The weekend read: why SPACs came, went, and failed in digital health–the Halle Tecco analysis/memorial service; why OpenAI is going to be a bad, bad business

April 10, 2025 | by

Let us now hold the formal memorial service for the SPAC–the special purpose acquisition company, at least for digital health. Halle Tecco, whom many of us know as the founder and past CEO of Rock Health, plus angel investor, plus adjunct professor in digital health at Columbia, now has an opinion blog on Substack. As our Readers know, this Editor, who is none of the above, has been shoveling dirt on SPACs here on TTA since they became an Easy Way To Avoid the cumbersome, oh-so-tiresome preparation for a public IPO during the Digital Health Boom of 2020-22 (RIP). She has been covering their Trouble Every Day and demise ever since. Having not kept quantitative track of Cracked SPACs, only the news as they floated, declined, and failed, this Editor enjoyed Ms. Tecco’s quantitative analysis of the overall picture. She puts it into a readable business context. 

Shockingly, SPACs across all IPOs are still going on. In 2023 and 2024, total SPACs as a percent of IPOs neared 40%. Their high was reached in 2022 at 73%. The attractiveness of SPACs was obvious: an investor sets up a publicly traded company and goes through the hassle of an IPO. It raises money on public markets and from investors to acquire another company. Then it hunts for a company to acquire. The target is landed, is acquired, symbols change, and the deal is done, all in three to six months. The acquired company doesn’t have to go through the investor pitches, the due diligence, the incessant filing…less fuss and muss, but missing the rigor of a traditional IPO. For the SPACs, especially those focusing on digital health, 2020-22 became FOMO Fever–the fear of missing out.

For digital health companies, the boom became a race to the bottom. 

  • 30.4% went bankrupt, some spectacularly, others with a whimper as they’ve failed, one after the other: 23andMe, Cano Health, Babylon Health, Nuvo, Pear, others
  • 26.1% were acquired well below their SPAC entry price: Sharecare, SOC Telemed, Akili and others. The only exception: Augmedix, with a $40 million SPAC valuation, was bought for $139 million by Commure. (Commure is backed by General Catalyst and Andreessen Horowitz; Commure/Athelas itself is an interesting and complex story.)
  • 39.1% are still in business but trading below their SPAC entry price. A number flirted with the Devil of Demise and are recovering: Clover Health, Owlet (baby monitors), Butterfly (ultrasound POC), Talkspace. DocGo became a Covid play and then got into political trouble and is nearing $2/share from their late 2022 high of just below $11. And others.
  • There is exactly one success story: hims & hers (4.3%)

Enjoy this read on her blog. If you prefer a podcast, here’s Ms. Tecco on her ‘Heart of Healthcare’ with Mohamad Makhzoumi (link is to Spotify), co-CEO of New Enterprise Associates (NEA), a VC in healthcare and technology (33 minutes), discussing healthcare’s evolution, so to speak, from “the trailer park of venture investing” and the hilarious ‘healthcare hokey-pokey’. And here’s a Gimlety View of SPACs from 26 June 2024.

Another Big and Disastrous Fail in the making may be OpenAI, the creator of ChatGPT. It is converting from a non-profit to a for-profit company, losing its founder group, fundraising like crazy, and generally has ditched its Mission. “OpenAI is an AI research and deployment company. Our mission is to ensure that artificial general intelligence benefits all of humanity.”  OpenAI has raised the largest venture-backed fundraise of all time, $6.6 billion, and is now valued at $157 billion. Why overvalued? A tell is that SoftBank has invested $500 million into this megillah–this Editor recalls that SoftBank invested in Theranos and WeWork. Another tell–the NY Times and The Information estimated that Open AI lost $5 billion in 2024, it loses money on every copy of ChatGPT, and its revenue projections are near-absurd at $11.6 billion in 2025 and $100 billion by 2029. It totally ignores that every major player has an AI program, from Microsoft to Google. If you’re a fan of ChatGPT or need your eyes cleared around this type of AI, grab your cuppa and a bottle of your favorite pain reliever for Ed Zitron’s article, OpenAI Is A Bad Business. (Ed is an English tech writer, podcaster, and PR specialist)

Extra, extra!: ATA Action forms Virtual Foodcare Coalition, Ophelia and Spring Health partner on opioid treatment, ISfTeH renews NSA status with WHO

April 10, 2025 | by

Extra non-merger/financing news.

A new virtual food initiative from ATA Action. In another sign that the ATA Action portfolio is enlarging, they announced the formation of a new advocacy group, the Virtual Foodcare Coalition. The new group, composed of organizations ranging from food providers to telehealth and a law firm, is promoting healthy food as an integral part of healthcare. Their five policy priorities center on Federal laws, telehealth, and cross-state practices:

  1. The Medical Nutrition Therapy (MNT) Act
  2. Funding for Medically Tailored Food and Food Benefits Management that Foster Optimal ROI and Sustained Impact
  3. Rationalize Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and School Meals; Align with Clean Food Initiatives
  4. Expand Reimbursement and Incentive Models for Telenutrition, Remote Monitoring Devices, Remote Therapeutic Monitoring and Foodscripts
  5. Facilitate Cross-State Nutritional Healthcare Delivery

The founding coalition members are: Albertsons Companies, Inc., Circle Medical, Foodsmart, hims & hers, Lifepoint Health, Nixon Law Group, Nourish, and Teladoc Health. With RFK, Jr. as head of Health and Human Services, there’s no better time. Release

Ophelia and Spring Health partner for opioid treatment. In another alliance to expand telehealth treatment versus standing alone, Ophelia, an opioid use disorder (OUD) treatment provider, will be joining with Spring Health in providing medication-assisted treatment (MAT) OUD for Spring Health’s employer and health plan clients. Spring Health’s telementalhealth clients include Adobe, Bumble, General Mills, Moda Health, Wellstar, and Guardian with a total access to 20 million lives. In return, Ophelia’s clients will now be able to access Spring Health’s behavioral health services, including therapy and psychiatric support, in an expansion of Spring Health’s portfolio. Release

Internationally, it’s another three-year agreement between ISfTeH and WHO.  ISfTeH, the International Society for Telemedicine & eHealth, is formally a Non-State Actor (NSA) in official relations with the World Health Organization (WHO). That status has been renewed for another three-year period. In that regard, ISfTeH works on and provides input to Research on Quality of Care, the Global Telehealth Community of Practice (GTCoP), Digital Health Atlas, Global Digital Health Monitor, Guidelines on Cross-Border Telemedicine, the WHO Acute Care Action Network (ACAN), and more. ISfTeH members also have an opportunity to participate in some of the WHO’s annual constitutional meetings–contact here for more information. LinkedIn post. ISfTeH/WHO’s collaboration document. Hat tip to Frederic Lievens of ISfTeH.

Midweek roundup: Transcarent closes Accolade; Walgreens beats Street; New Mountain Capital’s Office Ally buy-in; Neuralink Blindsight human trial coming up; PM Keir Starmer touts NHS data research; FTC’s PBM litigation break

April 10, 2025 | by

Transcarent closes Accolade buy, changes its game. Transcarent’s $621 million acquisition of Accolade was wrapped up in record time (two months from announcement). This takes the Nasdaq-listed Accolade private and rewards its former shareholders with $7.03 in cash. For a stock that peaked in late December 2020 into January 2021 above $59.00, and within the past year was above $9.00, this was salvage not profit except for speculators. The combined company in corporate care management now has 20 million members and more than 1,700 employer and health plan clients.

Notably, and very much in keeping with Glen Tullman’s M.O., the lead in their release is a new and rather generic marketing statement: “one place for health and care”. Much space is devoted to combinations: Transcarent’s generative AI WayFinding with Accolade’s True Health Actions member database to deliver clinical guidance to members. Transcarent also is promoting its generative AI as reducing the administrative burden for clinicians. The combined company is merging executive teams and much of its software. But the reality is combining two companies with clearly opposing care management products: Transcarent with a cost-saving, software-based, risk pricing model for self-insured employers, Accolade with a traditional human-based per member per month service model incorporating corporate care navigators and benefits consultants. Neither Accolade CEO Rajeev Singh, nor other members of top management whose shares fully vested (Stephen Barnes, Robert Cavanaugh, and Richard Eskew), are not listed in the new management lineup, though earlier information indicated that retention bonuses were offered. CNBC, Mobihealthnews  Also TTA 19 Feb reviewing MedCityNews’ Arundhati Parmar’s take on the combo and updated background TTA 21 Feb.

Walgreens beats Street analyst expectations on revenue, narrows losses. Winding up its public financial reports before the Sycamore Partners acquisition is finalized, Walgreens reported on Tuesday their fiscal Q2. Revenue was up 4% versus prior year to $38.6 billion. Losses were reduced to $2.9 billion versus prior year’s $5.9 billion loss. Per share losses were $3.30 versus $6.85. The year-ago loss included a $12.4 billion non-cash impairment charge related to VillageMD goodwill, which resulted in a $5.8 billion charge attributable to WBA, net of tax and non-controlling interest, and a $455 million non-cash impairment charge related to certain long-lived assets in the U.S. Retail Pharmacy segment. Operating cash flow in the current quarter was negatively impacted by $969 million of legal payments primarily related to PWN/Everly Health [$595 million, TTA 26 Feb] and multiple opioid-related settlements. WBA also withdrew 2025 financial guidance with the sale pending by end of year.  Release, Healthcare Dive

VC New Mountain Capital makes investment in Office Ally. The NMC “strategic growth investment” in the practice management/payment clearinghouse/EHR company is alongside Francisco Partners, which will also reinvest alongside management. The investment amount is not disclosed. Vancouver, Washington-based Office Ally enables the exchange of more than 950 million transactions and works with 80,000 healthcare organizations. For the $55 billion in assets NMC, this was evidently a better investment than their quickly terminated bid for 23andMe. Release

Neuralink’s next move–overcoming blindness. The Elon Musk-backed brain-computer interface (BCI) company announced at a Wisconsin town hall streamed on YouTube that its Blindsight implant will be tested in humans by the end of 2025. “Neuralink has had in monkeys a working device we call Blindsight,” Musk said. “It has been working well, and the monkeys are healthy for a few years now.” (The video clip is at 6:15 in this independently produced Neura Pod video, credit to Ryan Tanaka who follows Neuralink). The Blindsight implant works to restore vision in individuals who have lost sight and even their eyes or optic nerves by stimulating the visual cortex. The implant received FDA Breakthrough Device designation last September. Ironically, reviewers of Elon Musk’s Neuralink project and other brain-computer interface companies were among the 20 fired at FDA’s Office of Neurological and Physical Medicine Devices [TTA 21 Feb]. Mobihealthnews

Short takes:

NHS being ‘turbocharged’ by PM as medical research center. Prime Minister Keir Starmer took the lead on this, not the NHS, in announcing the creation of a new health data research service based on NHS data. The intent is to make all NHS data accessible through a secure single access point for national-scale data sets. The UK government and the Wellcome Trust will invest up to £600 million. This is part of the government’s Plan for Change to set up a modern industrial strategy, unlocking the potential of the Oxford‑Cambridge growth corridor, and “pro-growth measures to build a strong, resilient economy with more well-paid jobs”.  Gov.uk release

A longish break for the major pharmacy benefit management (PBM) companies. The Federal Trade Commission (FTC) announced that it was staying its insulin pricing litigation against the three major PBMs: Caremark (CVS), Express Scripts (Cigna), and Optum Rx (UnitedHealth Group). The long-running action initiated last year by the now-departed FTC chair Lina Khan ran into FTC problems with the change of administrations. First, there are not enough commissioners at present to try the case, with the firing last month of two Democrat commissioners. Republican Melissa Holyoak recused herself. The new FTC chair, Andrew Ferguson, initially recused himself since he, while Virginia solicitor general, had advised the state’s attorney general on filing an amicus brief in a class action case against PBMs. He unrecused himself on 3 April (X statement) so that the case can continue when the FTC has enough commissioners. The PBMs countersued in November. The stay is 105 days followed by evidentiary hearings 225 days later, meaning that next February is the earliest the case can resume. It’s a break for their parent healthcare companies’ share prices, which have been weighed down by the FTC action. FierceHealthcare, Healthcare Dive

Rock Health’s digital health Q1: more money, fewer deals, more additions and partnerships in ‘leapfrogging’

April 8, 2025 | by

There’s a small uptick and some optimism in the air for US digital health deals after all. After a 2024 that realistically was a ‘down round’ or Back To 2019, 2025 is picking its way through the New Reality of Global 52-Card Pickup, powered by a new US government and still-defining AI technology. Let’s unpack what Q1 was like in Rock Health’s view:

  • Funding was $3.8 billion across 122 deals, with an average deal size of $24.4 million. Compared to Q1 2024, total investment was up ($2.7 billion) as was the average size ($20.6 million) but number of deals were down (133).
  • Q1 funding also exceeded Q4 2024 funding in a pattern typical of the past few years.
  • 83% of deals were seed, Series A, and Series B rounds, not much different than 2024’s 86%. There were a few exceptions listed by Rock Health. By far the largest was Hippocratic AI’s $141M Series B but also Achira’s $33M seed, and Open Evidence’s $75M Series A. MSK player Vori Health sported a $53 million Series B in March
  • There were only 5 Series D or larger deals but three were jumbo sized: Innovaccer ($275M), Abridge ($250M), and Qventus ($105M), which pulled the average up to $105 million, nearly double that of FY 2024.

Rock Health is mum on unlabeled or funding not disclosed deals, such as the ones TTA noted through the quarter: Summer Health -Caraway, Neuroflow-Quartet Health, Iris Telehealth-InnovaTel, Dispatch Health-Medically Home, and Wysa-April Health.  It also doesn’t provide its usual analysis of healthcare value propositions and clinical indicators.

An interesting analysis in the shorter-than-usual announcement breaks down an approach they’ve dubbed ‘leapfrogging’, defined as ways companies can acquire knowledge or shift to respond to market dynamics:

  1. Tapestry Weaving. It’s a quaint way of saying that capabilities can be bought through M&A. (Business can be bought that way too–Transcarent closed its $621 million buy of enterprise care navigator Accolade today.) 
  2. Modular Tech Stacks. This type of tech design allows companies to switch out or add in tech as the market changes or better tech emerges.
  3. Channel Partnerships. Companies, by adding partners, add capability at low cost and reach, though the logistics of partnering, the integration cost and quality of service aren’t easy lifts.
  4. Engaging Disruptors. Companies invested in certain standard processes can expand by allying with their disruptors, versus viewing them as competitors. 

What’s not mentioned in the report are the high profile failures this quarter: 23andMe’s bankruptcy, Walgreens’ sale to Sycamore Partners, and Veradigm’s failure to sell itself.  Given the past few months, we’ll be doing a lot of ’embracing uncertainty’ this year!  Also FierceHealthcare

News roundup: Hinge Health may postpone IPO, Rite Aid may enter 2nd bankruptcy, Veterans Affairs committees want new EHR costs & timeline, fired Texas health plan head hired private eyes to spy on members, providers, lawmakers

April 8, 2025 | by

Isn’t April a bit early for roller coaster rides?

Hinge Health may postpone its IPO. This is absolutely to no one’s surprise. Virtual MSK provider Hinge Health had filed a SEC S-1 preliminary prospectus back in mid-March [TTA 14 Mar] with few specifics, and had not committed to any dates. With Mr. Market taking multiple rides on an old-school wooden roller coaster, Hinge is dangling a postponement. Business Insider spoke with the usual Insider who said rather minimally that the company intended to start speaking with investors towards the end of April and go public in May, but now may postpone. They might still go public on this schedule if Mr. Market sees Hinge as a good alternative buy. Supposedly, they have the cash on hand and don’t need the IPO to finance the business. By this stage, there’s a gaggle of investors hungry for a partial or full exit financed by Other People’s Money on their $826 million invested to date: 8% shareholders Coatue, Tiger Global Management, Whale Rock Capital Management, Bessemer Venture Partners, Insight Partners (19%), and Atomico (15%). Founders Daniel Perez (CEO) and Gabriel Mecklenburg (director), who own 18.9% and 8.2%, may also be eager to cash in. Hinge is keeping mum as they must. This Editor’s bet is that their IPO will be no later than June. Yahoo! Finance

Rite Aid may go through the Pain of Bankruptcy yet again. Sadly, the distant third in the pharmacy/retail healthcare market is rumored to be considering another bankruptcy as not seeing a sustainable way forward as a private company. Alternatively, they are exploring selling parts of its business, though it’s hard to imagine who would buy. In the October 2023 bankruptcy, the company went from 2,000 locations and 47,000 employees to 1,300 locations, exiting entire states to concentrate where they could have some market impact. They sold Elixir, their pharmacy benefits manager, and settled with major creditors. In March 2018, they had downsized by selling 1,932 store locations for $4.38 billion to Walgreens. Like Walgreens and CVS, they are also dealing with legal liabilities from opioid-related lawsuits. Reportedly, they are being advised by Big Law firm Paul Weiss to advise on options, such as what can still be sold and what kind of bankruptcy. Wall Street Journal, Chain Drug Review, Daily Mail

The VA and Oracle have some ‘splainin’ to do to Congress. As VA has put stakes in the ground with migrating 13 VA Medical Centers from VistA to Oracle, a few Members of Congress on Veterans Affairs committees in the House and Senate have been awaiting More Information on the Electronic Health Record Modernization (EHRM) program. What they want to know are the fundamentals: costs and updated schedules. VA has not yet provided a cost update that is mandated by laws and Office of Management and Budget (OMB) directives governing major acquisition programs. The Congress members from both parties requesting the information are: Sen. Jerry Moran (R-Kansas), Richard Blumenthal (D-Conn.), Rep. Mike Bost (R-Ill.), Rep. Mark Takano (D-Calif.), Sen. John Boozman (R-Ark.), Sen. Jon Ossoff (D-Ga.), Rep. John Carter (R-Texas) and Rep. Debbie Wasserman Schultz (D-Fla.). Senator Moran press release

Private Eyes Are Watching You. They See Your Every Move. Mark Sanders, CEO of Superior Health Plans in Texas, a Centene health plan, admitted before the Texas House Delivery of Government Efficiency Committee that he had hired private investigators to get “background information” on lawmakers and plan members, specifically about claims, in a 26 March hearing on Medicaid procurement. The Dallas Morning News had previously uncovered examples of members who were being investigated from 2017 on, when Mr. Sanders became CEO. He testified that “investigators had done “routine” background checks into several state representatives, senators, health care providers, patients and their families and a journalist.” The state officials included Texas Land Commissioner Dawn Buckingham, then a state senator, and Southlake Republican state Rep. Giovanni Capriglione, according to documents obtained by The Dallas Morning News.  One claim denied was, according to the paper, Linda Badawo of Mesquite, Texas, and her 3-year-old son D’ashon Morris. “D’ashon, who was denied private duty nursing despite emphatic protests from Linda, his doctors and nurses, pulled his trach out and was found not breathing, as his caregivers warned he would.” Mr. Sanders called these ‘routine background checks’ and ‘general research’  no longer being done. Rep. Capriglione is now chair of the committee holding the hearings, which surely meets the Sicilian Standard of revenge as a dish best eaten cold.

Superior used a Missouri-based security company, Griffin Personnel Group, to perform these and other investigations. One investigation the committee uncovered said that Griffin attempted to obtain the divorce records of Sen. Charles Schwertner, R-Georgetown, just a few months after his wife filed in early 2019. Sen. Schwertner and Rep. Capriglione were members of budget committees at the time. Centene is HQ’d in St. Louis, Missouri.

Texas Attorney General Ken Paxton almost immediately announced an investigation into Centene’s practices. Centene fired Mr. Sanders within hours, stating “The conduct highlighted yesterday during the course of the Texas House Committee hearing is not reflective of our values nor is it a practice Centene’s current leadership condones. To this end, Mark Sanders is no longer with our organization.” Perceptive Readers will note the subtle ‘dig’ at the previous CEO; in 2017, Centene’s CEO for then over 20 years was Michael Neidorff, who is no longer here on this planet to defend himself. Centene is now controlled by activist investor Politan Capital.) At stake are hundreds of millions in state Medicaid contracts.

(Disclosure: this Editor worked for an ACO management services organization owned by WellCare, not Superior, acquired by Centene, and technically worked for Centene for less than one year ending in 2020.)

Perspectives: Bridging the Gap in Rural Healthcare Through Telehealth

April 7, 2025 | by

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic is the closure of rural hospitals and whether telehealth can bridge this access gap. The author, Hari Prasad, is co-founder and CEO of  Yosi Health, a full-service technology ecosystem that connects patients with their providers through the entire care journey before, during and after the visit, creating delightful patient experiences and modernizing the entire healthcare patient experience. 

Rural hospitals across the United States are at risk of closing especially if Medicare and Medicaid cuts are enacted. According to a March 2025 report by the Center for Healthcare Quality and Payment Reform, over the past two decades, nearly 200 rural hospitals have already closed. It’s an economic reality that could leave hundreds of thousands of Americans without local medical care.

Rural communities, which already face challenges related to limited healthcare resources, transportation, as well as staffing and economic constraints, are likely to experience even greater disparities in access to essential services. As these hospitals and clinics face potential shutdowns, telehealth is emerging as a critical tool to maintain healthcare connectivity and improve patient outcomes in these underserved areas.

The threat of rural hospital closures has far-reaching implications. For many residents, these facilities provide not only emergency care but also routine health services, chronic disease management, and preventive screenings. With the loss of a nearby hospital, patients are often forced to travel long distances for care—a situation that can delay treatment and exacerbate health conditions. Additionally, the closure of rural hospitals often leads to increased pressure on remaining facilities, further straining resources and limiting access.

Telehealth, which allows patients to connect with healthcare providers through digital platforms, offers a promising solution to these challenges. By enabling virtual consultations, remote monitoring, and digital care coordination, telehealth can mitigate some of the negative effects of hospital closures. It provides patients with timely access to medical advice and treatment without the need for long, costly journeys to distant facilities.

In my experience at Yosi Health, we are witnessing a notable trend: rural healthcare providers are increasingly turning to telehealth as a means of bridging the access gap. Digital tools and virtual care platforms have evolved to support not only routine consultations but also more complex care management needs. For example, remote patient monitoring is now being used to track chronic conditions such as diabetes and hypertension, ensuring that patients receive ongoing care – without the constant need for in-person visits.

Furthermore, telehealth solutions are proving effective in reducing hospital strain. By diverting non-emergency cases from overcrowded emergency departments, these platforms help ensure that hospital resources are preserved for patients in critical need. Virtual visits can also lead to more efficient use of healthcare resources, allowing providers to manage larger patient loads with improved workflow efficiencies.

There are, however, challenges that must be addressed for telehealth to reach its full potential in rural areas. One of the key issues is the digital divide. While broadband expansion initiatives and improved rural telecommunications infrastructure are making strides, many rural communities still lack reliable internet access—a crucial component for successful telehealth implementation. Policymakers at the state and federal levels, including considerations in the Federal 2026 budget, are beginning to recognize the importance of investing in these areas. Such investments are essential to ensure that telehealth can serve as a viable alternative to in-person care in rural settings.

Another challenge is ensuring that telehealth services are fully integrated with existing healthcare systems. Interoperability between telehealth platforms and electronic medical records (EMRs) is vital to maintain a seamless flow of patient information, which in turn supports continuity of care. As more healthcare providers adopt digital solutions, the need for standardization and robust data exchange protocols becomes increasingly important.

Ultimately, while telehealth is not a complete substitute for all in-person care, it is a powerful tool that can help maintain continuity in the face of rural hospital closures. By improving access to care, reducing travel burdens, and alleviating pressure on overstretched facilities, telehealth can play a central role in preserving the health of rural populations.

The ongoing evolution of telehealth technology offers a hopeful outlook for rural healthcare. As innovations continue to improve service delivery and integration, it is imperative for stakeholders—providers, policymakers, and technology developers alike—to collaborate in expanding these solutions. In doing so, we can help ensure that rural communities are not left behind, but instead have access to the high-quality, timely care they deserve.

For Perspectives editorial and additional opportunities such as supporting TTA through advertising, contact Editor Donna.

News roundup: 9 additional VA centers named for Oracle 2026 EHR rollout; ATA Action acquiring, expanding with DTA; Dr. Oz to lead CMS while HHS cuts; DOJ seeks death penalty for Mangione

April 4, 2025 | by

VA moving forward with the 2026 Oracle Cerner rollout of (lucky?) 13 centers. In March, the Department of Veterans Affairs (VA) announced that the EHR Modernization (EHRM) for 2026 would be expanded to a total of 13 sites, adding nine to the four in Michigan announced in December. True to form, ‘later this year’ was less than one month later, yesterday. The additional nine are in Ohio (4), Indiana (3), Kentucky (1), and Alaska (1): 

Cincinnati VAMC-Fort Thomas (Fort Thomas, KY)
Chillicothe VAMC (Chillicothe, OH)
Cincinnati VAMC (Cincinnati, OH)
Dayton VAMC (Dayton, OH)
Louis Stokes Cleveland VAMC (Cleveland, OH)
Fort Wayne VAMC (Fort Wayne, IN)
Marion VAMC (Marion, IN)
Richard L. Roudebush VAMC (Indianapolis, IN)
Alaska VA Healthcare System (Anchorage, AK)

The four locations in Michigan are VA Battle Creek Medical Center, VA Detroit Healthcare System, VA Ann Arbor Healthcare System, and VA Saginaw Healthcare System. This is almost two years after all installations replacing the venerable VistA were halted in April 2023, with the priority to fix the five troubled current deployments and the 2024 MHS joint installation at Lovell FHCC. This series is termed ‘market based’ with the locations relatively close to each other for greater efficiency, versus the earlier far-flung centers. In addition, “VA will adopt a standard baseline of products, workflows and integrations aligned with subject-matter-expert recommendations.” VA release, HealthcareDive

ATA Action acquires Digital Therapeutics Alliance (DTA), launches Advancing Digital Health Coalition. The advocacy arm of the American Telemedicine Association (ATA) will be combining with the DTA, a 501(c)(6) non-profit trade association with a mission of advancing digital therapeutics globally. The new organization will continue to take policy roles in advancing telehealth, ATA Action’s focus, but expanding into policies governing digital health tools in diagnostics, remote patient monitoring, and AI, leveraging DTA’s established relationships at the FDA and international regulatory agencies. Kyle Zebley will remain executive director of ATA Action. Andy Molnar, CEO of DTA, will transition to head of digital health at ATA Action. ATA Action is also launching the Advancing Digital Health Coalition, a membership non-profit which will extend the work of the DTA into advocacy for innovative digital health technologies transforming patient care, including digital therapeutics, prescription drug use related software (PDURS), and remote monitoring devices. Timeframe was not disclosed. ATA-DTA release, Advancing Digital Health Coalition release, FierceHealthcare, Healthcare IT News

Over at the Feds, Dr. Mehmet Oz was confirmed today (Thursday) by the US Senate to head the Centers for Medicare and Medicaid Services (CMS). The vote was 53 to 43.  Former TV personality and PA Senate candidate Dr. Oz, a cardiac surgeon, graduated from the University of Pennsylvania, earning both an MD and an MBA from Wharton. He became a professor at the Columbia University – Vagelos College until 2022. The now-whitehaired Dr. Oz will be CMS Administrator over a downsizing organization, which will be 300 staff lighter and with a Congress that needs to find billions in savings. Within Health and Human Services (HHS), Secretary Robert F. Kennedy Jr. has presided over 10,000 in packaged out layoffs, with another 10,000 laid off this week for an ultimate 25% downsizing across all agencies to 62,000. Reports indicate confusion, which is sadly typical of mass layoffs for organizations of size. HealthcareDive, MedTech Dive 27 Mar, MedTechDive 3 April, HealthcareITNews

The US Department of Justice (DOJ) will seek the death penalty against Luigi Mangione. The Federal murder charges brought in December have been increased by Attorney General Pam Bondi. She has directed Acting US Attorney for the Southern District of New York, Matthew Podolsky, to seek the death penalty for this murder as an act of political violence, premeditated and threatening the public. Currently, the Federal government has a moratorium on executions which she has committed to reviving. The accused murderer of Brian Thompson, CEO of UnitedHealthcare, is currently incarcerated at Brooklyn’s Metropolitan Detention Center, facing first-degree murder as an act of terrorism charges brought by New York State. He and his attorney are requesting that Mangione have access to a laptop for reviewing case documents, an unprecedented privilege. Mangione also faces charges in Pennsylvania on gun and false identification charges from his flight from NYC. The DOJ will be waiting some time for Mangione, as the New York charges have precedence. New York has not yet set a trial date, which is certain to be a circus given his fan girls.  DOJ release, FierceHealthcare, NY Post

Are Hippocratic AI and AI “nurses” the wave of the future–or just another tide of hype? Two articles question.

April 3, 2025 | by

Gimlet EyeTwo Gimlety views of a hot AI player, Hippocratic AI. 2025’s first $1.6 billion valuation unicorn after its January $141 million Series B venture round is on a hiring streak. Their ‘safety focused generative AI for healthcare’ built on large language models (LLMs) has developed multi-age, ethnicity, and language AI-powered virtual “nurses” to interact with patients on post-discharge follow ups for medical and hospital visits, chronic care management, and medication reminders. The purpose of the agentic AI nurses is to close the gap of healthcare staff shortages.

On their website, the recorded demos of the ‘nurses’ roleplaying with real nurses sounded to this Editor responsive, warm, convincing, and uncannily human–the opposite of AI agents this Editor has dealt with, which are robotic, clearly on narrow scripts, and easily thrown off by off-script or critical questions, resulting in long silences and cutoffs. But none of the ‘patients’ threw curveballs, talked about multiple conditions, or deviated much in the Q and A. In other words, the bots got to shine.

Last month, it released its Polaris 3.0 product which organizes 22 LLMs having 4.2 trillion parameters, using proprietary data, documentation, regulatory documents and other training materials then tested by clinicians. It claims a clinical accuracy rate of 99.38% compared to 98.75% for their previous Polaris 2.0 version and upgrades in audio processing, agent emotional quotient, and improved clinical documentation. At the end of the month, Hippocratic AI announced seven new hires at C and VP levels, coming from major companies like Amwell, Blue Shield of California, non-profits such as Population Services International, and smaller healthcare companies such as Sidekick Health and Notable. Quite a move for a company only formed in February 2023, 22 months ago.  Release, Mobihealthnews

Hippocratic AI is on a roll, but as with any sudden rise and particularly with LLM AI, the technology and claims are being examined closely. Two articles on Substack take a critical view–this Editor strongly suggests getting a cuppa and taking time to read them carefully.

The shorter of the two (and open to all) is Thomas W. Dinsmore’s “No Bots, Please” . He looks at Hippocratic AI’s tech from the perspective of someone highly experienced in machine learning tools and platforms from back when we called them algorithms. He presents a lot of cautions and yellow flags.

  • Testing apparently not done on real patients
  • Their claims of Polaris’ accuracy are not benchmarked externally. “Independent benchmarks are impossible with a proprietary model like Polaris.”
  • LLMs are ubiquitous, costs are coming down, and investing in a company with proprietary LLMs may not be the smartest move.
  • Hippocratic AI has many healthcare ‘partners’ (this Editor counted 15), many glowing endorsements from healthcare leaders, an impressive timeline. The rub? They are likely not paying anything, which is unusual for a Series B anything much less a unicorn. (I can personally confirm this last point.) Everyone will say nice things about you if you are free.
  • He points out two types of value creation in healthcare. The first is doing a routine or even highly skilled process faster and better. The second is creating an entirely new capability.
  • The touted healthcare shortage number is way overstated. The 15 million healthcare worker shortage cited by WHO and Hippocratic is global. The need in developing nations is primarily midwives, which can’t be done virtually. In the US, the number reported by the Bureau of Health Workforce (BHW) is closer to 2 million, with about 1 million nurses and the rest in LPNs, adult psychiatrists, family physicians, internists, and other clinicians.
  • The Hippocratic pitch is that their bots can replace nurses. The irony is that what the bots do best–patient education–isn’t being done by nurses, based on a McKinsey study on nursing workloads. The nurses’ biggest time suck is updating documentation, followed by hunting and gathering (everything from locating patients to finding equipment), and medication administration. None of which can be done by Hippocratic AI. 
  • Bots have very limited use with mentally ill patients — and negative for those in crisis.

Conclusion: The model is shaky. The effort in creating bots is wasted. What would be a lot more useful in healthcare would be a system that prioritizes, flags, and notifies staff of a patient deteriorating who needs a real human being to call.

Want more? The Really Long Read is Sergei Polevikov’s Hypocritical AI: $45/Hour Human Nurses Babysitting $9/Hour “AI Nurses” in AI Health Uncut. This may be only partially viewable by those who are not subscribers (and it’s worth the small amount). It is a very deep and critical dive into Hippocratic AI, if what it is selling is real (red flag–their releases contain a lot of numbers which aren’t verifiable), and VC hype. The main sections of the article:

  1. What exactly Hippocratic AI is selling, including poor workflow and EHR integration 
  2. What’s really under the hood of its “AI agents.”
  3. The reality behind “AI nurses”—and the human nurses tasked with babysitting them.
  4. Whether Hippocratic AI fine-tuned its models using confidential insurance or health data obtained from Health IQ.
  5. The toxic corporate culture, code of silence, and reliance on H-1B/O-1 visa “slavery.”

Plenty of references and comparisons. If you aren’t skeptical after the Dinsmore article, you will be after this. A must read.

23andMe’s slim list of prospective buyers–who must uphold privacy policies, according to the FTC. But what about that survey information? *Updated*

April 3, 2025 | by

Barely a week later, but only a few buyers are lining up for 23andMe’s parts. The future of the bits and pieces of 23andMe and their 15 million customers apparently are in the Magic 8 Ball’s response class: “reply hazy, try again” and “cannot predict now”. Not entirely surprising is the lack of vigorous and financially competitive interest in them. Fortune counted the interested parties at only three, plus unsurprisingly, their controlling shareholder Anne Wojcicki.

Here’s their rundown:

Nucleus Genomics. This isn’t a surprise as their founder, Kian Sadeghi, had posted an article about their pass at 23andMe on Substack last September. [TTA 12 March, Editor’s comments] Sadeghi has often likened Nucleus to Netflix versus 23andMe’s Blockbuster, where the second generation survives while the first generation dies off. Nucleus’ consumer offering are $400 tests that it claims can identify health risks for more than 900 conditions. Like 23andMe, Nucleus got in trouble with an early offering, a genetic test for IQ. Supposedly, Mr. Sadeghi is not all that interested in the genetic database, but in Lemonaid, the telehealth remedy site that 23andMe bought for $400 million ($100 million cash, $300 million in now worthless stock). The objective is to integrate telehealth and remedies with Nucleus’ tests, broadening the ‘one and done’ nature of most genetic testing–the original reason why 23andMe bought it. Nucleus has some cash on hand and resources to call in, having closed a $14 million Series A in January and backed by Reddit founder Alexis Ohanian and Peter Thiel’s Founders Fund.

The Sei Foundation. A blockchain developer and advocate for decentralized science (DeSci), it’s proposed a unique use case for the 23andMe database. Their X posting states that they can plug 23andMe genomics information into their blockchain, return data ownership to users through encrypted, confidential transfers, and then allow users to choose how their data is monetized and share in the revenue. They maintain that this would be compliant with existing healthcare and data privacy laws. Gerald Gallagher, general counsel for the foundation, said that “The legal issues involved are not specific to whether or not the data is stored on chain, and the current policy requires notice and new approvals from customers in the event of a sale of assets or change in control.”

Pinnacle Reliability. CEO/founder Ryan Sitton of this complex systems data analytics company for industrial reliability expressed interest in 23andMe before the Chapter 11 via this LinkedIn posting that offered $100 million four weeks ago. The social post did not lead to a real and properly financed offer to the board. According to Fortune, he has renewed his interest.

Anne Wojcicki stated her intent to buy the company when the Chapter 11 was announced and she stepped down from the CEO position. Neither she nor her spokesperson has had any further comment. 

23andMe and buyers better keep the data privacy promises. Federal Trade Commission (FTC) chairman Andrew Ferguson has already notified representatives of the US Trustee Program, a Justice Department division that oversees administration of bankruptcy proceedings, that 23andMe currently, as well as any future owners, must retain the data privacy policies put into place by 23andMe, such as they are. “The FTC believes that, consistent with Section 363(b)(1) of the Bankruptcy Code, these types of promises to consumers must be kept. This means that any bankruptcy-related sale or transfer involving 23andMe users’ personal information and biological samples will be subject to the representations the Company has made to users about both privacy and data security, and which users relied upon in providing their sensitive data to the Company,” he wrote. “Moreover, as promised by 23andMe, any purchaser should expressly agree to be bound by and adhere to the terms of 23andMe’s privacy policies and applicable law, including as to any changes it subsequently makes to those policies.” This seems to be a straight-up reading of current law, even if the current administration’s policy is to bring FTC and other agencies under closer control by the executive branch, a tangent which occupies the last two paragraphs of the Ars Technica article.

Guess what other information 23andMe has on its 15 million users? Survey data! 85% of 15 million users consented to have their individual data used for research. As part of that research, 23andMe requested that users complete an optional survey which added to their profiles. These extensive questions were not available for prior review, but the FAQs made it clear that once you consented to answering them, every time you visited the research page, you’d get questions to answer until they were all answered. In other words, endless continuing research. The rationale presented to users was to “help drive scientific and medical discoveries”. So, when you request to delete your data, will the survey data associated with the user profile be withdrawn as well? The lengthy article in The Conversation seems to conclude, no.

If it remains identifiable, this trove of data could be matched up with other data for law enforcement or to discriminate against someone at high risk for developing a genetic disorder. That type of discrimination is banned for employment and health insurance, but not life insurance or long-term care. Or it could be used to compile a more personal profile for marketing purposes. This needs to be cleared up. Despite this, every person with a 23andMe account should request that their personal data and anything else associated with it be deleted, immediately, before this information finds its way to a new buyer.

Weekend reading: 23andMe updates, a view at variance from the former co-founder, and a deeper historical analysis

March 28, 2025 | by

23andMe passes the ‘First Day Motions’ test in Federal bankruptcy court. On Wednesday, 23andMe received permission from the court to, during their Chapter 11:

  • Pay employee wages and benefits
  • Compensate certain vendors and suppliers in the ordinary course of business for goods and services
  • Enter into the term sheet of the $35 million debtor-in-possession financing agreement (DIP Facility) with JMB Capital Partners
  • Begin the process of selling substantially all of its assets* through a Chapter 11 plan or pursuant to Section 363 of the US Bankruptcy Code.

The court also approved the bidding procedures that take place over the 45-day clock that started with the bankruptcy petition on 23 March. Bidding is conducted by the company and Moelis, their independent investment banker.

  • Qualified bids must agree to comply with 23andMe’s consumer privacy policy and laws regarding treatment of customer data.
  • Any sale transaction involving the transfer of customer data requires court oversight and regulatory approvals.

Additional first day orders on the Kroll (claims agent) website are the retention of two law firms, Goodwin Procter LLP and Lewis Rice LLP by the Special Committee of the board of directors, and the continued use of cash management systems, intercompany transactions, honoring certain prepetition obligations, and priority on administrative expense to postpetition intercompany claims against debtors.

The next step is the ‘Second Day’ hearing that follows up on financing, with the entry of an order approving the DIP Facility and ‘additional requested relief’ that isn’t specified in the 23andMe release. 

*Given that thousands, perhaps tens or hundreds of thousands of a reported 14 million users, are deleting as much data as they can from the 23andMe database, what will the value of that genetic database be? Regarding that database, will there be a third-party ‘guard’ on that database appointed by the Court?

The TTA summary of the bankruptcy 24-26 March  This Editor likened the 23andMe implosion to that of Theranos–a watershed event that forces a rethinking of how we treat the privacy of customer medical data not covered by HIPAA, such as genetic data, as we approach (or try to approach) the mountain called ‘personalized medicine’.

23andMe’s co-founder, Linda Avey, essayed in LinkedIn yesterday that 23andMe was a missed opportunity to create a grand genomic dataset that would combine blood work, deeper gene sequencing, and wearable date culminating into actionable insights. The data is now fragmented among many holders.  In her conclusion, she was polite but unsparing: “Without continued consumer-focused product development, and without proper governance, 23andMe lost its way, and society missed a key opportunity in furthering the idea of personalized health. The 14+ million people who bought into the concept deserve to see their data moved to a secure platform with new leadership and vision. Consumers, however, should be careful sharing their data if they don’t trust its secure and ethical use”.Ms. Avey, a scientist and venture investor, was forced out of the company in 2009.

23andMe’s failure is more significant than Theranos as an example of reality versus the hype. Theranos was a near-straight up fraud with blood labs that didn’t work. 23andMe had a technology that worked and could with accuracy your ancestry and genetic risk factors, though the latter got them into trouble with the FDA with a cease-and-desist in 2013 [TTA 2 April 2014] that they didn’t emerge from till late 2015. But ancestry and genetic risk are ‘one and done’ readings. It’s not an ongoing business model. How do you get members to return and pay for more tests, even if they lose money? How do you get investors? Pivot to research and ‘therapeutic development’. The reality, as Anne Wojcicki herself admitted, is that there’s no money in diagnosis and prevention. “No one makes money in healthcare by keeping you healthy” and  “There’s no profit motive for people to get this information. A doctor does not make money if they give a diagnostic”–and this was said by her in 2019.

So how did the company become valued at $6 billion by 2021? Work the story, work the hype around preventative healthcare to get more venture rounds and then a SPAC facilitated IPO. “Personalized healthcare”.  A “research platform powered by engaged customers”.  While the real money was in selling the data to Pfizer, Genentech, and GSK–and that started back in 2015. All couched in ‘personalized healthcare’ and research.

Far, far more on this is over at AI Health Uncut, Sergei Polevikov’s Substack site. Grab your cuppa and/or lunch. It has more financial facts, particularly around 23andMe’s early years, and the botched opportunity of the Lemonaid acquisition. Everyone is a loser when it comes to 23andMe, except the Lemonaid founders who walked away with $100 million in cash (but lost $300 million in stock). It comes to the sad and numerically relentless conclusion that 23andMe was actually bankrupt since 2018. It was chasing ‘an impossible dream’ and was dishonest about its business model. The end result was that public trust in health tech erodes again–and that investors and founders trust each other a lot less. (And Mr. Polevikov also dubbed 23andMe another Theranos.)

Editor’s note: AI Health Uncut may be paywalled. I encourage our Readers to support Sergei’s work on Substack–for a modest annual subscription amount, you gain full access to his work, past and present, charts, videos, and articles.

News roundup: Walgreens settles 10 year running false claims suit for $5M; UniDoc to buy AGNES Connect; launches from Klarity Health, Tunstall UK, HSE Ireland; VITAL WorkLife survey finds yawning gap in clinician/management mental health perceptions

March 27, 2025 | by

Walgreens continues to tidy its accounts. The ten-year-old whistleblower-initiated Federal lawsuit charged that Walgreens violated  anti-kickback statutes for Medicare and Medicaid was settled for $5 million on Tuesday. The claim was that patients at the Cook County Health & Hospital System’s Ruth M. Rothstein CORE Center were induced to fill prescriptions at Walgreens’ specialty pharmacy by waiving copayments, an inducement that violated the False Claims Act. The lawsuits were filed in the Federal District Court for Northern Illinois by Sarah Castillo Baier and Rita Svendsen Baier in 2014, then by the Department of Justice and the state of Illinois filing their joint complaint four years later in 2018. The settlement will be divided between the two whistleblowers and the US and Illinois governments. This is Walgreens’ second settlement in the last month and pocket lint compared to the first; their $595 million bill for settling the $1 billion PWNHealth/Everly Health arbitration award came due at the end of February. Crain’s Chicago Business

UniDoc signs agreement to buy AGNES Connect from AMD Telemedicine. The Canadian ‘doc-in-a-box’ remote virtual clinic company has agreed to acquire the AGNES Connect business line, software, and customers to its present H3HealthCube product (right). Their NEIL Connect software for the HealthCube was already built on the AGNES Connect telemedicine clinical exam platform. Interestingly, UniDoc is acquiring the use of the AMD Telemedicine name for AGNES along with related goodwill and trademarks, for which they are paying a low US $175,000 in cash plus a revenue share. The Canadian Securities Exchange may have to approve, but the closing is expected shortly. The H3Health Cube was recently placed in Italy and Ukraine [TTA 13 Feb]. Release

This week’s three launches are:

  1. Klarity Health launches Kiwi Health. Telehealth and independent private practice management platform Klarity Health’s new Kiwi Health is designed as an an all-in-one marketing and communications tool. It provides practices with SaaS tools to set up and promote an online presence in 30+ clinical directories, professional website management, patient intake and scheduling, a patient portal, loyalty, and engagement. Klarity has operations in 40 states with practices serving over 100,000 patients while retaining 94.3% of its doctors–all on a slim raise of $12.5 million. Release
  2. Tunstall Healthcare UK introduces Communicall Digital. This fully digital warden call system is designed for supported housing and retirement communities including extra care environments. It enables residents not only to summon assistance through its alarm feature, but also to manage door entry and room-to-room video calls through a simple touchscreen system. The system also reports resident activity to care staff through the Central Management Platform. It is fully compliant with the UK’s digital transition requirements to the industry-standard BS8521-2 (NOW-IP) protocol. THIIS
  3. Ireland’s Ministry of Health launches the Health Service Executive (HSE) Health App. The initial release will enable Irish residents to access and store their health information including self-declared medications; view a list of medicines received through the Irish Drugs Payment Scheme or Medical Card Scheme; their European Health Insurance Card (EHIC); their medical Long-term Illness (LTI), Drugs Payment Scheme (DPS) and GP Visit cards; flu and COVID-19 vaccination records; maternity service appointments, and information on HSE services. Additional features will be rolled out during 2025. Ireland Department of Health release

Meanwhile, clinicians and their leadership stand waaaay far apart on burnout and workplace mental health. A study from VITAL WorkLife, a mental health provider for healthcare workforces including physicians and nurses, finds that there’s a Grand Canyon of a perceptual gap between clinicians and healthcare employer leadership.

  • 79% of clinicians feel unsupported — while 95% of leaders believe they are addressing healthcare worker burnout
  • 80% of clinicians believe that it’s urgent to address to address mental health challenges in their organization–but only half of the leadership agree
  • Over 70% of clinicians believe that their leadership considers organizational mental health a low-priority issue
  • 98% of healthcare leadership believe that they make workplace mental health a priority, while only 39% of clinicians agree–and believe that organizational performance is far more their concern.
  • 92% of healthcare leadership believe that existing programs are well tailored to organizational needs–but only 16% of clinicians agree. 33% disagree and an addition 51% find themselves in the ‘middle’. 

The online survey of 210 healthcare professionals across the US was taken over a three-week period in January 2025, with a cross-section of healthcare functions including leadership level medical, nursing, HR, and wellness staff, as well as clinicians. The full survey is available for download at this link. Release

Perspectives: As police step back from mental health calls, telepsychiatry steps forward

March 26, 2025 | by

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Our hot topic today is community mental health crisis response, and the role that telepsychiatry can play in an integrated approach to  prevent crises from escalating. Today’s contribution is from Andy Flanagan of Iris Telehealth. As CEO, he drives strategy, operations, and culture, leveraging his extensive healthcare and leadership experience. A four-time CEO with a background in global health tech, he holds degrees from Northwestern and the University of Nevada, Reno.

Law enforcement is stepping back from mental health crisis response. Sacramento County Sheriff recently announced deputies will no longer respond to non-criminal mental health calls, citing a recent Ninth Circuit Court ruling that questioned police involvement where no crime has occurred.

Sacramento isn’t alone. In Austin, Texas, the police union president declared that “the Austin Police Department must stop responding to mental health calls,” as reported by Fox 7 Austin.

Law enforcement is underequipped for mental health crises. But who should respond instead? How do we build a system that connects people in crisis with appropriate care?

The answer lies in creating integrated crisis response systems that combine trained mental health professionals, community resources and telepsychiatry to ensure people in crisis get immediate access to appropriate care, regardless of location or timing.

The current crisis

In Austin alone, police responded to 34,000-52,000 mental health calls annually since 2020. Nationally, the burden is immense, with behavioral health-related emergency department (ED) visits doubling from 2011 to 2020, now reaching approximately 47 visits per 100 people.

When law enforcement withdraws from mental health response, this pressure shifts to already strained emergency departments. Without alternative systems in place, people experiencing mental health crises have nowhere to turn except hospital EDs, leading to overcrowding, extended wait times and less-than-optimal care environments for behavioral health needs.

First responders face an impossible task. Most receive minimal mental health training — often just 40 to 120 hours — compared to the years of specialized education mental health clinicians receive. This gap creates dangerous situations like the DeSilva case that prompted the Ninth Circuit ruling.

A better approach

Communities are discovering more effective models for mental health crisis response. The nationwide 988 Suicide and Crisis Lifeline provides immediate access to trained counselors, while integrated crisis response systems — like Austin’s approach of offering mental health services as a 911 option — show promising results. When Austin callers select mental health services, they’re connected with Integral Care clinicians who conduct assessments, provide support and deploy mobile crisis teams when needed. According to Fox 7 Austin, 87% of these calls are resolved without police involvement.

Specialized mental health professionals are the cornerstone of these systems. These experts bring the right training and perspective to de-escalate situations, connect individuals to appropriate resources and provide trauma-informed care. Unlike law enforcement, their approach centers on therapeutic intervention rather than control and containment.

Technology bridges access to specialized services. Telepsychiatry enables immediate access to mental health expertise, even when providers aren’t physically present. Digital platforms can connect crisis responders with psychiatrists for real-time consultation, ensuring appropriate assessment and care planning from the first point of contact. This is particularly valuable for rural communities with provider shortages, where in-person mental health specialists may not be readily available.

The role of telepsychiatry

Telepsychiatry platforms connect patients directly to behavioral health expertise before crises escalate. Today’s technology enables immediate access to qualified mental health professionals through smartphone apps, community centers and EDs. Modern systems incorporate AI-driven analytics to optimize patient scheduling and resource allocation without replacing clinical judgment.

The benefits are immediate for patients who receive specialized care within 30-45 minutes versus traditional ED visits taking 2+ hours. Healthcare providers gain psychiatric expertise without maintaining 24/7 in-house specialists, addressing a critical gap where 54% of U.S. hospitals have no psychiatrists available for ED and inpatient consultation services. When telepsychiatry is effectively implemented, health systems experience reduced boarding times, lower admission rates and improved emergency department throughput. One hospital avoided more than $1.7 million in boarding costs with a 281% return on investment, while another reduced psychiatric patient length of stay by 70%.

Technology works best when enhancing human expertise, not replacing it. A recent Iris Telehealth survey found 41% of respondents would feel comfortable receiving treatment recommendations from AI-powered mental health tools, and 33% would leverage these tools if integrated into services they already use (think telehealth platforms or primary care visits).

As law enforcement rightfully steps back from mental health crisis response, we must step forward with integrated solutions that combine human expertise and technology. Telepsychiatry represents one critical piece of a comprehensive approach connecting people in crisis with appropriate care.

For Perspectives editorial and additional opportunities such as supporting TTA through advertising, contact Editor Donna.

Breaking: 23andMe files for Chapter 11 bankruptcy–whither customer data and security? An impact similar to Theranos?

March 24, 2025 | by

The exploding plastic inevitable comes to its inevitable end. 23andMe’s board filed for a Chapter 11 bankruptcy with the Eastern District of Missouri (!) Federal bankruptcy court on Sunday night (Case 25-40976). Anne Wojcicki, CEO, 49% controlling shareholder, and board member, stepped down from the CEO position, but remains on the board. Interim CEO is Joseph Selsavage, 23andMe’s chief financial and accounting officer,  according to their SEC Form 8-K filing.

In their announcement, 23andMe will, with court approval, actively solicit asset sales over a 45 day period.

Anne Wojcicki’s final non-binding proposals on 10 and 11 March were rejected by the Special Committee of the board of directors evaluating asset sales and now the bankruptcy.

Anne Wojcicki’s statement on X early on Monday morning was of a piece with her statements as 23andMe entered its death spiral starting in 2023. “We have had many successes but I equally take accountability for the challenges we have today. There is no doubt that the challenges faced by 23andMe through an evolving business model have been real, but my belief in the company and its future is unwavering.” In her post, she also said that she would bid for assets sold by the company. 23andMe has not issued any further statement or response to their former CEO’s comments.

The Chapter 11 versus 7 filing means that 23andMe will continue to operate as it sells assets and eventually shuts. It will be up to the board–including Ms. Wojcicki–and the bankruptcy judge regarding the disposition of the company’s assets, which include teleprescriber Lemonade and the large 23andMe genetic database. Those assets and liabilities essentially cancel each other out: $100-500 million in assets and the same in liabilities, according to the filing.

And about that large genetic database–the California attorney general Rob Bonta has already advised California 23andMe registered users to delete their data and request their samples to be destroyed. However, as previous articles have discussed, your data remains–de-identified, which the AG’s statement doesn’t go into in its “reminder” (more like a press opportunity for a 2026 reelection bid?). Mercury News  See today’s update for how-tos–and experiences in deletion.

23andMe has stated that it will not change the way that consumer data is stored or safeguarded, and will continue to operate as usual through the Chapter 11 process. They published an ‘open letter’ blog for customers that positions them as finding “a partner (Editor’s emphasis) who shares our commitment to customer data privacy and allows our mission of helping people access, understand and benefit from the human genome to live on.” which is frankly, misleading.

Perhaps the Chapter 11 is saving Ms. Wojcicki from a tremendous financial mistake in buying out the rest of the common shareholders, though the filing wipes out her investment in the company. It will be interesting to see the court’s comments on the ownership of what at its peak was a $6 billion-valued public company. CNBC  

This story is developing, but has developed ‘legs’ like Theranos in terms of mainstream impact. When YouTube tarot card readers are covering it….   

Updates 25-26 March   

MedCityNews yesterday recapped the various Wojcicki-led efforts to take the company private as Readers have been following, with the interesting addition that by 10 March, at least one minority shareholder, Zentree Investments, felt slighted. Zentree then bought more Class A stock to boost its ownership stake to 13%. (I wonder how they woke up on Monday.) Unfortunately, there were no further insights on why New Mountain Capital retreated from its short-lived offer to buy 23andMe with Ms. Wojcicki that went sideways by 28 February.  (Perhaps someone found something that led to the mutual conclusion of ‘Are we crazy?’)

The first hearing before the bankruptcy court, the Debtors’ First Day Motions, will be tomorrow, Wednesday 26 March, in St. Louis before the Honorable Brian C. Walsh. 

There is no hint of a pre-packaged bankruptcy leading to a reorganization of the business in any of the materials linked below.

From the Form 8-K and the Kroll case summary (Kroll is the claims agent for the company):

  • 23andMe has agreed with a lender, JMB Capital Partners Lending, LLC, to obtain up to $35 million in a senior secured term loan credit facility (DIP Facility). The debtor-in-possession financing from JMB is to pay for the Chapter 11 administrative costs and for working capital. This is subject to the bankruptcy court’s approval.
  • Subsidiaries of 23andMe (such as Lemonaid) will continue to operate. Lemonaid Health and two pharmacy operations are listed as  debtors in the filing.
  • On 21 March, Joseph Selsalvage was paid a retention cash bonus of $500,000 for his services through 31 December this year or 23andMe’s emergence from bankruptcy, whichever is earliest. If he leaves before the end of the retention period or is terminated for cause, the entire amount will be clawed back. The only exceptions are death, disability, or departure for ‘good reason’ as defined in the retention agreement.
  • The board was increased to five members, adding Thomas B. Walper as a non-employee member of the board and the Special Committee (formed for buyers) through the 2027 shareholders meeting. He will be paid $35,000 per month. Mr. Walper is a partner at Los Angeles’ Munger, Tolles & Olson LLP and specializes in bankruptcy law.
  • Any transaction will be subject to customary regulatory approvals, including, as applicable, the Hart-Scott-Rodino Act and the Committee on Foreign Investment in the United States.

From the 23andMe release:

  • The Special Committee rejected Anne Wojcicki’s final bids in the amended Schedule 13D made on 10 and 11 March.  
  • The company in the Chapter 11 will sell substantially all of its assets in a Section 363 sale.
  • Matt Kvarda, a managing director at Alvarez & Marsal, was appointed as chief restructuring officer.
  • First day motions (tomorrow) include requesting from the court authority to pay employees and certain vendors, reducing operating expenses such as real estate leases, and resolving all outstanding legal liabilities stemming from their October 2023 cyber incident.

Since 23andMe’s database includes personally identifiable information and Lemonaid stores medical information as a prescriber of various remedies, it is possible, but to be confirmed, whether Federal entities such as HHS will be involved in approvals of asset sales that have patient information. Those who submitted their tests for genetic analysis are not covered by HIPAA and in fact signed away many of their privacy rights in their submission. 

Information on deleting your user records if you used 23andMe, or you know someone who needs to know how:

Contrary to what many would like to have or to believe, 23andMe retains parts of user information after user deletion, such as: genetic information, date of birth, and gender “as required for compliance”; deletion request information “including but not limited to, your email address, account deletion request identifier, communications related to inquiries or complaints and legal agreements.”

Despite this, deleting your account is the wisest move, according to every expert this Editor has read.

Basically, you are deleting your account, revoking any research consent, and destroying any samples they may have retained. Simple, eh? Not quite! Step-by-step how-to guides are available on ZDNet (simplest) and TechCrunch (scroll to the end). This Editor cannot test as she never used 23andMe. Arundhati Parmar of MedCityNews‘ experience in attempting this process is chronicled in a LinkedIn video and on TikTok.  Expect website crashes, slow responses at best, and more than a few hitches.

New  FierceHealthcare’s Dave Muoio riffs on the data privacy issues which can be summarized as a “data stewardship crisis”. The few protections that members/users have are based on consumer protection laws. 23andMe’s privacy policy, as noted above, was explicit about the minimal protection they offered and that they had the right to access, disclose to others, and sell your genetic information:  “your Personal Information may be accessed, sold or transferred as part of that transaction and this Privacy Statement will apply to your Personal Information as transferred to the new entity. We may also disclose Personal Information about you to our corporate affiliates to help operate our services and our affiliates’ services.” Mr. Muoio reached out to experts at SOCRadar, QuantHealth, the Future of Privacy Forum, the Holland & Knight law firm, Pixel Privacy, and others. The consensus is that state and Federal safeguards are wholly inadequate.

Editor’s opinion:

23andMe’s cavalier attitude during their 2023 data breach, caused by their sloppy security (well documented by others and analyzed in our article here with previous articles linked within it) but blamed by their management on members reusing passwords, was symptomatic of a certain arrogance and attitude. By 2023, the company was already in trouble. Why would anyone believe that they’d be any less cavalier about personal genetic information?

Will this be another ‘watershed’ event like Theranos? The level of mainstream consumer media coverage the 23andMe bankruptcy has received reminds this Editor of the demise of Theranos. But here, there is no glamorous young founder in a black turtleneck jetting about and working in a Silicon Valley high-tech lab perpetrating a fraud. Here, the founder and key shareholder is a mature wealthy woman who kept a fairly low profile, the technology worked, the consumer business broke fresh consumer ground and, for its time, getting your genetic information and ancestry was a popular concept. GSK’s five year deal was completed–not renewed, but no lawsuits ensued. What was way off was its $6 billion valuation in 2021 after its SPAC and IPO.

Its faltering wasn’t news like Theranos or (for that matter) Walgreens either. The concatenation of failures along the way, save for the 2023-24 data breach/hacking which was news and drove away customers by the carload, was hardly noted at all. Yet suddenly. every one who ever dealt with 23andMe is anxious about their DNA being sold, with rumors of nefarious buyers like Bill Gates and from China popping up with notorious frequency.

We’ll see if this leads to change in genetic privacy laws and policies.

Short takes: interesting takeaways from the Veradigm earnings call, VA cuts ~6 EHRM contracts; mergers for DispatchHealth-Medically Home, Wysa-April Health

March 21, 2025 | by

The Veradigm earnings call following the 2022 financial release had to be…interesting, perhaps in what wasn’t said. HIStalk’s reporter took away several key points succinctly; a full reading at their site is recommended (scroll down). In brief:

  • “The financial impact of the internal control failures was $239 million in asset reduction and $46 million in fees.”
  • The company will not be current on its financial reporting until 2026
  • The core provider and life sciences businesses went wobbly
  • ScienceIO, bought in February 2024, generated no revenue. The AI/LLM acquisition was touted as being incorporated into other business lines, trimmed with jargon.

The accumulation of things that just aren’t tucked, tied, and moving forward gives the impression of uncertainty. And uncertainty is a bad place to be in a billion-dollar business. Veradigm consists of a complex mix of businesses. Yet the CEO, Tom Langan, is still ‘interim’ after 10 months which affects the leadership. Months ago, the company was for sale, yet all the interested bidders who could have well afforded Veradigm took a pass. Now they are facing a ‘standalone future’.  Right after that announcement, an activist investor intervened and is now calling the shots on board members [TTA 19 Mar, 22 Feb]. Stay tuned….

VA cutting contracts, including six EHRM sub-vendors–a wrench in the EHRM works? According to this Federal News Network report, the total number of canceled contracts, originally announced as 875 contracts, was later reduced to 585. Included in the cuts were at least six small contractors tied into the EHR Modernization (EHRM) with Cerner. While VA is ‘walking back’ the termination of some of these EHRM contractors working on essential pieces such as interoperability and HIPAA compliance, these small, generally veteran-owned companies with specialized workers have already laid off staff. What’s really telling is the statement from FNN’s source, which this Editor doubts you’d hear outside of government or a huge global company: “For every FTE in government, there’s maybe two, three, even four support resources that are assisting. The government is just there for decision-making. The groundwork, and all the other work, is being done by this contract support team. Right now, they’re just trying to do damage control.” In addition, 24 on the EHRM team either were laid off or took the buyout. Having once worked for a contracting RPM company for the Veterans Health Administration which had its contract terminated after over 10 years, this Editor can testify to 1) the devastating effect and 2) the specialized skills of people making up these support teams.  Hmmmm….

Hospital-at-home DispatchHealth and Medically Home to merge, effective mid-year. Terms of the transaction, headquarters location, and employee transitions were not disclosed. According to Healthcare Dive, Jennifer Webster, CEO for DispatchHealth, will lead the combined organization under the DispatchHealth name. Both offer same-day in home medical care, recovery services, and hospital-level care at home. DispatchHealth, headquartered in Denver, raised $403.2 million through a March 2021 Series D. Medically Home in Boston raised $197 million through a January 2022 Series D. They don’t have investors in common, unusually for mergers of late. Medically Home focuses on health systems and physician groups for serious and complex care decentralized management, while DispatchHealth base is with insurance companies, value-based entities, as well as health systems. Coverage for the combined entity is stated as nearly 40 health systems, as well as most major health plans and value-based care entities, with 2,200 employees, over half in frontline care. Release. 

Over in Telemental Health Land, Wysa and April Health are merging. Wysa primarily features an AI LLM chatbot for cognitive behavioral therapy, targeted to individuals and employers, while April Health partners with primary care providers for behavioral care management with live managers. The Wysa chatbot in 2022 received FDA Breakthrough Device Designation for use by patients 18 years old and older with a diagnosis of chronic musculoskeletal pain, depression and anxiety. April Health has already integrated the Wysa chatbot with its services for LifePoint Healthcare and The Newton Clinic (affiliated with MercyOne). Terms of the transaction, headquarters location, and management transitions are not disclosed. Wysa has raised about $35 million in funding, with the last round in 2023, while April Health has seed funding only. Release, Behavioral Health Business, Mobihealthnews 

News roundup: NHS England to be abolished, absorbed into UK DHSC, while IT glitch shorts 5,200 from screenings; Veradigm *finally* files 2022 financials (updated), VA-Oracle EHR now promises 13 installs in 2026

March 19, 2025 | by

The semi-independent entity of NHS England is scheduled to be absorbed by the UK Government within two years. Formed in 2012 under the David Cameron-led Government, NHS England (formally the NHS Commissioning Board) with the enactment of the 2012 Health and Social Care Act reforms, will now be directly controlled by the Department of Health and Social Care under the Secretary of State for Health and Social Care, Wes Streeting, who said, “We need more doers and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.” The intent, according to Prime Minister Starmer’s announcement on 13 March, is to institute a centralized model that eliminates over-regulation, duplication, and slashes the £200 billion it currently takes to operate semi-independently. 

NHS England staff were warned of cuts up to 50%, and incoming chair Dr. Penny Dash, said in an agency statement that she will “work to bring together NHS England and DHSC to reduce duplication and streamline functions.” NHS England has doubled staff since 2010 when it peaked in user satisfaction and waiting times, declining ever since. Healthcare IT News

NHS England has a guide here on ‘what you need to know’ about the two-year abolishment announcement and key points from both the Starmer and Streeting speeches along with answers to MPs’ questions. Notably, “integrated care boards (ICBs) and provider trusts have been told to make further cuts, with ICBs asked to make 50 per cent reductions in their running costs by Q3 2025/26 and trusts being told to cut their “corporate services” budgets back to pre-pandemic levels.” The greatest concerns center around cuts to frontline staff though budgets are for now in place.

Separately, an IT glitch in NHS England’s GP patient registrations meant that 5,261 people weren’t notified of routine screenings. When GP practices did not fully complete patient registrations, the IT admin error meant their information was not passed into NHS screening program systems. Thus the reminders were not sent out for routine bowel, breast and cervical cancer, and abdominal aortic aneurysm screenings. This apparently started in 2008 but wasn’t identified till last year. It’s estimated that 10 patients may have died since that time. Digital Health UK

Veradigm files its delayed 2022 financials, at long last–and still unaudited. These were the infamous financials that delisted the company from Nasdaq due to a software problem that was reported that year. It made subsequent years non-auditable though the company reported profit on its complex operations. Veradigm stock fell, it failed to sell itself for the estimated $1 billion last year to one of the five most interested bidders [TTA 31 Jan], and now is essentially controlled by an activist investor, Kent Lake PR LLC, which has added four independent board directors [TTA 22 Feb]. The 2022 financials plus restatements of 2021 and 2020 financials were filed in their SEC Form 10-K. 2022’s net loss was $86.4 million, 2021’s net income was $139.7 million, and 2020’s was $696 million. Non-GAAP income per share was for the respective years ($0.77), $1.01, and $4.37. Now for 2023 and 2024….  Veradigm release is a long read

Updated: Healthcare Dive confirmed Veradigm’s flat revenue projection for 2025. Two new board directors and a chairman were appointed: Jonathan Sacks, a partner at Stonehill Capital Management, and Bruce Felt, CFO at cloud software company Domo on the board, and Lou Silverman as chairman. Mr. Silverman joined the board last month and replaces Greg Garrison, who last month announced his retirement after the 2022 financials were filed. Under the agreement with investor Kent Lake PR LLC, all had to be approved by them [TTA 22 Feb].

The Department of Veterans Affairs (VA) will roll out the Oracle EHR to a planned total of 13 sites in 2026. The announcement last week added nine sites to the previously announced four sites in Michigan. The additional nine will be announced later this year. VA also announced that the complete deployment and presumed replacement of VistA will be as early as 2031. On Oracle’s part, the EHR is being moved to the cloud (Oracle Cloud Infrastructure/OCI) with the first phase completed this year and full migration by end of 2026. 

Two statements closing the VA’s release are interesting (Editor’s emphasis in bold); interpreting them, deployments will be regionally implemented and procedures standardized for each, versus the extremely customized approach taken with the first six deployments:

VA is pursuing a market-based approach to site selection for its deployments going forward. This will enable the department to scale up the number of concurrent deployments, while also enabling staff to work as efficiently as possible. 

VA will adopt a standard baseline of products, workflows, and integrations aligned with subject-matter-expert recommendations. The standardized national baseline will ensure successful Federal EHR implementation, accelerate deployments, simplify decision-making, and support future optimizations.

Healthcare IT News, TTA 26 Feb on the most recent Congressional hearings

Breaking: Stefano Pessina to near-double stake in Walgreens after Sycamore Partners takeover–reports

March 18, 2025 | by

Another ‘go big or go home’ move by Signor Pessina. The Financial Times reports this afternoon from “people familiar with the matter” that Walgreens Boots Alliance chairman Stefano Pessina will nearly double his 17% stake in Walgreens to 30%, once the take-private sale to Sycamore Partners closes.

Sr. Pessina will be providing cash for the deal by voting 100% of his shares in favor of the transaction, then reinvesting all cash received. According to the FT, his current stake in the listed group is worth as much as $2.1bn which is a handsome chunk of change in this leveraged buyout–and also makes the LBO possible. A sale and take-private also benefits his spouse and business partner Ornella Barra, who heads up the WBA international business.

The $10 billion equity deal could be worth up to $23.7 billion if assets like VillageMD are divested, with the value of net debt, capital leases, and other items are figured in, along with spinoffs, closures, and carveups [TTA 11 Mar]. Those spinoffs are likely to include Boots in the UK, Shields Health Solutions in specialty pharmacy, other international operations, and even Walgreens’ US pharmacy business. Crain’s Chicago Business

The FT in an accompanying article points out that common shareholders are receiving a 63% bump on their current shares’ value. Bondholders who bought in better days, and saw their bonds fall to 65 cents on the dollar, may either have the bonds left outstanding or Sycamore may have to pay it off at par value.

One can only hope for Sr. Pessina that ‘go big or go home’ works out better here than it did with the buys of VillageMD and Summit Health/CityMD.

Editor’s note: expanding on an earlier comment that she offered to Walgreens in reviving a retail model, taking into account how shopping habits have changed even for those of us preferring to shop in person, and reaching out to those who are less able to shop or are far away:

  • Put in or run pharmacies and related health and beauty aids (HBA) sections/aisle in supermarkets, which are already expanding their pharmacy/HBA operations. This could be branded or ‘white label’. One stop shopping. Many supermarkets have their own (Stop & Shop, Publix), but many (e.g. Acme, many Shoprites) don’t have.
  • Create mobile delivery of prescriptions and HBA through mobile vans, pop-ups, and delivery services to homes, senior centers, FQHCs, clinics. Ordering would use voice, text, and online.