerns such as power draw, transmission lines, water usage, disruptions, even heat foci (a Cornell Tech study found a 10 degree rise on current data centers). Many local “interests” use these tentpoles to support the classic tactics of dissuade, delay, and (ramping up) the difficulty. When the pockets like Oracle’s aren’t deep and labeled ‘debt’, this hurts.

In the New Mexico west bordering Texas, where it’s underpopulated and land is cheap, Oracle’s 1,400-acre, 2+ gigawatt Project Jupiter super data center build for OpenAI is hitting roadblocks, primarily around power. The original plan to power it with gas from its own natural gas plants hit environmental potholes. Then Oracle switched to natural gas fuel cells from Bloom Energy. They use little water, pollute less and are reasonable in carbon emissions. But the cost? $8 billion, a few billion more than the gas plants. They also have other sticky requirements; to not degrade, the cells must continuously run, which scuppers Oracle’s plan to switch off to far cheaper solar on sunny days. TTA 7 May

New Mexico and to a lesser degree west Texas have rising environmental concerns. New Mexico in particular is generally hostile to big business and fossil fuels. The natural gas pipeline needed to supply the cells that runs through New Mexico is on its second rejection by the New Mexico Environment Department. The next hearing isn’t till 19 October. The cherry on this cake? The state Attorney General is investigating complaints from local residents that their names were used fraudulently in support of said fuel cells. The greenhouse gas emissions are also claimed by environmental groups to be equivalent to New Mexico’s two largest cities, a claim that evades logic for Albuquerque alone. These groups now are pushing for a data center moratorium, a growing national cause that ignores that the data center is partly built, the water being used is non-potable from outside the area, and that the builder, Oracle, is working hard to respond to critics in the local areas by plowing money into local concerns.

Oracle isn’t the only one, but the one with the least resources. Oracle, Microsoft and OpenAI projects in Wisconsin are having costly difficulties with power authorities on building transmission lines and cost sharing. This may add another overrun of $100 million to Oracle/OpenAI’s Port Washington, Wisconsin data center. Oracle’s low credit rating also hurts them, where Wisconsin’s state power regulator is requiring financial guarantees in cash or lines of credit in case the project fails. This will cost Oracle $100 million–annually. In Texas, Big AI such as Meta and Google are having more success in partnering with local power utilities in building permanent infrastructure and renewable sourcing, including closed water systems to prevent toxic wastewater runoff into land and local water systems.

So why is Oracle making a chancy bet at the Data Center Infrastructure Landlord Table? Concluding from The Information: “even though the cost to build and power a gigawatt of AI is bordering on at least $60 billion, Nvidia servers powered by its Grace Blackwell chips, renting out at $3.50 an hour, could generate around $12 billion to $13 billion a year, including operating costs.” Your Editor reads this simply as a 4-5 year payback. However, that statement rests on a mountain of assumptions–that hourly rental costs remain high, that build costs remain somewhat stable or lower, that land and construction stay relatively cost static, that the small coterie of AI customers keep paying their bills, and that local groups do not succeed, as they seem to be doing, in increasing costs, demanding moratoria, and delaying online dates.

There are many reasons why Oracle’s bonds are hovering just above ‘junk’, as Mr. Market keeps reminding us. Computing UK. Add to that list that data center cost assumptions have gone spectacularly sideways and the expectations within Oracle didn’t account for (drum roll) The Unexpected.

Oracle did have some very good news last week from the Federal Government for its first Ladder in awhile. The Department of War (a/k/a Department of Defense) is contracting with Oracle for software in a deal that could be worth up to $7 billion over ten years. The exact contract has a base value of $3.31 billion for the first five years of the agreement and a total value of $6.99 billion if the additional option years are exercised.

The DoW Enterprise Software Initiative (ESI) puts contracting into a centralized framework to expedite procurement, versus the typical individual procurement process by separate agencies. The DoW ESI covers procurement for intelligence agencies and the Coast Guard. According to CNBC, “The contract covers the use of Oracle software in on-premises data centers for branches of the military, the U.S. intelligence community and the Coast Guard, according to a statement. The Central Intelligence Agency was Oracle’s first customer. A five-year base period for the contract includes perpetual and subscription-based software licenses, maintenance and consulting, according to one description.” DoW in its own release expects savings of $441 million when compared to the cost of buying Oracle products separately. (And come on, fellow writers. It’s the Department of War at the top of the release, not the Department of Defense, whatever arguments including historical you may have about it.) Oracle release, Federal News Network

Catching up to Masimo’s ‘unfinished’ business: Danaher completes $9.9B acquisition of Masimo. $634 million damages from Apple upheld, but Kiani lawsuits continue

July 29, 2026 | by | No Comments

Danaher closing the Masimo acquisition for a eyewatering $9.9 billion in early June definitely flew under this Editor’s  radar. Let’s catch up. As your Editor “Alibi Ike’s” on this (blame it on an airshow, not an injury!), beyond its $9.9 billion “Hollywood Ending” deal in February, here’s the ‘need to know’ about the medtech giant’s final deal for Masimo and the latter’s future.

  • The completion was 10 June, when Masimo stock was delisted at a final price of $179.95 (MASI, Nasdaq). The closing beat the expectation of H2 2026 by a month.
  • The Danaher offer was $180/share (DHR, NYSE). When the offer was made, Masimo stock was trading around $130. This made for a very good deal for long-suffering Masimo shareholders and Politan Capital, which forced out owner/founder/CEO Joe Kiani in a blistering September 2024 proxy fight. Masimo shareholders approved it in May.
  • Masimo will operate as a brand and division under Danaher Diagnostics, led by EVP Diagnostics Julie Sawyer Montgomery with Masimo CEO Katie Szyman continuing as CEO of the division.

Danaher updated its full-year 2026 guidance on 21 July with its Q2 earnings release. “For full year 2026, the Company expects non-GAAP core revenue will increase in the 3.0% to 4.0% range year-over-year. The Company is also increasing its full year adjusted diluted net earnings per common share guidance to a range of $8.45 to $8.60 versus previous guidance of $8.35 to $8.55. to incorporate Masimo’s expected contribution.” The $150 billion market cap Danaher is likely to pursue other acquisitions as well.

Competitively, it positions Danaher against industry giant Medtronic in patient monitoring, specifically in pulse oximetry and related technology. Masimo’s pulse oximetry and patient monitoring devices overlap somewhat with but extend Danaher’s existing Radiometer products in blood gas analysis and testing. Denmark-based Radiometer is stronger in European markets while Masimo is primarily US/Canada based. There is also diagnostic segment overlap with Beckman Coulter Diagnostics. It also expands Danaher’s offerings in sensor-based technologies and overall to integrated delivery networks, or IDNs. Other Danaher products within Diagnostics are Leica Biosystems and Cepheid. Given Danaher’s extensive and existing footprint in diagnostics and a legitimate fit, Masimo may get some long-overdue capital development and real management attention.

Courtesy of Editor Ted Green at Strata-Gee, in closing out the Masimo/Sound United file at his consumer electronics/AV custom integrations business newsletter here, this is how Danaher’s current products and Masimo’s complement each other in diagnostic market segments.

One caution for Masimo’s independent operation is that Danaher will now start executing on $125 million of annual cost synergies and more than $50 million of annual sales synergies by the fifth full year after the deal closure. “Cost synergies” usually mean shared corporate infrastructure, supply chain efficiencies, and streamlined back-office operations, although Danaher to this point has not filed any WARN notices for Masimo in California or Federally. Another caution is the meshing of Masimo’s corporate operations and ‘culture’ with the Danaher Business System methodology, as Masimo’s recent history has resembled a roller coaster ride at an amusement park with pieces coming off and the occasional passenger doing an aerial. Danaher closing release, MedTech Dive, Yahoo Finance

What’s left in LitigationLand?

  • The Apple Watch litigation ended with a Federal win for Masimo. It won the Federal patent infringement case in November and was awarded $634 million in damages. A Federal appeals court rejected Apple’s request for a new trial last week. Orange County Business Journal, paywalled. 9 to 5 Mac
  • Contrary to this, in April the International Trade Court (ITC) refused to reinstate the import ban on the redesigned Apple Watches imposed in December 2023. Reuters Whether Danaher will continue to pursue this isn’t known, but given the win versus Apple and the Danaher emphasis on diagnostics, the ITC import ban on a consumer product goes far down the list in importance.
  • The Kiani lawsuits over his separation are proceeding in Orange County (California) Superior Court. These are over compensation owed to him when Kiani was ousted as CEO. His argument is that the employment contract is ambiguous about the timing of payments and that the unpaid compensation qualifies as wages. Judge Thomas Lo ruled last month that the suits could continue. The stakes are not small. The contract contained a $450 million severance payout. Kiani is seeking an added $100 million in damages from the company’s former six board directors affiliated with activist investor Politan Capital Management. Kiani is represented by Marshall Camp of Hueston Hennigan LLP. OCBJ In March, Judge Lo disqualified Quinn Emanuel Urquhart & Sullivan LLP from representing the six board members because the firm had originally defended Kiani’s employment agreement and violated ethics around confidentiality and loyalty. Daily Journal-Cal Lawyer 
  • There are other lawsuits active in Delaware and Washington, DC.

And in other June news, Masimo gained FDA 510(k) clearance for an opioid-induced respiratory depression detection capability integrated into the Radius VSM wearable continuous patient monitor. It uses Masimo’s smartSET pulse oximetry sensor platform to identify early signs of respiratory compromise in hospital patients receiving opioid therapy. Release 

One more TTA Hat Tip© to Ted Green of Strata-Gee for being an excellent inside source on Masimo, the agita around the (sold) Sound United, and the culminating proxy fight between Politan Capital and Joe Kiani. Here’s his history of Masimo’s “wild and crazy ride”.  He now returns to being THE newsletter for professionals in the consumer electronics/AV integrations business!

This week’s Must Read: the dangerous financing of AI data center buildouts–and how they resemble the 2020 health tech boom

July 23, 2026 | by

For this week’s Must Read–now that we are past World Cup and mostly past America250–here’s another bracing essay from Ed Zitron’s Where’s Your Ed At in The Subprime Data Center Crisis. Get a couple of cuppas and some time–it’s dense.

Mr. Zitron compares how data centers are financed today to the pre-2008 boom in collateralized debt obligations (CDOs) that insured mortgage bonds. CDOs, by raising money around these bonds near-endlessly, subsidized an artificial boom in housing demand stimulated by  historically low interest rates. Those of us around (nearly all our Readers) know how badly that wound up in 2008, with the circular grift crash taking down Lehman Brothers and other financial institutions and putting us into a four-year recession. It also made financing nearly unavailable for health tech companies just getting out of their Series A or B.

CDOs aren’t financing data centers, but Special Purpose Vehicles (SPVs) are. The SPV raises debt financing for a data center and sells it to institutional investors, asset managers or banks. The SPV makes the payments to the contractors and suppliers such as Nvidia for chips. How they pay interest on the debt is via a special account. Finally, when the data center starts to generate revenue, the SPV uses those funds to first pay for the operating expenses of the data center, then creditors (based on their seniority in the debt), then whatever is left goes to the holding company, such as CoreWeave. It reveals how companies like Meta, Google, Amazon, and Microsoft are financing their data center builds. (It does appear on this Editor’s reading that Oracle, by directly taking on debt, is taking a different route.)

It’s a complicated scenario. The analogy he draws is that the financing for data centers is equivalent to the subprime mortgages of 2008. It’s  compounded by the apparent fact that capacity being built in the pipeline far outstrips demand by a factor of 15, based on an industry report cited by Mr. Zitron. In addition, the demand is not from profitable companies. He cites that “70% to 90% of that demand is from Anthropic and OpenAI’s unprofitable services.”

It also assumes three factors govern AI expansion in a grab for world savings looking for safe bets:

  1. AI data center demand is infinite and all compute will be used.
  2. AI data centers all have “locked-in customer demand.”
  3. That these are “safe” investments, backed by the richest companies in the world.

Exactly what demand is out there? Companies and countries are guessing and making huge financial bets. Mr. Zitron basically calls it an AI bubble inflated by AI companies and abetted by the media because no one is accurately measuring the demand versus capacity.

It’s a scenario that screams ‘red flags’ and ‘Danger, Will Robinson’.

Read, you decide. 

But the scenario Mr. Zitron outlined raised the goose pimples on this Editor’s neck.

Those of us in healthcare have been to this rodeo before. And the bronco riders were all taken to the ER. Or the morgue.

If the term SPV sounds a little familiar to Readers, to this Editor, the term and the structure strongly resemble Special Purpose Acquisition Companies (SPACs) which for a time in 2020-2022 were the It Girl of getting around the typical IPO process for many a health tech company, such as Babylon Health. Admittedly, SPACs and SPVs work differently. SPACs raised money from investors, IPO’d themselves to raise more money, and then in an ‘blank check’ transaction, sometimes with additional investment, acquired a private company, thus taking it public. All in 3-6 months! Simple, right? None of the muss and fuss, due diligence, or SEC scrutiny of an IPO. And as a device, it’s still being used.

Yet look at the outcome in healthcare. Nearly all of the healthcare SPACs ‘cracked’ after 2023 with stock values cratering within months or a year, Hims being one of the very few exceptions and maybe the only one. 30% went bankrupt. 26% were acquired well below their IPO price. And the remainder survive, some having flirted with the Devil of Demise, all below their IPO and valuation. For a tidy summary of the rolling SPAC collapse, read TTA 10 April 2025 and 26 June 2024. 

But what CDOs, the current AI bubble, and the 2020-2022 health tech/telehealth bubble have in common is a complicated way of financing designed to skirt regulations and proper market analysis, coupled with a healthy dose of illusions. Each bubble is based on a set of assumptions that envisioned endless geometric growth and future profitability, coupled with a “desire to believe” that negated logic and the entry of outright fraud. In 2020, we had a real lack of accurately gauging demand for health tech and telehealth services, especially in direct-to-consumer and telementalhealth services. The healthcare SPAC bubble also misread the viability of companies and their business models, many of which had more in the realm of hopes and founder dreams than validity in the marketplace. SPACs evaded scrutiny and created great headlines for this Editor. It was endless. Apprehensions were brushed away. It was also unsettling to this Editor who had a very small role in a long-ago iteration of a financing and business boom/bust–airline deregulation–at two airlines.

When the 2023 crash came, wiping out billions in investment, it was pretty much confined to healthcare and health tech. It’s still being worked through in the consolidation of health tech (not all bad and to be expected), in bankruptcy court (23andMe), and the outright frauds in Federal courts (Done Global). To quote myself from June 2024: The investment scene in health tech and AI strongly resembles the Wild West days of airlines post-deregulation 30 years ago. Investor money in, now fleeing for the exits, whether the bankruptcy court or passing the hot potato to others with money.

AI, of course, dwarfs the SPAC-driven health tech boom by a 1000X factor. And has the capacity to take down a world economy.

Chutes & Ladders: Data breach clouts Clover, OpenAI agent escapes sandbox to attack Hugging Face, Precision’s surface BCI achieves thought control, Tempus AI $1.5B Personalis buy, Karoo Health’s $16.2M Series A

July 23, 2026 | by

In the Chutes department, it’s an insurer breach and an AI model that broke dramatically out of its sandbox.

Clover Health reported that three employee accounts were breached. The breaches were implemented through a ‘classic’ social engineering scheme such as phishing–the kind that this Editor was trained on years ago when she worked in marketing for a unit of a well-known health insurer. This sounds minor except that the three accounts were of “non-managerial employees with access to member visit-scheduling and broker-facing sales functions.” However, these employees also had access to some personally identifiable information (PII) and protected health information (PHI) of members. Apparently, there was outside, non-authorized activity because Clover’s SEC Form 8-K filing reported that it was “contained and terminated” but Clover is still investigating the extent of the breach and must complete required reporting and member notifications. The employees did not have access to claims or corporate financial systems. Clover Health, considered a pioneering ‘insurtech’, has remained relatively small, with 156,000 Medicare Advantage PPO members in Georgia, New Jersey, Pennsylvania, South Carolina, and Texas. Healthcare Dive

Agentic AI Gone Wild–the breakout of its sandbox of an advanced OpenAI agentic AI system into Hugging Face’s open-source AI model repository platform. OpenAI admitted in a blog post published yesterday (21 July) that the attack originated during internal testing of its own AI models. In what it called an “unprecedented cyber incident”, their own investigation revealed that “we now know that this particular incident was driven by a combination of OpenAI models — including GPT‑5.6 Sol and an even more capable pre-release model, all with reduced cyber refusals for evaluation purposes — while being internally tested on a benchmark⁠ of cyber capabilities.” Even though the testing was run in a ‘highly isolated environment’, OpenAI admits that the models found a way to gain internet access and attacked Hugging Face’s servers. Hugging Face detected and stopped the activity while OpenAI claims it found the activity internally. What’s scary is that Anthropic (Claude Mythos) and OpenAI now have had ‘out of the sandbox’ incidents in their frontier AI development worlds. As OpenAI put it, “The incident also makes clear that advanced models can discover and exploit novel attack paths in real-world systems without source-code access. It highlights that advanced cyber capabilities must be developed alongside stronger safeguards and defensive tools.” Hugging Face reportedly had to use GLM 5.2, an open-weight model developed by Chinese firm Z.ai, to investigate it because US AI models had restricting guardrails that blocked investigation. Computing 21 July, 22 July

And there are a few Ladders this quiet week.

Precision Neuroscience has successfully implanted its brain-surface brain-computer interface (BCI) into able-bodied test subjects and achieved successful thought-controlled cursor control. Unlike Neuralink, Precision’s implants rest on the surface of the brain, not in the brain. Neuralink’s subjects are also are mobility-impaired [TTA 10 July]; Precision’s patients have full movement but had neurosurgical procedures for a variety of reasons. By enrolling in the Precision research study, the patients were able to move solely by thought cursors to navigate games like Pong and Mario Cart on tablets and smartphones while in recovery. The 510(k) investigational devices were removed in a five-minute procedure before the patient went home. This is a real advance for a less-invasive BCI. Mobihealthnews, video (YouTube)

Tempus AI has agreed to acquire Personalis for $1.5 billion. Both are public companies listed on Nasdaq. Tempus AI is a precision medicine company using AI to analyze data for personalized care and therapeutics. Personalis is a cancer genomics company that uses DNA minimal residual disease (MRD) testing to detect cancer recurrence. The offer to Personalis shareholders is for $16.25 per share of common stock which was a 6% premium to last Friday’s closing price; it closed today (22 July) at $12.47.  The deal is for Tempus shares with the option for cash. Personalis had Q2 preliminary revenue of $22.4 million. The transaction is expected to close in late 2026 or early 2027. Mobihealthnews, Tempus release

We close with a fairly hefty (for these days) $16.2 million Series A for cardiovascular tech company Karoo Health. The oversubscribed raise for the Albuquerque, New Mexico company was led by 7wire Ventures and Allumia Ventures, with participation from First Trust Capital Partners, LLC, SpringRock Ventures, Hyde Park Angels (HPA), and other marquee investors. Karoo combines on-site and virtual care teams with their proprietary technology in cardiac care for cardiology practices and health systems in a value-based care model that connects, patients, providers, and payers. The technology platform is designed for earlier detection, improved coordination, and data-driven care delivery. Karoo release, FierceHealthcare

News roundup: Withings Medical Group service launches, MPs urge cancellation of NHS/Palantir FDP contract, IKS closes TruBridge buy for $557M, ATA comments on prelim CMS PFS for telehealth, Philips’ AI-powered…toothbrush

July 16, 2026 | by

Withings USA expands monitoring into clinical care services. Withings’ reach from devices into clinical care is definitely something unusual, as it’s rare that a device developer gets into the messy care space, much less with a ten-year commitment. Here Withings, with the Withings Medical Group, is entering care for Original Medicare beneficiaries via CMS’s new ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions). ACCESS is a ten-year CMS Innovation Center model that pays providers on chronic disease management outcomes. It launched on 5 July.

Withings Medical Group will concentrate on cardiovascular, kidney, and metabolic health (CKM), beginning with hypertension, diabetes, and obesity. The medical group’s care team will work with the beneficiary’s primary care providers to build an individualized care plan for each member. The Withings Medical Group teams can also prescribe and adjust medications and support the beneficiary on lifestyle changes.

From the release: “This focused scope reflects a deliberate, clinically rigorous approach to entering care, and it marks only the beginning of a broader ambition for how Withings supports health over the long term. It also aligns with the ACCESS Model’s ten-year, phased approach to testing whether outcome-aligned, technology-supported care can improve outcomes for Medicare beneficiaries nationwide.”

In the UK, two Commons committees have urged the Health Innovation Minister to cancel the contract for the NHS Federated Data Platform (FDP).  The developer, Palantir, has come under fire in both the UK and US on its ties to defense and security agencies in those countries and with Israel. Palantir contracted with NHS England starting in 2023. The Commons committees objecting to Palantir to Health Innovation Minister Preet Kaur Gill are the Health and Social Care Committee and the Science, Innovation and Technology Committee. They are urging using a contractual break in February 2027 to term the contract, seek another contractor, or develop one in the UK. The concerned Members cross parties and are joined by the trade unions and 100 NHS data and technology specialists, who have separately objected to the FDP in a letter to Health Secretary James Murray.

The FDP is a key part of NHS digital transformation to facilitate storage and analysis of health datasets to improve planning, patient care and hospital operations. But the concerns apparently are more political, targeting Palantir and alleging that its defense and security contracts will discourage patients from allowing their medical information to be used. If we in the US shared similar concerns, Microsoft, Meta, AWS, and Oracle wouldn’t have a single healthcare contract. Computing UK

IKS Health wrapped up its TruBridge buy last Thursday for $557 million. The acquisition, announced last April, closed a quarter earlier than expected. IKS is a healthcare software company for administration and documentation, with TruBridge an EHR and revenue cycle management (RCM) provider to primarily rural hospitals. The combined company now has a US customer base of 150,000 clinicians and 2,000 healthcare organizations. IKS Health is traded in India with US operations in Dallas. The TruBridge acquisition is their third this year, financed with $600 million over five years in debt sourced from Citibank, JPMorgan Chase and Deutsche Bank. TruBridge shareholders received $26.25 in cash per share as offered in April. The release is singularly unrevealing on whether TruBridge will continue as a separate product line, nor on any operational/management continuity. It is another example of consolidation and ‘line extension’ between similar companies. MedCityNews

If it’s midyear, it’s time for a preliminary CMS Physician Fee Schedule draft. ATA ACTION has an early review of its telehealth and technology changes proposed by the Centers for Medicare & Medicaid Services (CMS) that affect physicians serving Medicare beneficiaries. From the release (PDF):

  • Telehealth: In addition to changes to extend existing telehealth flexibilities, CMS proposes adding five codes to the Medicare Telehealth List, clarifying critical care consultation code descriptors, creating two new telehealth modifiers, and allowing physicians to bill for telehealth services involving residents when either the teaching physician or resident is in the room with the beneficiary.
  • Remote Patient Monitoring: CMS proposes tightening guardrails and recalculating payment for remote patient monitoring (RPM) and remote treatment monitoring (RTM) services. Key changes include restricting RTM billing to patients with an established relationship with the billing practitioner, requiring a separately reportable initiating visit tied to the start of monitoring services, prohibiting use of third-party remote monitoring companies, lowering monitoring valuations, and potentially consolidating current CPT codes into four new G-codes (two RPM, two RTM) covering initial setup and monthly monitoring/management.
  • Technology-Enabled Care: CMS is seeking broad feedback on modernizing Medicare reimbursement for technology-enabled care, with particular interest in primary care, care management, capitated payment models, and AI.
  • New–Software as a Medical Service (SaMS): Aligning with the OPPS proposed rule, CMS introduces a new category – Software as a Medical Service – defined as algorithm-based clinical decision-support software with clinical or diagnostic functionality (excluding remote monitoring and prescription digital therapeutics). SaMS providing secondary analysis of lab data would shift from the Clinical Laboratory Fee Schedule to the Physician Fee Schedule.
  • Merit-based Incentive Payment System (MIPS) Improvement Activities: CMS proposes two new technology-focused improvement activities: clinician use of AI to improve patient care, and use of interoperable clinical decision support.

Whether these survive to the Final PFS is dependent on comments, Congress, and budgets.

And now we have AI for our electronic toothbrush. Philips goes AI in its latest model, the Philips Sonicare DiamondClean 9900 Prestige. It uses built-in, on-device AI and spatially aware guidance to track brushing. There’s a 12-segment “Mouth Map” on the handle, with a light ring that gives real-time visual feedback on your coverage, pressure, and scrubbing habits. For those of us who like to press down, the SenseIQ sensor automatically adjusts intensity so we aren’t so bad. It has eight modes and three intensities, a bit more than their top-of-the-line existing Sonicares. And it comes in five premium colors! Well, well…as a faithful user of my Philips Sonicare toothbrush since a rather extensive dental  ‘remodeling’ a few years ago, and guilty of sometimes being a bit sketchy about my completeness, I am somewhat dismayed that to be au courant, I will need to acquire this new model…but it won’t be available till this fall in the US and Europe. Release, Mobihealthnews

A gloomy view on Oracle going forward: debt, cash flow, and dependence on OpenAI

July 16, 2026 | by

Oracle is beginning to turn into one of those cautionary case studies. And that’s not good news for healthcare. From their faltering EHR to the hacking of their software, Oracle’s news hasn’t been cheerful. While still profitable in the quarterly reports, the debt load and its obligations in their chosen wrenching changeover from a software developer/seller to an AI infrastructure landlord have been followed by speculation. The latest speculation from June is selling their EHR business [TTA 2 June]–if they can find a buyer. The EHR is a distant second to Epic in every metric [TTA 27 May] and Oracle has an immense obligation to the Federal Government for both the Military Health System (MHS) and VA’s EHR Modernization that won’t complete projected rollout until 2031.

A recent analysis published in Seeking Alpha (may require free account, PDF here) will give one further pause.

The debt load is a crusher. There’s anywhere from $72 to $100 billion in debt on Oracle’s books, and that preceded the PIMCO financing of $16.3 billion that included equity. Their credit rating from major raters is one step above junk: BBB-negative from S&P Global Ratings and Moody’s Baa2 Negative outlook. [TTA 7 May] Oracle has already projected it needs more: an additional $40 billion in fiscal 2027 through a mix of debt and equity.

Net debt is soaring. Oracle ended FY 2026 with net debt of $97.6 billion. This represents a ~20% increase versus the $81.4 billion of FY 2025. Looking forward, this analyst is projecting that the net debt by end of FY 2027 will be in the range of ~$120 billion.

There’s another little problem called cash flow. Years of positive free cash flow, even during the pandemic recession, turned sour in their FY 26 to a negative $23.7 billion. The analysis states that Oracle is now heavily dependent on external cash–debt–to finance its AI infrastructure building. S&P also noted that capital expenditure has been geometrically increasing: $6.9 billion (2024), $21.1 billion (2025) and $55.7 billion (2026). The guidance for fiscal 2027? Between $90 and $95 billion. That is over a 70% increase. Cash flow clearly can’t pay down the debt they already have, a fact that banks factored in to cut off the lending spigot.

Its performance obligations are also crushing. $553 billion has been reported for OpenAI alone [TTA 7 May].  This article reports remaining performance obligations of $638 billion, about half of which is for OpenAI. Despite the disparity in numbers (perhaps completed obligations?), in this analyst’s view, something happens to OpenAI–for instance, a pullback in the confidence of markets to finance their aggressive expansion (and, this Editor would add, an IPO)–Oracle would be hit hard. To paraphrase an overworked analogy, if OpenAI stumbles and sprains its ankle, Oracle would break both legs.

But..but…isn’t demand supposed to be increasing, infinitely?  Increased demand is critical to continued financing. Yet there are leading indicators that demand is leveling off. Corporations are increasingly limiting internal use of AI by employees to tamp down soaring token usage costs and control budgets. These companies have also found that AI tools often do not work as well in replacing humans as they were cracked up to be. And now seemingly every software offering is ‘powered by AI’. The newness is wearing off.

The chip cycle is speeding up–not good news for AI infrastructure builders.  Nvidia is now in full production of its Vera Rubin chip, which is dramatically faster than the previous generation Blackwell chip. Our March reporting picked up that Oracle had forward commitments with Nvidia to use the older Blackwell chip for the OpenAI data centers, and OpenAI wasn’t happy about that. It’s not a simple matter of going to Nvidia and returning old chips and getting new ones–that isn’t done. Vera Rubin is also twice as expensive on a per-rack basis than Blackwell–$7.8 million versus $4 million. Add to this the long taffy pull of building (online is 12-18 months minimum), power, water, and labor costs…it adds up, as any builder will tell you.

Given the above factors, it shouldn’t be any surprise that Oracle stock is down 30% since last December and continues to decline.

Extra: The article also contains a short history of financial cycles. There are parallels drawn comparing the AI boom we are in to similar technology-driven boom and bust cycles, dating back to the building of canals in the 1700s, railways in the 1800s, and electrification in the early 1900s.  

Editor’s note: Any analysis of Oracle’s financial health is based on this article, previous articles, multiple sources, and Oracle’s disclosures. Our interest is primarily in the well-being of Oracle Health and the markets it serves. We do not engage in stock picking and none of the above should be construed as financial advice.