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Chutes & Ladders: Click Therapeutics raises $50M, lays off 27%; India’s IKS Health in talks to buy TruBridge for over $600M; TELCOR buys Sample for RCM expansion

April 15, 2026 | by Donna Cusano | No Comments

So far, not a lot of ups and downs this week….

What’s both a Ladder and a Chute?

Click Therapeutics put together a healthy Series D of $50 million to commercialize its digital therapeutic for the treatment of the experiential negative symptoms of schizophrenia. That’s a cheerful earful, except for the reported 27% of their employees who just got chuted with a pink slip. In the reported range of 100-250 employees, that means 27 to 67 employees being told ‘no work for you’ after bringing the company to the commercialization point. That is a deep cut.

Boehringer Ingelheim and Click jointly developed the digital technology, which received Breakthrough Device Designation by the FDA in 2024 as an investigational technology. It provides an an adjunct to standard antipsychotic therapy through interactive psychosocial intervention techniques.

With the $50 million funding, Boehringer turned over commercialization to Click. What is odd here is that companies with investigational tech and large partners usually keep the staff lean. Commercialization and funding then means that hires change from researchers to marketers, sales, and compliance, for a net gain. The next question is…when?

Austin Speier, chief strategy officer, commented to Behavioral Health Business: “While we are incredibly excited about the potential of CT-155, that shift means making hard changes to our team to match our new commercial mission. These were not decisions we made lightly, and we are deeply grateful to everyone who helped us reach this stage.” CT-155, as it is formally known, does not yet have FDA clearance. It has a Phase III study, CONVOKE (NCT05838625), a Phase III, multicenter, randomized, double-blind, 16-week study evaluating the efficacy and safety of CT-155 versus a digital control app. Neither the BHB and FierceBiotech articles nor Click’s release reveal a timeline for FDA clearance and marketing. Which means that final FDA approval may be more distant than the funding and turnover make it appear.

Indian RCM provider IKS Health seeks to add TruBridge’s RCM for $675 million. Talks are reportedly in an advanced stage with an all-cash offer funded by a $675 million debt facility from banks like Citi, Deutsche Bank, and JP Morgan. It covers both purchase price and refinances TruBridge’s existing debt. No formal offer has been tendered to TruBridge’s board or shareholders. Surprisingly, this has gained little notice in the US healthcare press.

TruBridge provides HIT, an EHR, and RCM for health systems and practices. It is both established from the late 1990s, when RCM was new, and fairly large–it serves 1,500 healthcare organizations and employs 3,500 people with revenue of $347 million. It IPO’d in 2002 as CPSI on Nasdaq, converting to TruBridge in 2024. IKS Health is HQ’d in Mumbai but has a US HQ in Texas. It has 13,350 employees and a global base of 600 clients. It’s public on the National Stock Exchange of India Limited (NSE) and BSE Limited (BSE). In addition to RCM, it offers care coordination, risk and optimization, and utilization management tools for value-based care. Digital Health News (India)

Also in RCM, TELCOR is buying Sample Healthcare. Amount and transitions are undisclosed. Like TruBridge, TELCOR started in the late 1990s. It serves both hospital and independent labs’ RCM for billing plus point-of-care and laboratory data. It has a 57% market share in the US for point-of-care solutions and serves over 2,700 hospitals and laboratories. Sample will add an AI-driven workflow engine that will be marketed as a separate product. It received seed funding out of Y Combinator in 2024. It’s easy to determine that Sample is a tuck-in acquisition for TELCOR. TELCOR release.

VA’s Oracle EHR resumes go-lives at four Michigan systems–finally

April 15, 2026 | by Donna Cusano | No Comments

On schedule, the VA’s EHR Modernization resumes after a three-year-plus hiatus. The four VA Medical Centers (VAMCs) announcing their go-lives over this past weekend are all in Michigan’s VISN 10: Ann Arbor, Battle Creek, Detroit and Saginaw. Four more are planned for June, also in VISN 10 (a VISN is a VA region): Dayton Ohio, Chillicothe Ohio, Cincinnati, and Cincinnati-Fort Thomas Kentucky, then three more in August and two more in October. Based on the schedule, calendar 2026 will have a total of 13 system rollouts, all in VISN 10 except for the last in October, which will include VISN 20’s Anchorage, Alaska VA Health System. [TTA 8 Feb]

The only exception to the hiatus was a joint Military Health System/VA implementation at Lovell in Chicago, which has had its own bumps after its start in March 2024. VA previously had five disastrous implementations, VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022. After many actions to fix them, the VA halted implementations in April 2023. Even in 2025, in its agency report, the VA’s Office of Inspector General in their March 2025 report, and their January 2026 report on VA’s Management and Performance Challenges for FY 2025 found a distinct lack of VA staff confidence in the EHRM and its performance to date [TTA 8 Feb].

Strategically, confining the rollouts to one VISN and a small group at a time is smart because of the geographical adjacency and not scattering efforts all over the US. After these 13 however, there are 157 more. VA has pegged a full completion by 2031.

In its press release announcing the April go-lives, the VA identified four factors that got the EHRM off the dime. FTR:

Fixing hundreds of problems related to the initial rollout of the EHR system at the six original VA sites. Some of these related to efforts by local VA facilities to customize the system, which only complicated the process.
Eliminating the bureaucracy that was holding the project back. VA replaced that unwieldy system with a single council that answers to top VA leaders, increasing accountability and making it easier to find and implement common sense decisions.
Getting local facilities more involved. As VA’s lead official on the EHR rollout, VA Deputy Secretary Paul Lawrence has visited all 13 deployment sites this year and has engaged directly with facility leaders at each location to answer questions and make sure these sites are ready to go.
Hiring more people to ensure the rollout goes smoothly. VA has already hired dozens of staff to help with the rollout in Michigan and other locations and is in the process of hiring a total of 400 people.

Last year, VA terminated contracts for at least six independent contractors supporting the EHRM as part of a mass cleanup of department contracts. FNN

Federal News Network, Healthcare Dive

There is nothing in the release, of course, about Oracle Health’s manpower cuts, rumored to be 30%, nor the persistent talk that the EHR unit will be sold or spun off. Or the effects that the recent indictment of a former EHRM head will have in Congress. In this Editor’s view, Oracle’s corporate redirection to and big bet on AI datacenters strongly suggests that Oracle will not be engaged with this deployment by the time 2031 rolls around.

Two weekend ‘must reads’: the New Yorker’s Sam Altman/OpenAI exposé–and comments; a further deep dive into Carbon Health’s implosion

April 10, 2026 | by Donna Cusano | No Comments

Too long to summarize or opine on this week–but a must for your weekend reading. Grab the cuppa for the talk of AI World–a New Yorker dissection of Sam Altman, the CEO of OpenAI (link below). To say it is an exposé worthy, at first glance, of the Old School (ain’t no school like the Old School–Ed.) on probably the most important company of AD 2026 is to undersell it. It’s a long article and you’ll need at least one break.

OpenAI, founded as a non-profit with integrity at its core to “prioritize the safety of humanity over the company’s success, or even its survival”, recapitalized last year as a for-profit corporation with 26% of the shares owned by the OpenAI Foundation. It is now a trillion-dollar company that had no trouble raising a paltry $122 billion last week [TTA 2 April] though arguments are made that at least some of that money are IOUs or contingent. ChatGPT has become almost generic for AI, like Kleenex has become for tissues. The battles over control and direction of the company are now totally controlled by Sam Altman, whom former colleagues are not shy about pointing out his difficulty with the truth and a pattern of deceit, for instance to his board, to employees, and Microsoft. Yet everyone continues to do business with him. The FOMO Factor is very strong.

Mr. Altman makes extremely broad statements on the future of work (most traditional managerial, healthcare, and IT jobs will be taken over by AI, thus most of us will be unemployed), has easy access to President Donald Trump, as well as other world executives, and may, as the headline barks, control our future. Thus, he is a person of consequence.

My read so far of this is that within OpenAI, there is no one to counterbalance Mr. Altman’s immense ambition, his desire to dominate and win, not only with AI but also over all business and everyday life. These are character issues that also show up in aspects of his personal life, detailed in the article. If past results are predictive of the future, this flaw usually curdles into the desire to control countries and a complete disrespect for the rest of us leading our lives.

Sam Altman May Control Our Future–Can He Be Trusted?,

I will offer two LinkedIn comment posts on this article from an AI person I respect, the head of Curiouser.ai, Stephen Klein. Many of his posts on LinkedIn deal with what AI can and cannot do in business. He writes that he is “committed to designing technology that augments people, creates jobs, and elevates humanity. It’s time we all got back to thinking for ourselves.” 7 April, 8 April

Our second Must Read is from Sergei Polevikov’s AI Health Uncut, a long analysis on the failure of Carbon Health and what it tells us in “this business we have chosen”. “What The Hell Went Wrong?” and its implications need answers–because it’s being repeated again and again. Today’s article (9 April) is Part 1 of 2, sets the stage about the mistakes made (insiders talk) and, with full credit, springboards off Stuart Miller’s (Haverin Consulting) original analysis made at the time of the Chapter 11 reorg. What we called the ‘Ominous Parallels’ was a Must Read here on 12 February. TTA (as Telecare Aware, our original name) and this article are also mentioned twice (thanks!).

Those who have yet to subscribe for Mr. Polevikov’s analytic, erudite, and revealing (Emperor’s New Clothes!) POVs can read part of this article for free–but seriously, if you’re in this business, the subscription is worth your money. He also podcasts (links are on his Substack, link at lower right sidebar).

An early and scandalous publisher (before he utterly lost it), Matt Drudge, used to say that he ‘went where the stink is’. Mr. Polevikov does the same. The stink is of our broken primary care reimbursement system, the Covid steroids that pumped up the company, flailing management running through money like drugs, and good ideas for patient care buried under incompetence.

Perspectives: Exploring the Telehealth Extension: Building Infrastructures for Better Access

April 9, 2026 | by Donna Cusano | No Comments

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic is on how the most recent two-year extension of Medicare telehealth flexibilities necessitate a more robust healthcare infrastructure to better utilize the additional data generated by remote patient monitoring. The author, Jiang Li, Ph.D., is founder and CEO of Vivalink, Inc., a Silicon Valley company developing digital health technology solutions for remote patient monitoring in healthcare and clinical research.

Ensuring equal healthcare access to Americans across the country is an ongoing effort. The latest funding bill from Congress looks to improve access by expanding where and how people receive care through a two-year extension of Medicare telehealth flexibilities. The bill adds to the five-year extension to the CMS Acute Hospital Care at Home (AHCAH) waiver, which allows hospitals to deliver acute inpatient care in patients’ homes with full Medicare reimbursement. Since its launch in 2020, the program has continued to receive extensions in the continued effort to ensure Americans living in rural or remote areas receive the healthcare they need.

Under the current Medicare extensions, telehealth provides real-time medical and mental health appointments over secure video from a patient’s location, along with a wide range of Part B services such as specialist consults, rehab, and psychotherapy. This latest extension allows beneficiaries to continue receiving this care from an expanded list of healthcare providers. While the original waiver was authorized in response to COVID-19, research shows that around 17% of healthcare visits were conducted via telehealth modalities post-2020, with over 116 million global users listed in 2024.

Telehealth helps address a gap in healthcare access felt by many Americans living in rural locations. While the extension provides flexibility for those patients to continue receiving remote care, it isn’t enough to close the gaps in American healthcare on its own. What will define its success is a deliberate investment in infrastructure from health systems, policymakers, and technology developers alike.

Exploring the Access Problem

Nearly 80% of rural America is classified as medically underserved, facing barriers such as provider shortages, high poverty rates, and a rapidly aging population. For Medicare-eligible patients in these communities, the obstacles to consistent care, including transportation limitations to caregiver responsibilities, can often prove to be insurmountable, blocking them from necessary medical care.

We see the direct result of these consequences in the data. One significant example is cardiac rehabilitation — more than one million Americans become eligible each year, yet fewer than 20% participate. Even among those referred, less than 34% enroll, largely because the model still demands repeated clinic visits that many patients simply cannot manage. This has been a slow but sure systemic struggle, embedded in how care has historically been designed and delivered.

We can see these consequences further compounded by issues with traditional monitoring. Episodic, in-clinic measurements offer only brief snapshots of a patient’s health, often missing transient but dangerous events occurring between visits. A study at Brigham and Women’s Hospital found that 27% of cardiac surgery patients experienced new atrial fibrillation episodes after discharge that traditional follow-up would have missed entirely. This post-discharge period, long treated as a clinical blind spot, illustrates the value of supporting remote care.

Making Changes for a Stronger Infrastructure

The outcomes of the AHCAH waiver have been significant: an analysis of over 5,800 patients treated under the waiver at Mass General Brigham found in-care mortality below 1%, compared to a national inpatient average of approximately 2%, with only 7% requiring return hospitalization. The cost savings are notable as well, with one review finding that hospital-at-home (HaH) patients cost approximately 20% less than traditional inpatients, allowing Medicare to spend $1,000 to $3,300 less per case across common conditions like pneumonia, heart failure, and sepsis in the 30 days post-discharge.

To ensure similar outcomes and savings at scale, a stronger infrastructure is needed. We’re already seeing movement in the replacement of traditional, episodic data by medical-grade wearable sensors capable of continuous ECG monitoring, temperature tracking, and real-time data transmission. We’re already seeing solutions for issues such as interrupted data capture during connectivity gaps, simply by expanding the storage capabilities of devices that support rural Medicare populations.

Interoperability is equally important. Biometric data from wearables should flow directly into electronic health records and centralized clinical dashboards, delivering real-time alerts without burdening staff with manual data entry. For regional and mid-sized hospitals that serve the most underserved populations, this means access to modular platforms rather than expensive third-party bundles that absorb reimbursements before they reach patient care.

Supporting a Stronger Future

The decision to extend Medicare telehealth flexibilities is a market signal for health systems. Regulatory uncertainty has been one of the greatest barriers to the advancement of remote patient monitoring platforms, wearable infrastructure, and other programs. When reimbursement timelines are measured in months, it is difficult to justify multi-year infrastructure investments. As the CMS update extends reimbursement by two years, at-home care now has the opportunity to become an evolving standard of Medicare delivery worth investing in.

The opportunity extends well beyond Medicare. The same remote patient monitoring infrastructure enabling home-based acute care is powering decentralized clinical trials, expanding access for older and rural patients historically excluded from research. These opportunities for growth and inclusivity, supported by CMS, signal that at-home care is becoming a permanent feature of how Medicare is delivered.

Funding/deal roundup: WHOOP’s $575M Giant raise, Anthropic buys med AI startup for $400M, early stage fundings for Jimini, Insight Health; Noom buys compounder; Mount Sinai NY to embed OpenEvidence

April 9, 2026 | by Donna Cusano | No Comments

Deals lately are very large…or very small. All have “AI” somewhere. Some unusual ones this past week.

The WHOOP wearable definitely whooped it up with a $575 million Series G (for Giant) funding. It’s a fitness and health watch that is reasonably trim and presentable sans a screen. It tracks sleep, activity, heart health and menstrual cycles (if applicable) through measurement of heart rate variability (HRV), resting heart rate (RHR), respiratory rate, and blood oxygen levels, and appeals to the very athletic with metrics around recovery and strain. The Boston-based company claims 2.5 million members internationally; in 2025 it marked 2025 growth of 103% and exited at the infamous ‘run rate’ metric of $1.1 billion. Their AI twist is around biometric data and how it is used to guide tracking and performance. It is heavily pitched to elite sports with famous athlete endorsers/investors such as soccer star Cristiano Rinaldo, basketball’s LeBron James, and golfer Rory McElroy.

The round was led by Collaborative Fund and includes global participation from a gang of investors including 2PointZero Group, Qatar Investment Authority (QIA), Mubadala Investment Company, Abbott, Mayo Clinic, Macquarie Capital (entities administered by Macquarie Capital), Glade Brook, B-Flexion, IVP, Foundry, Accomplice, Affinity Partners, Promus Ventures, and Bullhound Capital alongside a group of prominent global athletes and individual investors. The additional funds will be used for growth in the US plus international expansion across Europe, the GCC, Latin America, and Asia. The wonderfully subjective (by investors) metric of valuation stands at $10.1 billion. Total funding since 2012 is over $900 million.

WHOOP received the infamous Warning Letter from FDA’s Center for Devices and Radiological Health (CDRH) in July 2025 regarding marketing claims for Blood Pressure Insights (BPI) on the basis that the company did not have an approved application for premarket approval (PMA) or 510(k) approval of that feature. The founder/CEO is contesting FDA as he believes that the feature is for general wellness purposes and is covered under the 21st Century Cures Act. Mobihealthnews, WHOOP release

(In all honesty, this Editor had only vaguely heard of it, but her idea of a expensive watch usually has the name Elgin or Hamilton on the face and is usually antique (Omega too, sigh). In fitness watches, she thinks of Apple, Samsung, and the low-profile Withings (which makes traditionally styled smartwatches) but none of them have persuaded her to part with several hundred dollars.)

Anthropic buys a tiny bio research software developer for a stunning $400 million in stock. Coefficient Bio was founded only eight months ago and reportedly had only nine employees. It was so stealthy that it never got past the placeholder website. The amount was reported by its 50% owner, venture capital firm Dimension, which realized a hefty 38,513% IRR on the investment. Coefficient was working on AI models and software for biological research. Apparently founder Samuel Stanton and his team will join Anthropic’s Health Care Life Sciences area. It’s interesting that Anthropic is building up their healthcare footprint after making their customized AI available to both consumers and clinicians, quite a contrast to OpenAI’s purchase of TPTN, a small podcaster of tech news and personalities (CNBC). HISTalk 4/6/26, Silicon Angle, Newcomer

Early stage companies also nabbed some decent fundings

Behavioral health therapy assistant Jimini Health raised $17 million in seed funding from M13, Town Hall Ventures, LionBird, Zetta Venture Partners, and OneMind, bringing total funding to more than $25 million. Their AI-forward (of course) Sage platform fills the niche left by fully remote telementalhealth companies in supporting large behavioral health provider organizations. NYC-based Jimini promotes a clinician-supervised and controlled patient-facing, reimbursement-ready and compliant infrastructure with licensed clinicians maintaining oversight of every patient interaction. According to the release, the funding will be used to build partnerships with “several of the largest behavioral health provider organizations in the country and expand Sage’s clinical capabilities across comorbidities, care settings, and patient engagement modalities”. Release, Behavioral Health Business, Mobihealthnews

Insight Health’s $11 million Series A will be used to scale its agentic AI platform. The round was led by Standard Capital, with participation from Kindred Ventures, Pear VC, Eudemian, 43 and ElevenLabs. Insight Health uses AI to automate routine clinical and non-clinical tasks such as phone and front-desk coordination, referral and fax processing, pre-clinical intake, and clinical documentation. For instance their agents engage with patients directly via voice or text. Current customer base is in clinics. Their Aura AI Scribe and Virtual Care Assistant are available in athenahealth’s Marketplace. Their total funding is about $16 million. Release, Mobihealthnews

Short takes:

Noom buys 503A licensed pharmacy Tailor Made Compounding (TMC). The buy, according to Noom, will enable them to expand beyond weight loss GLP-1s further into the healthy aging segment, with longevity peptides, hormone replacement, and cosmetics. Noom has weathered several pivots, starting in 2008 with fitness apps, then added behavioral change with a weight-loss coaching app in 2017. It has pretty much settled into the lucrative e-prescribing and wellness ‘preventative care’ area targeting health plans and employers. TMC’s client base includes 400 clinics and multiple telehealth partners, which presumably Noom will let them maintain. Acquisition cost and staff transitions were not disclosed beyond integration ‘later this summer’. Release, Mobihealthnews

‘IT’ clinical information search engine/AI chatbot OpenEvidence inks deal with NY’s Mount Sinai Health System. It is Mount Sinai’s first enterprise-wide AI deployment and integration across clinical roles, according to the health system’s announcement last week. It will be integrated into their Epic EHR. OpenEvidence, with a eyeblinking valuation of $12 billion [TTA 13 Feb], claims a daily average usage by 40% of US doctors in 10,000 hospitals and medical centers of their free search engine trained on journals and clinical medical data only. It fills a gap that competitors Doximity, Epocrates, and Medscape aren’t doing. It has added clinical trial matching to its capabilities filtering trials by study design, enrollment status, and geographic proximity. This adds on to Sutter Health’s integration into doctors’ Epic workflows announced earlier this year. Healthcare IT News

NY Times’ highly questionable but glowing–and viral–portrait of AI-created GLP-1 e-prescriber and marketer Medvi

April 9, 2026 | by Donna Cusano | No Comments

Hey, startup founder–why aren’t YOU building a $1.8 billion revenue company with AI and just you (and your brother)? In 14 months? On $20,000? Last week’s glowfest articles about Medvi in the Old Gray Lady NY Times (where you don’t expect it) went viral. The coverage would make the average tech bro founder feel just a little bit small. The private two-person company reported to the NYT that they earned $401 million in revenue in 2025, its first full calendar year, from 250,000 customers and made a 16.2% net profit, or $65 million, and now is supposedly on track (the old “run rate”) to make $1.8 billion in 2026. To compare to giant Hims, a public company built the old-fashioned way, that’s more than half Hims’ 2025 revenue. Medvi has not borrowed and has no investors, thus no external valuation.

It’s a simple marketing model selling e-prescriptions for GLP-1 weight loss, peptides and other longevity meds, others for specialized men’s and women’s health such as hormone balance and hair health, and prepackaged meals to go. Medvi runs the website, the checkout, and the customer relationship including service. All the sticky stuff, such as licensed physicians to prescribe, prescription processing, pharmacy fulfillment, shipping logistics, and regulatory compliance, are outsourced to OpenLoop Health (telehealth) and CareValidate (virtual care management and med fulfillment (plus presumably a meal supplier). AI tools wrote the website code and copy, the ever-popular ElevenLabs for customer facing voice tools, chatbots for customer inquiries, AI agents to connect all the systems…a veritable proof positive of the vision of Sam Altman of OpenAI on what he believes will be the Future of Business Without Workers, Only Customers. Winning Altman’s bet of the first billion dollar AI-built company, in fact.

AI handling most of the work, designed by founder/CEO Matthew Gallagher, who had to bring in his brother because it took off so fast. Outsourcing to known telehealth/telemedicine suppliers. All he did was the marketing and selling. A veritable genius in pulling this all together–then getting an article in the NYT that any PR person or marketing director would ‘kill’ for? What could be wrong?

Other media dug into the pretty picture, doing the work the NYT wouldn’t do. The chatbots initially hallucinated pricing and products for customers. It sent links to customers confirming intake forms that with a minor digit change in the sequential integer at the end, accessed other people’s records–a significant breach of HIPAA that was solved between the discoverer and an assistant at Medvi–but apparently never reported to HHS’ Office of Civil Rights as required. Medvi received one of those charming warning letters from the FDA in February about their website depicting GLP-1 injectables with their name on the syringe (still there) as well as featuring compounded weight loss and other meds as ‘FDA-approved’–yes, those compounded GLP-1’s no longer permitted for well over a year, and in any case, not approved. [TTA 12 Mar]. There is no record on the FDA website of a response (required within 15 working days) to the FDA letter. OpenLoop itself had a January data breach affecting 1.6 million patient records and is facing a class action lawsuit on compounded oral tirzepatide manufactured by Triad Rx–and sold by Medvi. Oh yes, there are faked up before-and-after pictures on the website of customers.

Even more blatant is its use of extensive affiliate marketing featuring deepfaked doctor pictures and personas talking up Medvi–5,000 ad campaigns reported by Meta in their library last week, according to Business Insider/MSN. The doctors quoted either did not exist or linked to stores in Angola. They used AI-generated video testimonials and recycled identical scripts across multiple fabricated doctors. Mr. Gallagher told the online outlet in an email that “maybe 30%” of its advertising was through affiliates”.

AI slop. And the Times fell for it!

This Editor predicts that based on the multiple articles read on background for this article, that the laundry list of problems goes on much longer than this. Medvi will either hire a cleanup crew, go forth and sin no more, or shut the doors in a hail of litigation. Each one of them has its own spin worth reading: Forbes (surprisingly), Drug Discovery & Trends, Techdirt (!–particularly tart), Futurism, Moneywise, LinkedIn. Mr. Gallagher better hold on the Lamborghini and start putting a significant part of that gusher of cash aside for a compliance expert and some good attorneys.

Former VA EHRM executive director Federally charged with accepting vendor cash and gifts, making false statements

April 3, 2026 | by Donna Cusano | No Comments

Not knighted, but indicted. The former executive director of the VA’s Office of EHR Modernization (OEHRM) from 2017 to 2021, John H. Windom, was charged with failing to disclose cash and gifts from vendors, then making false statements to investigators in failing to report those gifts. The three counts were brought by a grand jury in the Federal District Court for the District of Columbia on 25 March. They were originally sworn in on 30 October 2025.

According to the Department of Justice (DOJ), the charges carry a statutory maximum sentence of 20 years in prison, with false statements adding another five years maximum per charge and possible financial penalties. The three counts involve violations of United States Code (USC) Title 18, Sections 1001 and 1519.

As executive director for the OEHRM, Mr. Windom was responsible for leading the long-term vision, strategic management, technical direction, acquisition, and deployment of the Cerner EHR in the VA that was announced in June 2017 and awarded in May 2028. He is being charged with accepting and soliciting gifts and cash from a group of VA contractors and subcontractors he termed the “Power Group”, then failing to disclose them according to law. This group included eight persons in seven independent minority-owned contractor companies in IT and health IT services and technology, management consulting, diversity and inclusion work, project management, business development, and general support services. Two companies were prime contractors directly on the VA EHRM project and overseen by Mr. Windom.

He is accused of flagrantly accepting and demanding cash and gifts from the contractors, including meals, drinks, entertainment, casino chips from the MGM National Harbor and Aria Las Vegas, and gift cards for Louis Vuitton luggage totalling over $15,600. His demands from individuals and interactions with them are extensively detailed in the indictment. Mr. Windom also failed to report gifts on standard VA forms, and denied the gifts to Federal law enforcement officials interviewing him twice in 2021. In 2024, when interviewed again, Mr. Windom admitted accepting chips. The gift acceptances from vendors with clear conflicts of interest and failures to report, including on his required annual public financial disclosure form, were violations of established Federal ethics laws and regulations restricting gifts.

According to the indictment, he also pressured the vendors to make business decisions unrelated to the EHRM that advanced certain personal diversity objectives and then demanded to be rewarded. He also threatened this Power Group with economic and reputational harm, particularly but not only related to his diversity networking expectations (General Allegations, point 14).

John Windom, aged 64, has an interesting background. He joined the VA in September 2017 after retiring from service as a Navy Captain. While in the Navy, he had direct experience of the Cerner EHR implementation at the Department of Defense (DoD) as a program manager for their Defense Healthcare Management System Modernization Program. His 2017 appointment as executive director of the OEHRM replaced Genevieve Morris, interim chief health information officer, who had moved from ONC in July but resigned almost immediately in August citing a change in direction (MedCityNews). He became a three-year Limited Term Senior Executive Service (SES) member, a prestigious status in the Federal Government. As OEHRM ED, he reported to the Deputy Secretary of the VA and shifted after the May 2018 selection to onboarding the Cerner EHR. He became a career SES in July 2020. His Federal biography for Congress from this time is here. Mr. Windom was reassigned from OEHRM in April 2022, moving to deputy director of the Federal Electronic Health Management Office, a joint DoD-VA initiative to support the delivery of a single, integrated EHR. It is not clear where or if he is currently employed.

US Attorney for the District of Columbia Jeanine Pirro said in the DOJ release “As alleged, the defendant exploited his senior position for personal gain and concealed gifts and financial relationships that created serious conflicts of interest in the health care of our nation’s veterans. Such conduct is not only a betrayal of the public trust—it undermines confidence in the institutions dedicated to serving those who have sacrificed for this country.” The case is being investigated by the US Attorney’s Office for the District of Columbia, the FBI Washington Field Office, and the Veterans Affairs Office of the Inspector General (OIG). It is being prosecuted by Assistant US Attorney Emily Miller. No timeline for the start of the trial was announced.

None of this seems to have directly involved Cerner, now Oracle Health, per the indictment. But in this Editor’s opinion, because of Mr. Windom’s role in the selection of the Cerner EHR and the disastrous implementation of VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022, all terminated in 2023, Oracle would be unwise to not prepare for a few questions about Cerner’s relationship with Mr. Windom.

Both Senate and House VA committee chairs are highly concerned about this indictment. Apparently, it will not delay (and reasonably should not) the scheduled rollout of the 13 VA locations starting this month [TTA 8 Feb].

News sources include Federal News Network, Healthcare IT News, and Military Times.

Teladoc faces activist shareholder challenge, demanding $200M stock buyback, business spinoffs, cost cuts

April 3, 2026 | by Donna Cusano | 2 Comments

Languishing Teladoc faces activist shareholder as Q1 reporting nears. Pineal Capital Management, a Dublin, Ireland-based investment firm, issued on Tuesday an open letter to Teladoc’s board, management, and fellow shareholders. The letter publicly revealed their differences with management on the disconnect between the present low value of the stock (TDOC is trading in the $5 range), advocating unlocking what they term ‘the true embedded value of the business and significantly misprices its positive, longer-term prospects.”

While Pineal positioned Teladoc’s current situation as the global leader in virtual healthcare with a 100 million member base, it blamed the company’s “distressed-level valuation” — trading at 4.18 times enterprise value to EBITDA — on multiple management mistakes. These began with the 2020 acquisition of Livongo (a near-fatal self-inflicted error) and now extend to capital spent on bolt-on acquisitions proven to be not accretive to revenue at present, no presentation to shareholders of a multi-year business plan by management to increase share price (down 90% from pre-COVID highs), and share dilution through too many shares outstanding–177 million at present from 90 million in 2020.

Pineal’s remedy list is not unexpected and cuts straight to the chase:

Increasing cost efficiencies, primarily additional cost cutting.
A share buyback up to $200 million to reduce dilution.
Exploring a break-up of the two core businesses – Integrated Care and BetterHelp – into separate entities, via a sale or spin-off transaction.

It believes that Teladoc has plenty of upside due to expanding reimbursement for virtual healthcare, lower out of pocket costs (including permanent first-dollar coverage in high-deductible health care plans and two rural health support programs), their launch of their new 24/7 Virtual Care Platform, a shift for BetterHelp’s behavioral telehealth to an insurance-based payer model boosting conversion and lifetime value–expected to grow to a $100 million run rate in 2026, and international expansion, the real boost for BetterHelp. (This Editor notes that the ‘bolt-on’ acquisition of UpLift was a part of BetterHelp’s conversion to a payer model–see below.)

BetterHelp is Pineal’s primary focus in the letter as the ‘crown jewel’ versus the older Integrated Care platform. Pineal notes the recent $835 million acquisition by UHS of Talkspace, another telementalhealth provider with a checkered track record, as an argument for a BetterHelp spinoff or sale.

The ‘or else’, always a part of these activist challenges, is concern “that continued inaction risks a private-market bid at a level well below true intrinsic value”, poison to major shareholders.

Pineal owns TDOC shares through its Pineal Capital Fund 1. The number of shares was not disclosed nor is known through filings in Ireland or the open letter.

What this all means. Or could mean.

Teladoc’s 2025 was flat versus the prior year–retrospectively an improvement versus the bloodlettings of prior years. But their 2026 projection was also flat. In 2025, BetterHelp, their behavioral telehealth unit, fell 9% year over year to $950.4 million in revenue. In reporting 2025 results, Teladoc announced that the Integrated Care business would move from subscription models to visit-based revenue to compensate for enrollment reductions at some client health plans in government programs and reductions in ACA subsidies.

It’s a mystery why Pineal sees BetterHelp as a ‘crown jewel’ when for 2026, Teladoc is projecting a 7% revenue reduction. This Editor has not forgotten that BetterHelp was also seen by former CEO Jason Gorevic (exited 2024) as the future of the company. In May 2025, Teladoc added insurance coverage to primarily DTC BetterHelp by acquiring UpLift for $30 million.

There have been some gains in the share price (about 6%) but it closed today slightly down at $5.28. Stock analyst Zachs isn’t exactly bullish on Q1 results to be reported on 29 April. Revenue projections are down 2.71% to $612.3 million versus Q1 2025, with EPS down $0.3, a 58% drop versus Q1 2025. The year looks equally down with revenue of $2.51 billion, essentially flat to down -0.81%. Yahoo Finance

But…there’s more, just like the direct response commercials.

A further analysis in Bitget shows that total institutional holdings in Teladoc declined by 29.4%. CEO Chuck Divita sold 27,731 shares on 11 March, reducing his direct stake by 7% to roughly $2 million. Yet for some reason, investor Ray Dalio through his firm Bridgewater Associates has been buying on dips, notably increasing its Teladoc stake by 151,000 shares or 31.2% in Q4 2025. However, this can be attributed to speculation to salvage a small (.01%) but underwater position.

It is clear that Pineal is pushing for a greater valuation of Teladoc shares, as well as a buyback that would bolster their fund’s cash position. It’s an educated guess, but they are not going to be alone among the battered shareholders, either. Watch for another shoe drop around the Q1 earnings report on 29 April.

Coverage from Reuters, Investing.com,

A study in contrasts: OpenAI raises $122B, eMed’s $200M Series A. Then there’s Avo’s $10M Series A, Stedi’s $50M Series C. And Oracle expands Nashville campus!

April 2, 2026 | by Donna Cusano | No Comments

Your Editor is feeling a little whipsawed this usually quiet pre-Easter and Passover week. We opened with 30,000 Oracle employees losing their jobs. Yet even if Oracle can’t get it, there’s plenty of money out there that’s looking for an investment home. Some rounds are huge–if it’s AI or GLP-1, you can bet on BIG–but most fundings for startups and early stage companies are modest in a pre-2019 way. The money that’s out there lines up for ‘sure things’.

OpenAI had no problem raising $122 billion as it moves to conquer the AI World (and maybe the Universe) via ChatGPT. Considering their claim that they are generating $2 billion in revenue per month, just replace the millions raised in the earlier digital age with billions. There’s a laundry list of investors including institutions, individual investors via banks, plus exchange-traded funds managed by ARK Invest. The anchor investors are strategic partners Amazon, NVIDIA, and SoftBank, with continued participation from Microsoft. SoftBank co-led the round alongside a16z, D. E. Shaw Ventures, MGX, TPG, and accounts advised by T. Rowe Price Associates. The release notes leadership in consumer AI and growth in enterprise AI; as noted here, in January OpenAI debuted ChatGPT for Healthcare (enterprise) and put into test ChatGPT for Health (consumer).

At a ‘virtual VC conference’ earlier this week, one investor panelist estimated that 14% of venture capital funding in 2025 went to exactly two companies, OpenAI and Anthropic (Claude). That disproportion rings alarm bells to this Editor, who well remembers the ludicrous dot-com boom/bust, and even earlier the insane financing that went into (mostly failed) airlines during deregulation–including the airline she worked for.

Another healthcare segment that hasn’t had much problem raising funds is e-prescribing of GLP-1 drugs. Miami-based eMed raised $200 million in its Series A, bringing its valuation to over $2 billion. Fronted by NFL quarterback legend Tom Brady, recently named founding chief wellness officer who is also an investor, the round was led by earlier investor AON Consulting with the addition of a starry roster of individual investors noted in their brief release. eMed’s eRx is marketed both to individuals and employers; the fresh funding will support further development of its agentic AI platform plus a new capitated model “designed to help employers bend the healthcare cost curve”. This Editor notes the lede in most articles about eMed is Brady and the $2 billion valuation; as our Readers know, the latter is a subjective and oft-inflated estimate of market value especially at this early stage. TTA dug into eMed and some of the company’s interesting history, crossing over into Ali Parsa and Babylon Health, here. Reuters, FierceHealthcare, Mobihealthnews

Moving back into reality, Avo, a NYC-based clinical AI information platform, raised a $10 million Series A. Avo’s calling card is bringing together EHR, revenue cycle including payer, patient data, and knowledge bases to streamline use at the point of care. Funders were led by Noro-Moseley Partners, with participation from existing investors AlleyCorp, Las Olas Venture Capital, MedMountain Ventures, Epsilon Health, and new investor Scrub Capital. Avo has a solid roster of customers that include Geisinger, Mass General Brigham, and local providers such as Englewood (NJ) Health. They also have an intriguing feature: an ambient listening copilot that references patient data and generates documentation that improves revenue cycle. Release

Stedi’s Series C is typical in this hard-raise market in both level and number of investors, with a bit of a twist. The $50 million raised brings their total to $142 million, and will be used to expand its product presence and scale infrastructure. Denver-based Stedi’s calling card is an API-first and cloud-native financial clearinghouse that in revenue cycle management sits between healthcare providers and payers (insurers) to process essential transactions like eligibility checks, claims, and electronic payments. The funding was led by by Addition, with participation from Stripe, Ribbit Capital, USV, First Round, BoxGroup, and Bloomberg Beta. There was also a group of angel investors who jumped in, including Tobi Lütke (CEO of Shopify), Guillermo Rauch (CEO of Vercel), and Karim Atiyeh (CTO of Ramp). Finsmes

Since we opened with Oracle, we’ll close with them. Five days before 30,000 employees globally were declared unnecessary, Oracle announced that they leased additional space in Nashville, specifically 116,000 square feet within The Neuhoff District at 1320 Adams Street. Oracle now has 2,000 “seats” across three Nashville locations. The release touts “teams focused on a wide variety of roles, including sales and marketing, cloud engineering, software development, and product management. The company is actively recruiting ambitious thinkers and leaders eager to shape the next generation of cloud infrastructure and AI innovation. ” Perhaps some of those hundreds of folks in KC and other locations can be rehired in Nashville (sic).

The Oracle shoe dropped: Oracle lays off 18%–20-30K–of global employees, in their largest ever layoff (Updated 2 Apr)

March 31, 2026 | by Donna Cusano | No Comments

A bad wake up this morning for too many people. To absolutely no one’s surprise to close out this month, including Mr. Market (right), Oracle Corporation laid off an estimated 20-30,000 staff globally, or a reported 18% of its 162,000 employees. Emails signed by “Oracle Leadership” went to affected employees as early as 6 AM US Eastern Time.

It is the largest layoff in the company’s history, by a company not shy about rolling layoffs. It was rumored to be this extensive at the top of this month with the departure of five key executives and a TD Cowen analysis [TTA 6 Mar]. As is typical, Oracle stock on the NYSE rose close to 4% as of 1pm ET today.

What we know:

There were no HR calls, no videos, no manager calls, no advance warning, which is the current cold and human-free style one now expects. Many surviving managers up to senior levels weren’t told in advance of team layoffs, based on Reddit postings.

As anticipated, Oracle Health, as part of the RHS area, was hard hit with 30% layoffs, based on press reports and Reddit/The Layoff.

Early reports (to be updated) out of primarily India, where Oracle employs many thousands in IT and development, indicated the layoffs hit hardest in these areas–FTA RollingOut via Times of India:

RHS (Revenue and Health Sciences) — employees described a reduction in force of at least 30%, with 16 or more engineers from individual business units cut in a single action. (Editor’s Note: this includes the Oracle Health EHR team which was the former Cerner)
SVOS (SaaS and Virtual Operations Services) — similarly reported a 30% or greater reduction, with manager-level roles included in the sweep.
NetSuite’s India Development Centre (IDC) — cuts spanned project management, individual contributor, and manager roles across multiple seniority levels.

The terse email informs employees that “we have made the decision to eliminate your role as part of a broader organizational change. As a result, today is your last working day.” Employees are also instructed to provide their personal email in order to receive FAQs and separation documents to sign off via DocuSign, as their Oracle emails will be deactivated “soon”. They are also warned against downloading any Oracle “confidential information”. Reports indicated that Mac laptops have new tracking software to determine violators, and that access to systems was already disconnected for those released. Full email text is available on Business Insider.

Some employees noted April 3 as their formal last working day, with a one-month “garden leave” period to follow. Based on TheLayoff postings, some in the US have later dates such as June 1.

Details for India employees indicate that the normal “N+2” severance package of salary paid in months=years of service was offered. Unvested stock (e.g. RSUs) was lost. Those with vested stock still had access via Fidelity.

Many of those laid off in the US are in Kansas City Missouri (the former Cerner HQ), and have 10-20 years with the company. Most dates are before vesting of unvested RSUs. Slack counts indicate at least 10,000 gone, and likely more. Layoffs also took place in Canada and Europe, according to reports.

US labor laws about layoffs are at two levels, Federal and state; the latter varies. To this Editor’s knowledge, no Federally required WARN (Worker Adjustment and Retraining Notification) notices nor information under OWBPA (Older Workers Benefit Protection Act, which applies when employees over 40 years old are laid off) have been filed. Federal WARN starts with 50 or more employees 60 days before a plant closing or mass layoff. Many states have their own WARN laws and triggers.

What does this mean?

Oracle has taken on a massive debt load that has halved the stock from last year’s highs. For starters, Oracle took on $58 billion in new debt in just two months. Without exception in these reports, the need for layoffs and restructuring are being laid at the feet of the debt required for an extraordinary and costly change in company direction–from a provider of rapidly eroding SaaS to cloud computing services and AI datacenter contracts. This is despite a strong Q3 and year projections [TTA 11 Mar] which had some but not enough positive effect. It is not just the debt load dragging down Oracle though–it is the time that these datacenters take to build out, get online, and generate cash flow.

TD Cowen’s report, covered in our 5 February article, nailed this quandary to the max. Oracle has entered into multiple contracts with OpenAI, Meta, and Nvidia. Lenders have doubled their interest rates on these Oracle projects to near non-investment grade levels, Oracle’s credit default swap (CDS) spreads have tripled, and private datacenters for lease are scarce because of limited market financing. Oracle can transfer some of these buildout costs to clients, but takes on risk for the bulk of it. In this Editor’s view, Oracle trapped itself into a classic squeeze. FTA: If the company doesn’t build the datacenters, it risks falling behind its massive strategy to dominate the AI datacenter business. Yet the price of this is to abandon its massive investment in healthcare, a linchpin strategy, and the customers there.

Oracle is in a tight spot without a lot of options other than more unattractive debt that further depresses the stock price. Their buildouts of datacenters, such as Stargate in Abilene, Texas, have been fraught with conflicts–the long ‘taffy pull’ of buildouts versus the annual development of ever more powerful chips that AI clients want before cash flow gets going. The difference in timelines is the killer [TTA 10 Mar]. And I suspect that Nvidia doesn’t take exchanges on their chips, once purchased.

Their largest shareholder with 40% of voting stock, executive chairman/CTO/founder Larry Ellison, still took his dividend. Unlike other founders in the past, he hasn’t mortgaged a yacht, an island, or sold a share to help stake the company in this transformation [TTA 6 Mar]. Instead, he seems to be focused on supporting his son’s Skyhorse media endeavors, the latest being the besting of Netflix in buying Warner Bros. He is also 81. These are factors to investors. Our Readers will recall that in 2022, Michael Neidorff, 25-year CEO of Centene, was forced out at age 79 by an activist shareholder group (Politan Capital, later famous for upending Masimo) that referred to both his age and tenure.

One does wonder how many of the laid off employees had specific skills that would have been useful in changing over to cloud/AI. It’s doubtful that Oracle had any process to evaluate individual competencies or capabilities for future fit. Having gone through a mass layoff when Centene absorbed WellCare Health Plans, this Editor knows first hand that companies do not evaluate individuals–they cut based on category, place, title, compensation, and other factors. Survivors either are in the right place, category, or sprint through internal contacts to another berth. This post on LinkedIn by a company that has created a ‘verification infrastructure’ to do this evaluation, instead of layoffs “based on broad assumptions about job categories rather than verified assessments of individual capability” makes you wonder whether an IT giant like Oracle even considered this approach before spending easily half a billion dollars on ‘restructuring’.

What are the consequences of fewer people at Oracle Health? This month (April), the massive 13 facility EHRM rollout with the VA begins. And Congress, by this late spring and summer, which is budget time, will be turning the full force of scrutiny on Oracle if it doesn’t go as smooth as 30 momme silk satin. And what will it mean to health system clients and prospects? Where is their reassurance that when an IT person emails or picks up the phone with a problem, that there will be someone at Oracle Health who even knows them? Based on Reddit posts, some employees were doing their onsite support jobs when they got their termination notices and had to leave. “Is anybody there? Does anybody care?” may be the cry of hospital IT managers. That’s not good for sales or account teams…if anyone at Oracle cares about new sales and retentions.

Is Health, once the focus of Oracle’s Big Transformation, now just a used and broken toy? What’s the future of Oracle Health if the strategy is AI 24/7 and EHRs and healthcare system SaaS just do not fit the picture anymore?

Updated 31 March PM: Oracle is not admitting the cuts or the volume of them publicly. CNBC’s sources are stating only that the cuts are ‘in the thousands’. This corresponds to the early reports in Business Insider (link above). This Editor wonders if they ever will beyond a filing with the SEC. Also Wall Street Journal. One wonders how long they can keep mum to customers and shareholders.

In addition, if WARN notices aren’t filed at locations with 50+ employees and layoffs aren’t delayed for 60 days, expect blowback at the US and state department of labor levels plus class action lawsuits. Oracle may actually sneak under this particular wire with dispersed locations and remote workers. Updated 2 April: A WARN notice was filed in Missouri, home to most of Oracle Health’s employees at the Kansas City campus. 539 employees have been laid off effective 26 May-1 June, which fulfills the 60 day notice requirement. Reportedly they are on payroll but not working. As of now, Oracle will keep the campus open. We previously noted that KC gave Cerner and later Oracle considerable incentives to build that campus. Fox 4 Kansas City

Chutes and Ladders: UnitedHealth sued by faith-based investor group, Qualified Health raises $125M, Cerebral acquires Inflow ADHD app, Flourish Care’s $5.7M seed

March 26, 2026 | by Donna Cusano

In the Chutes department, once again UnitedHealth Group can’t catch a break. This time it’s a shareholder lawsuit by a Quebec-based religious non-profit group, Fond des Missions (formerly the Fond Durocher). They had submitted a proposal to UHG for inclusion in its proxy materials for the 2026 Annual Meeting. It requested a report from the Board of Directors that describes the healthcare consequences of its acquisitions over the past 10 years–a very interesting take on UHG’s acquisition strategy, how it runs a reported 2,700 subsidiaries, and whether this strategy benefits member health.

UHG declined the request on the basis that it related to “ordinary business” and attempted to “impermissibly micromanage” the company’s operations. The Securities and Exchange Commission (SEC) did not object to (not agreed with) UHG’s decision due to shutdown-related backlogs at the agency. This decision to omit the proposal made Fond des Missions unhappy enough to file a lawsuit this week in the US District Court for the District of Columbia. The suit seeks to enjoin UHG’s decision to omit the proposal from a shareholder vote as unlawful under SEC regulations and award Fond the costs for the suit.

Fond des Missions was founded as a Canadian charity by the Roman Catholic Congregation of the Sisters of the Holy Names of Jesus and Mary. Their missions are active in Africa, South America, and North America. It is a member of the Interfaith Center on Corporate Responsibility, a coalition of more than 300 faith-based investors. For last year’s annual meeting, Interfaith had submitted a proposal for a vote on the effect of healthcare delays and denials on the public. This was also rejected. Whether this suit will be decided in time for this year’s proxy materials and the annual meeting, usually mid-year, is to be determined. Healthcare Dive

In Ladder-land, Qualified Health raises $125 million in a fresh Series B. The new funding was led by New Enterprise Associates, Inc. (NEA), with participation from new investors Transformation Capital, GreatPoint Ventures, Cathay Innovation, and Menlo Ventures’ Anthology Fund, an AI innovation fund created in partnership with Anthropic. Earlier investors also participated, bringing the public benefit company’s total raise to $155 million. Qualified Health’s platform provides health organizations with the infrastructure to deploy and scale generative AI in areas such as governance frameworks, post-deployment monitoring and role-based access controls. The new funding will enable the PBC to further deploy their platform to additional health systems such as Mercy, Emory Healthcare, University of Rochester Medicine, Jefferson Health, and University of Texas System. Release, Mobihealthnews

Cerebral expands its mental health platform with ADHD app Inflow. The Inflow app will add additional support options to telementalhealth provider Cerebral’s ADHD patients via Cognitive Behavioral Therapy (CBT) and personalized tools. Neither acquisition cost nor management transitions were disclosed, although both will operate separately. Cerebral has come a long way from their near-death controlled substance distribution violations, finally settled with the DEA and DOJ less than two years ago [8 Nov 2024]. Release, Mobihealthnews

And in the burgeoning women’s health segment, Flourish Care gets a boost with a $5.7 million seed round. Their hybrid services combine both virtual care and in-person maternity care delivered by local, credentialed doulas. The doulas are maternity experts who guide mom through pregnancy, birth and baby’s first months at home. Over 40 health plans offer the service with minimal or zero out of pocket cost. The raise was led by Zeal Capital Partners with participation from Rogue Women’s Fund, Collide Capital, Symphonic Capital, Capita3, Slater Technology Fund, Create Health Ventures, Catalytic Impact Foundation and others. Release, Mobihealthnews

‘AI doctor’ Doctronic raises $40M Series B, but faces controversy on autonomous Rx renewals in Utah and effectiveness claims

March 26, 2026 | by Donna Cusano

Doctronic’s raise impresses, but so do the questions around its AI tech. Earlier this week a hot AI telehealth startup announced a hefty (for these times) $40 million Series B raise that topped off a Series A of $20 million last September and a $5 million seed round in April. The $40 million was funded by Lightspeed Venture Partners, Union Square Ventures, MANTIS Venture Capital, Davidovs Venture Collective, and Abstract. The New York City-based company was founded in 2023 and only constructed its clinician network in early 2025. It claims to be on track to earn $10 million in revenue in 2026.

The basic health tech sounds not that unusual: a chatbot discusses your medical concerns and questions, much like a Claude for Healthcare, Microsoft Copilot Health, Teladoc, Ro, or even Google Gemini. The next step is a clinician referral, available 24/7 in all 50 states, for a low $39. It also claims to securely retain your information and timeline/meds/labs, not using the data for AI training.

Where the controversy centers is Doctronic’s first-ever state-approved autonomous AI test with the state of Utah. Announced in January, it will test whether a chatbot agent can evaluate and renew existing prescriptions for Utahns without human clinical oversight. In the pilot first phase, the renewals, which include 192 drugs for chronic conditions, will be overseen by clinicians before being sent to a pharmacy, but the intent is to move through this phase quickly to a pilot of full prescription renewal autonomy. Utah is permitting this through the Utah Department of Commerce’s Office of Artificial Intelligence Policy. The goal is to speed renewals of maintenance medications, the majority of activity, thus reducing medication noncompliance. Non-compliance is a leading driver of preventable health outcomes and with health decline, avoidable spending. Utah Department of Commerce release, Doctronic blog

Benefit manager Healthesystems outlined the process for its blog, with a view to the issues. “At the Doctronic prescription renewal portal, patients must confirm that they are located in Utah, enter the medication they want refilled, and then select an in-state pharmacy for fulfillment. Users must then upload their ID, along with a verification selfie and proof of an old prescription and then pay a $4 service fee. The AI system reviews the information to ensure a prescription history exists, after which a health assessment is given, where patients must answer certain questions before the program issues a refill. If the AI is uncertain if a prescription should be renewed, it refers the patient to a Utah-licensed human physician.”

A big reveal is here. The physician review prior to being sent to the pharmacy is for only the first 250 patients; the next 1,000 patients will be reviewed retrospectively. After that, only 5-10% of renewals will be audited after the fact, monthly. The issues for the two Healthesystems reviewers are risk–missing a loss of stability or extended renewals beyond original intent, for instance–and maintenance of oversight. Who is ultimately held accountable for the chatbot’s actions?

A JAMA Health Forum article (19 March) raises additional issues. There apparently has been no pretesting of the prescription chatbot, only simulation testing. The application references a preprint study in medRxiv, written by equity owners in the company and only about the existing website chatbot. Moreover, the agreement is well-hedged to protect Doctronic. FTA:

If prescription errors injure patients, Doctronic’s accountability is murky. Its contract requires it to compensate Utah for any liability costs the state incurs and Doctronic took out a special malpractice insurance policy. Yet, the terms of service that users of the prescription renewal system must agree to—which seem to have been developed for the company’s AI doctor system—currently state that Doctronic disclaims all responsibility and liability for system accuracy or harmful outcomes.
A further oddity is that the Utah contract relieves Doctronic of the obligation to “generate, maintain, and make available to each patient” the patient’s medical records.

It closes with a short discussion of ‘scope creep’ (Editor’s emphasis): “Once an AI system has secured acceptance, vendors may be able to push updates that include substantial changes without attracting the same degree of scrutiny as the initial adoption. Concerns that low-risk pilot programs may legitimize higher-risk deployments at scale have been expressed about the Centers for Medicare & Medicaid Services’ new pilot program using AI to conduct prior authorization reviews of some services in traditional Medicare plans.”

And where is the proof that the AI chatbot can’t be spoofed? STAT (Mario Aguilar), who has been following Doctronic, located a February test by UK-based cybersecurity firm Mindgard that tested Doctronic’s existing chatbot and fooled it into into believing deliberate “official” misinformation, a bogus guideline that allowed triple the standard adult normal dose of Oxycontin, a Schedule II controlled substance. Sergei Polevikov in AI Health Uncut (subscription required, but you should) describes it in far greater and scary detail, including his own test. He also points out and analyzes other Doctronic questionable claims, such as volume (claiming 24 million ‘helped’ not borne out by website traffic), problems with the Utah formulary and refilling several problematic drugs, an odd connection with a Belarus company, and whether this should be regulated by FDA. To be continued.

Drafted House bill may threaten VA/Oracle EHRM rollout

March 25, 2026 | by Donna Cusano | 1 Comment

The VA’s EHR modernization (EHRM) plans may be hearing screeching brakes or a swerve if this bill sees daylight. Last week’s House Committee on Veterans’ Affairs reviewed 27 bills plus five discussion drafts as part of its sweeping reauthorization initiative to review, improve, and reauthorize specific programs and sectors at the Department of Veterans Affairs (VA). Many of these programs haven’t been reauthorized by Congress in three decades. House VA Committee release 18 March

A two-year leash. Of most interest re the EHRM plans is the 33-page discussion draft (PDF) of a bill proposed by Rep. Nikki Budzinski (D-IL), “To provide for the modernization of the electronic health record system and other health information technology activities and systems of the Department of Veterans Affairs, and for other purposes.” It specifies a series of reports from the VA Secretary that constitute ‘guardrails’ on the EHR implementation–a noun used extensively by both Chairman Bost and member Budzinski. At the 18 March meeting, according to FedScoop, Rep. Budzinski’s proposed bill would require the VA to “create a baseline of clinical and business workflows, as well as technical requirements, to ensure the standardization of VA practices and systems.” It would also set new “health care quality metrics” based on the VA’s own Strategic Analytics for Improvement and Learning Value Model, and new reporting and independent verification and validation requirements.” If the bill becomes law, the VA secretary has two years to certify that the system’s requisite baselines and metrics “show consistent improvement” and that at least two VA facilities implement the Oracle EHR with the certifications in place. What this bill does introduce is to prevent any renewal or options for the Oracle contract if the requirements aren’t met.

The question that this Editor would pose to Rep. Budzinski is: isn’t this bill and its requirements coming a little late in the day? 13 health system EHR rollouts are already planned, starting in April for the year, announced in February by the EHR Modernization Integration Office (EHRM-IO) [TTA 8 Feb]. The VA stopped Oracle EHR rollouts in 2023 save for Lovell in Chicago. Since then, the original six disastrous installs have been overhauled and tested. There have been multiple hearings, floggings of Oracle executives, and extensive reports from the VA’s Inspector General. What does this bill add to the mix, and do these ‘guardrails’ add meaningfully to performance?

The Committee chair, Rep. Mike Bost (R-IL), reportedly wants to use an NDAA-style process (named after the National Defense Authorization Act) to unify the bills into one ‘must-pass’ legislative bill. One can expect that some of the bill’s language will be written into the final bill, but it will be, in true House fashion, picked over and simplified from the elaborate language in the draft.

It makes Oracle’s clean performance on the upcoming VA EHRM implementations even more critical, yet…

Yet another factor. By end of month, the rumored 20-30% Oracle layoffs, outlined with some specificity on boards such as Reddit, will undoubtedly hit Oracle Health hard. Oracle has a contract, governmental, and regulatory obligation with the VA. Despite that, the rumors also say that even those areas will be hit, perhaps less hard, but still reduced in size–sacrificed for the financial obligations tied into the New Shiny Object, datacenters. [TTA 6 March, 10 March] This is also despite Oracle’s strong Q3 showing which didn’t break out Oracle Health. Something has to give, and it’s politely called ‘restructuring’.

News roundup: Microsoft debuts a rebooted Copilot Health, Stryker whacked by Iranian cyberattack, Amazon buys Rivr robotics for delivery, Turquoise Health’s $40M raise, Verily raises $300M to shake off Alphabet control

March 20, 2026 | by Donna Cusano

Microsoft joins the AI health chatbot club with a rebooted Copilot Health. Copilot Health will be much like its competitors: OpenAI/ChatGPT for Health and Anthropic’s Claude for Healthcare [TTA 28 Jan]. It allows consumers to upload their medical records, health histories, and data from wearables and connected devices, then draw on that information to organize, analyze, and provide guidance to individuals. It’s a reboot because, as Sergei Polevikov of AI Health Uncut revealed, Microsoft debuted Copilot for Health last October. The earlier iteration lacked access to EHRs and medical records other than personally held. Copilot Health now uses HealthEx to connect to EHRs, hospitals, and patient portals, and pull that information after consent–same as Claude for Healthcare. (ChatGPT uses b.well) Mr. Polevikov makes the logical argument that the HealthEx API (and b.well’s) already have the full framework standards and compatibility to be marketed DTC, for the consumer to do as he or she pleases. Unlike ChatGPT and Claude, there is no provider version. (ChatGPT’s consumer version is still in slow rollout.) Healthcare Dive, AI Health Uncut (subscription required)

Orthopedics device and robotics giant Stryker cyberattacked, recovering, Iranian hacktivists identified. Last Wednesday (11 March), Stryker revealed that a severe, global cyberattack disrupted its customer support, ordering, manufacturing, and shipping operations, wiping information from . It affected operations within the Microsoft environment. It has not affected products including connected products. As of Tuesday, Stryker reported that it had been “contained” on the damage they are aware of and that systems are starting to be restored, though the full scope of the disruption is not yet known. Other reports indicate disruption and wiping on multiple systems.

According to DataBreaches.net and Bleeping Computer, the Iranian-linked Handala hacker group claimed that they had stolen 50 TB of data, then wiped tens of thousands of systems and servers across the company’s network including applications such as Intune Company Portal, Teams, and VPN clients often used on personal devices. Handala is “linked to Iran’s Ministry of Intelligence and Security (MOIS) that targets Israeli organizations with destructive malware designed to wipe Windows and Linux devices.” Their message on Bleeping Computer positions the hack as retaliation against Israeli attacks on Iran and calls Stryker a “Zionist-rooted corporation”, which is rather ‘rich’ for a company founded and HQ’d in Kalamazoo, Michigan. Healthcare Dive 13 Mar, 17 Mar

Amazon buys Rivr to test robot delivery. The Swiss startup has limited information on its website (but plenty of video). It has developed 4 wheeled “General Physical AI” robots with legs that can negotiate steps and drop off packages. Amazon intends to test the Rivr robot for doorstep delivery to assist its third-party delivery contractors who perform the arduous and highly pressured ‘last mile’ delivery from Amazon warehouses to customer doors. Amazon has been investing in robotics since 2012 for warehouse operations. It previously invested in Rivr’s $22 million seed round last March through its Industrial Innovation Fund and Bezos Expeditions, Jeff Bezos’ VC firm, for a valuation of $100 million. Rivr tested the delivery robots last year in Austin with Veho, a package delivery service, though the final outcome (scaling to 100 robots) is not confirmed. CNBC, TechCrunch

Turquoise Health scored a $40 million Series C funding. Turquoise is a pricing and payment platform that connects data, contract intelligence, and revenue cycle workflows for clear pricing transparency and to reduce the cost of errors in administration, claims, and reimbursement. The round was led by Oak HC/FT, with participation from existing investors including Andreessen Horowitz, Adams Street Partners, and Yosemite, for a total raise of $100 million. Release, MedCityNews

And winding up the week, Verily raises $300 million–and independence from Alphabet. Now rebranded as Verily Health Inc., it is now a precision health solutions company. It has pivoted since at least 2016 from various iterations as originally the Google X life sciences ‘skunkworks’–devices, bioelectronics, smart contact lenses, smartwatches, smart diapers… The funding was led by Series X Capital, with participation from Alphabet, UCHealth, the University of Colorado Anschutz and other investors. Alphabet remains a significant minority investor in Verily, while no longer having a controlling stake. Release

Perspectives: Telehealth as Infrastructure–Building a Financially and Clinically Sustainable Virtual Channel

March 19, 2026 | by Donna Cusano

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic is how clinicians can take advantage of the telehealth flexibilities extension to 2027 by integrating telehealth and virtual care fully within their operational workflow and within patient care. The author, Matthew Order, is Vice President of Business Development at Yosi Health. He has more than 20 years of healthcare technology and SaaS experience including previous roles at MEDITECH, athenahealth and Buoy Health. At Yosi, he leads enterprise adoption across health systems, translating product integrations into measurable operational improvements for practices and patients.

The Centers for Medicare & Medicaid Services (CMS) recently extended many Medicare telehealth flexibilities through December 31, 2027. That policy decision signals what providers already know: telehealth is no longer a short-term option to expand access to care, but a permanent channel of care delivery.

That policy certainty is welcome, but it also exposes a hard truth: simply offering video visits won’t deliver value unless telehealth is embedded into the day-to-day operational workflows of the practice. Clinics that want telehealth to reduce cost, improve access, and protect revenue must redesign the patient journey so virtual care is predictable, reimbursable and measurable.

Here are the practical, operational steps clinics should take now.

Move pre-visit upstream

The biggest operational losses happen around patient visits, e.g. when intake is incomplete, insurance is unknown, or staff must chase missing information. One way to change this is by moving pre-visit work upstream: require or encourage patients to complete digital intake forms before an appointment and surface those discrete data fields directly into the chart. This isn’t just a patient convenience, it fundamentally changes how front-office work gets done. Studies show that centralizing reminders and automating pre-visit tasks improves appointment utilization and reduces no-shows, two levers that matter for telehealth ROI.

Treat eligibility as clinical infrastructure, not an afterthought

Nothing kills collections faster than an unpaid copay or an ineligible telehealth claim. Embed real-time eligibility and benefits checks into the pre-visit flow so patients see their financial responsibilities before the encounter and staff can resolve red flags ahead of time. Organizations that operationalize eligibility verification as a revenue-cycle control point report fewer denials and faster time-to-cash. This is the difference between telehealth being a marginal convenience and a reliable revenue stream.

Design rule-based automation for phone and scheduling channels

Studies show over 60% appointments are still made by phone. If your telehealth offering can’t integrate with phone volume and scheduling rules, it is difficult to scale. Deploy rule-based automation that reads live availability, applies clinic booking policies, verifies benefits, and either completes the booking or hands off with full context to a human. For transactional tasks, rule-based systems often outperform free-form AI systems because they reduce follow-ups, corrections, and operational risk.

Measure clinical and financial outcomes, not vanity metrics

Define a tight set of KPIs tied to margin and access: completed telehealth visit rate, no-show reduction, denial rate for telehealth claims, point-of-service collections, and staff minutes reclaimed per patient. A simple 60–90 day pilot with baseline and target thresholds will tell you whether integration and automation are working. And instrument technical reliability as well; API success rates, data mapping accuracy, and escalation quality matter just as much as outcomes.

Protect equity and patient experience as you scale

Telehealth should expand access, not create new disparities. Make digital intake mobile-first and low-bandwidth, provide multilingual options, and maintain assisted touchpoints (phone registration, in-clinic support) for patients who need them. Evaluate patient satisfaction specifically by channel; a good telehealth system should reduce friction, not shift it elsewhere.

Make governance non-negotiable

Without clear operational ownership, telehealth programs drift and performance deteriorates. Who owns booking rules? Who maintains payer mappings? What are clear escalation policies for clinical red flags? Assign cross-functional ownership (e.g. operations, revenue cycle, clinical leaders, and IT) and lock in a change-control cadence that prevents “rule drift” as policies and payer contracts change. Evidence that EHR workload-per-visit can rise even when visit volume falls illustrates why governance and workflow redesign must accompany modality shifts.

Pilot pragmatically—and scale what earns results

Don’t rip-and-replace overnight. Start with two tightly scoped pilots: for example, telehealth follow-ups for chronic care and virtual urgent visits for same-day access. Keep pilots time-boxed, assign a process owner, and require week-over-week reporting on the KPIs that impact margin and access. If real-time eligibility and pre-visit intake reduce denials and nursing callbacks in the pilot, scale; if not, iterate.

Why this matters now

Policy windows like CMS’s telehealth extension present a rare opportunity – but only practices that pair clinical intent with operational discipline will secure lasting gains. With continued Medicaid churn and administrative pressure on primary care, clinics can’t afford telehealth programs that add friction or unpredictability. Integrating intake, eligibility verification, automation, and governance turns telehealth into a reliable channel for expanding access and stabilizing revenue. Recent analyses from KFF highlight how enrollment volatility is already increasing administrative burden across care settings.

By operationalizing telehealth – moving work upstream, protecting revenue at intake, automating predictable tasks, and measuring what counts – clinics can shift from friction to flow. That’s the difference between telehealth that breaks even and telehealth that delivers sustainable access, better outcomes, and measurable financial returns.

Short newsy takes: Amazon Connect Health AI, UHS buys Talkspace for $835M, Oura buys Doublepoint, Science Corp.’s $230M raise, VSee’s debuts first autonomous telehealth robot

March 12, 2026 | by Donna Cusano

Our roundup is up!

Amazon adds Amazon Connect Health agentic AI for provider workflows to their roster. Amazon’s multiplicity of niches in healthcare adds a new solution, this time targeting providers. This is part of AWS’ health suite for EHRs, designed to handle high-volume administrative tasks such as appointment scheduling, clinical documentation, and medical coding. It also targets builders in EHR companies, healthcare ISVs (independent software vendors), and tech-enabled providers through a unified software development kit (SDK) to directly integrate Amazon Connect Health’s point of care capabilities into their existing workflows. It is based on the company’s Amazon Connect cloud contact center platform. Netsmart, Veradigm, and Greenway Health all use it, with Netsmart claiming an increase in ambient documentation adoption by 275% in its 1,300+ client network. Amazon release, HIStalk 3/6/26, Mobihealthnews

UHS beefs up its behavioral health capabilities with Talkspace. Universal Health Services (UHS) is a national for-profit provider of health services that include acute care hospitals, behavioral health, healthcare management, and even a health plan. For UHS, expanding their behavioral health services faced staffing shortages that has stymied patient utilization and growth, plus creates a continuum of in-person and virtual telemental health.

Talkspace was a fairly early entrant in virtual behavioral health services. It has grown to national coverage with over 6,000 therapists despite being a cracked SPAC from June 2021. Back then, it went public at $8.90 on Nasdaq with approximately 152 million shares outstanding for a valuation of $1.4 billion. Six months later, shareholders sued for securities fraud, and by June 2022 shares had plunged to the dollar level, becoming a Cracked SPAC Poster Child. But they patched the cracks (unlike others) and closed 2025 with $229 million in revenue, profitable with an adjusted EBIDTA of nearly $16 million, and 1.6 million patient sessions. They rebuffed buyers until this week. UHS is acquiring for $835 million or $5.25 per share, a 10% boost on their closing 8 March, subject to the usual Talkspace shareholder and regulatory approvals. There is no mention of management or employee transitions. Closing is expected during Q3 this year. Talkspace release, Healthcare Dive, Becker’s

Really Short Takes!

Biometric ring Oura is buying Helsinki-based Doublepoint, a private company that enables gesture recognition in wearables. Doublepoint staff including the founders will join Oura and remain in Helsinki. Acquisition cost is not dislosed, but Oura seems to have enough cash on hand with last year’s $900 million Series E leading to an $11 billion valuation. Mobihealthnews
BCI implant developer Science Corporation raised $230 million in Series C funding. Lightspeed Venture Partners, Khosla Ventures, Y Combinator, IQT and Quiet Capital were the main funders for a total funding of $490 million. Science is a competitor of Elon Musk’s Neuralink, but is concentrating on a BCI retinal implant aimed at restoring form vision to patients blinded by macular degeneration. PRIMA in a clinical trial restored vision to those blinded by geographic atrophy due to age-related macular degeneration. Mobihealthnews
And veteran telehealth robotics company VSee debuted the VSee AI Robot at HIMSS. According to their release, it is the first fully autonomous telehealth robot. It uses LiDAR (Light Detection and Ranging) for navigation. VSee’s market is hospitals, ICUs, and health systems. Remote clinicians can independently navigate the robot directly to a patient’s bedside without engagement by onsite staff for rounding, telestroke response, and specialist coverage. Pretty neat! VSee release

Chutes & Ladders: Click Therapeutics raises $50M, lays off 27%; India’s IKS Health in talks to buy TruBridge for over $600M; TELCOR buys Sample for RCM expansion

VA’s Oracle EHR resumes go-lives at four Michigan systems–finally

Two weekend ‘must reads’: the New Yorker’s Sam Altman/OpenAI exposé–and comments; a further deep dive into Carbon Health’s implosion

Perspectives: Exploring the Telehealth Extension: Building Infrastructures for Better Access

Funding/deal roundup: WHOOP’s $575M Giant raise, Anthropic buys med AI startup for $400M, early stage fundings for Jimini, Insight Health; Noom buys compounder; Mount Sinai NY to embed OpenEvidence

NY Times’ highly questionable but glowing–and viral–portrait of AI-created GLP-1 e-prescriber and marketer Medvi

Former VA EHRM executive director Federally charged with accepting vendor cash and gifts, making false statements

Teladoc faces activist shareholder challenge, demanding $200M stock buyback, business spinoffs, cost cuts

A study in contrasts: OpenAI raises $122B, eMed’s $200M Series A. Then there’s Avo’s $10M Series A, Stedi’s $50M Series C. And Oracle expands Nashville campus!

The Oracle shoe dropped: Oracle lays off 18%–20-30K–of global employees, in their largest ever layoff (Updated 2 Apr)

Chutes and Ladders: UnitedHealth sued by faith-based investor group, Qualified Health raises $125M, Cerebral acquires Inflow ADHD app, Flourish Care’s $5.7M seed

‘AI doctor’ Doctronic raises $40M Series B, but faces controversy on autonomous Rx renewals in Utah and effectiveness claims

Drafted House bill may threaten VA/Oracle EHRM rollout

News roundup: Microsoft debuts a rebooted Copilot Health, Stryker whacked by Iranian cyberattack, Amazon buys Rivr robotics for delivery, Turquoise Health’s $40M raise, Verily raises $300M to shake off Alphabet control

Perspectives: Telehealth as Infrastructure–Building a Financially and Clinically Sustainable Virtual Channel

Short newsy takes: Amazon Connect Health AI, UHS buys Talkspace for $835M, Oura buys Doublepoint, Science Corp.’s $230M raise, VSee’s debuts first autonomous telehealth robot

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Chutes & Ladders: Click Therapeutics raises $50M, lays off 27%; India’s IKS Health in talks to buy TruBridge for over $600M; TELCOR buys Sample for RCM expansion

VA’s Oracle EHR resumes go-lives at four Michigan systems–finally

Two weekend ‘must reads’: the New Yorker’s Sam Altman/OpenAI exposé–and comments; a further deep dive into Carbon Health’s implosion

Perspectives: Exploring the Telehealth Extension: Building Infrastructures for Better Access

Funding/deal roundup: WHOOP’s $575M Giant raise, Anthropic buys med AI startup for $400M, early stage fundings for Jimini, Insight Health; Noom buys compounder; Mount Sinai NY to embed OpenEvidence

NY Times’ highly questionable but glowing–and viral–portrait of AI-created GLP-1 e-prescriber and marketer Medvi