TTA’s May kickoff: is Oracle back from debt brink or in deeper? Deep learning AI vs. LLMs, chatbots take a whack with a PA lawsuit and AMA’s Congress appeal; ad trackers, M&A, more!

May 8, 2026 | by | No Comments

8 May 2026

AI dominated this week in multiple ways. Dr. Eric Topol opined on how validated deep learning AI use in medical imaging is hardly seeing any takeup by companies while gen AI and LLM chatbots get the funders and founders. Chatbots took a beating, with Character.AI being sued by Pennsylvania and AMA lobbying Congress for mental health bot guardrails. Is Oracle back from the debt brink with PIMCO’s bond fund financing for a data center or in deeper? Problematic ad trackers appear on state HIX websites, a buy and a Series B round it out.

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you!

News roundup: Amwell narrows Q1 and full year losses, AMA urges Congress for guardrails on mental health chatbots, hospital at home study finds lower ED visits and lower hospital mortality

Character.AI sued by Pennsylvania on its chatbots posing as licensed physicians and psychiatrists

Oracle steps back from the AI debt brink with $16.3B financing for MI data center, the Project Jupiter ‘clean energy’ experiment in NM, and a major Federal DOW contract

Chutes & Ladders: Ad trackers still on healthcare websites after lawsuits, FTC; the US Navy adds WHOOPs it up and expands Talkspace; HealthVerity to buy Symphony Health; Nervonik’s $52.5M Series B

Is the health tech business neglecting validated deep learning medical AI models versus less proven LLMs and generative AI?

Last Week’s Headlines

A quickie news roundup: ChatGPT for Clinicians unveiled, UHG to invest $1.5B in AI, Aidoc raises $150M, TriFetch raises $1.9M pre-seed, Boehringer Ingelheim & Eko Health partner on canine heart murmur detection

Breaking: OpenEvidence app access terminated in the UK and EU

(Updated) Medtronic reports corporate IT systems cyberattacked. 500K UK Biobank records breached in inside job. Are med device and research organizations the new hacker happy hunting ground?

‘Behind the Emergency’–a well-done presentation about and approach to a specialized healthcare market

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News roundup: Amwell narrows Q1 and full year losses, AMA urges Congress for guardrails on mental health chatbots, hospital at home study finds lower ED visits and lower hospital mortality

May 8, 2026 | by | No Comments

Amwell sees a light at the end of the tunnel while losses continue, as usual. Their Q1 closed with a reduced net loss– $10.3 million versus prior year’s $18.4 million and Q4 2025’s $25.2 million. Revenue was also lower: $54.9 million, down 18%, but exceeding their prior guidance. Revenue from subscriptions, Amwell’s current focus, of $24.9 million decreased about 23% from the prior year. Adjusted EBITDA also moved positively to a loss of $3.1 million versus Q4 2025’s $10.3 million. For their Q2, Amwell projects revenue in the range of $48- $52 million and adjusted EBITDA loss in the range of $2 to $4 million. Full year revenue remains at $195 to $205 million with adjusted EBITDA loss between $12 and $16 million, a reduction from prior projections. Healthcare Dive, Amwell Q1 statement

The American Medical Association (AMA) asks for more guardrails on AI mental health chatbots. In three letters sent to the House and Senate Artificial Intelligence Caucuses and the Congressional Digital Health Caucus, the AMA’s concern was around the emotional dependency on AI systems, the potential distortion of reality through prolonged interaction with chatbots. and the current lack of consistent safety protocols. They outlined several areas needing attention:

  1. Greater transparency in ensuring that users clearly understand when they are interacting with an AI system rather than a human being. Chatbots should not present as a licensed clinician or a human being. [See our earlier article on Pennsylvania’s suit against Character.AI]
  2. Clearer regulatory boundaries around how AI chatbots are used in mental healthcare, including diagnosis and treatment requiring oversight.
  3. Requesting that lawmakers direct agencies to establish a risk-based framework that clarifies when AI tools qualify as medical devices.
  4. Requiring developers to build safeguards, such as crisis-detection capabilities that can identify potential self-harm risk and direct users to appropriate resources and de-escalate harmful situations.
  5. Ongoing safety monitoring, mandatory reporting of adverse events, and stricter standards for tools used by children and adolescents.
  6. Limits on commercial influence, including restrictions or bans on advertising within mental health chatbots, and that chatbots aren’t ‘influenced’ by financial incentives.
  7. Robust data protection standards, including: limits on the amount of data collected and stored, safeguards to prevent unauthorized access or sharing of sensitive information, and clear user consent for data use.

Stanford’s recent research confirmed some common knowledge–that LLMs behind the chatbots pose significant risks by providing inappropriate responses, introducing bias and perpetuating stigma, which can result in dangerous consequences. AMA release, Mobihealthnews

Medicare beneficiary study compares hospital at home outcomes with traditional in-patient stays–and finds some good results. The JAMA Open Network published paper found that in over 15,000 patients (hospital at home, 4,174; in-patient 11, 697), treatment via “hospital at home was associated with significantly lower in-hospital mortality and emergency department (ED) use within 30 days of index admission discharge, with no significant difference in hospital readmissions within 30 days of index admission discharge compared with traditional inpatient care.” The study concluded that may maintain the same or better short term outcomes depending on “appropriately selected patients” (not specified) and that “future studies should evaluate implementation and equity”. The vast majority of patients in the hospital at home sample (nearly 97%) were urban. Healthcare Dive, JAMA Open Network

News roundup: 100+ medical orgs pile on Change/UHG; Teladoc hit with second class-action suit; Congress demands Oracle EHR improvement–or else; Transcarent intros WayFinding; Centivo buys Eden Health

May 23, 2024 | by

The fallout from the Change cyberhack hangs like smog over UHG. On Monday, the American Medical Association (AMA), along with about 100 other signatories from nationwide medical associations including CHIME and AHIMA, sent a strongly worded letter to Health and Human Services Secretary Xavier Becerra. It requested a clear delineation of responsibilities for breach reporting requirements created by the 21 February Change Healthcare ALPHV/Blackcat ransomware attack. Reporting is required by HHS’ Office of Civil Rights (OCR) under HIPAA.

Specifically, the AMA letter requested 1) more public clarity around reporting responsibilities to patients for the data breach and 2) that all reporting and notification responsibilities will be handled by Change Healthcare, not the providers. “OCR should publicly state that its breach investigation and immediate efforts at remediation will be focused on Change Healthcare, and not the providers affected by Change Healthcare’s breach”. To date, this doesn’t seem to be OCR’s position.

  • The AMA and signatory organizations maintain that it “is the responsibility of the covered entity which experienced the breach—UHG—to fulfill its obligations in regard to reporting the breach to OCR, notifying each affected individual, as well as any further HIPAA breach reporting requirements that may be applicable, such as notifying state Attorneys General and media outlets.”
  • OCR, on the other hand, has gone on the record in April as stating in their FAQs that “while the covered entity is ultimately responsible for ensuring individuals are notified, the covered entity may delegate the responsibility of providing individual notices to the business associate. Covered entities and business associates should consider which entity is in the best position to provide notice to the individual, which may vary, depending on the circumstances, such as the functions the business associate performs on behalf of the covered entity and which entity has the relationship with the individual.” (Providers can be considered business associates)

In other words, the providers want the full responsibility of contacting patients, state attorneys general, media, and others (e.g. class action lawyers) to be Change Healthcare’s. They do not want to be forced to contact their patients and, in all fairness, at this point do not know which patients were affected because they are not privy to Change Healthcare’s information. UHG has not yet produced a breach report to OCR. AMA letter to Becerra, Healthcare Finance News

When the stock falls, blame the marketing spend! The latest class-action lawsuit filed against Teladoc blames the company for spending money in digital and other media advertising promoting BetterHelp, their telementalhealth unit. The suit cites Teladoc’s public statements such as a “long runway” for BetterHelp’s membership growth and that spending would be inefficient due to the saturated category. Yet spending increased in 2023. The lawsuit charges that this directly deteriorated the company’s revenue, leading to a substantial fall in its stock price. Charged are Teladoc, and at the time CEO Jason Gorevic and CFO Mala Murthy. Stary v. Teladoc Health, Inc. et al., was filed on May 17 in the US District Court for the Southern District of New York. No response yet from Teladoc. Docket on Justia, Mobihealthnews

The House and Senate Veterans’ Affairs Committees jointly introduce legislation on VA’s EHR modernization. The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act would require the Department of Veterans Affairs to exercise even greater oversight of the Oracle Cerner implementation in these areas:

  • The quarterly reports to Congress would include additional quality metrics on user adoption, employee satisfaction, and employee retention/turnover where the Oracle Cerner EHR is introduced. This adds to existing required reporting on spending and performance.
  • Regarding additional rollouts, the VA secretary must certify that the sites are ready. He also must furnish corroborating data to Congress “demonstrating that all facilities currently using the Oracle Cerner EHR system have recovered to normal operational levels.”
  • If there is no improvement (presumably to this standard) at Oracle Cerner locations within two years of the bill’s enactment, the program will be terminated.
  • VA must also report on the status of VistA with details about “the operation and maintenance costs and development and enhancement costs” of the software and “a list of modules, applications or systems” within VistA that VA plans to retire or continue to use. 

HIStalk 17 May, NextGov/FCW

‘Not for sale’ Transcarent introduces an AI-assisted platform, WayFinding. The platform designed for end users of Transcarent’s enterprise health navigator combines generative AI with instant access to care providers to integrate benefits navigation, clinical guidance, and care delivery on a single platform. The personalized guidance enables the member to find a provider, find out costs, and guides to the best clinical action to take next. It then connects them to medical professionals or provides direct access into digital point solutions. It integrates information on details of the employer plan, ancillary benefits, the member’s medical history, and connection to clinical specialists. There is no information in the overly padded release on when the new platform will be available or how it will be offered to existing and new customers. This follows on Transcarent’s $124 million Series D funding two weeks ago.  FierceHealthcare, Mobihealthnews, TTA 8 May

Centivo acquires Eden Health virtual care. The purchase price was not disclosed. Centivo, headquartered in Buffalo NY, is  a health plan for self-funded employers. Eden, also providing services to employers, is a concierge provider that offers through a mobile app primary care, mental health, and care navigation services, plus workplace pop-up clinics. Eden also has technology that connects providers’ EMRs to their app. Eden’s services will be fully integrated into Centivo, which will enable it to expand to 50 states and increase from its current 120 employer base to 160. The combined organizations cover about 2 million eligible patients in companies ranging from Fortune 100 size to small businesses. Eden’s CEO will serve as a senior advisor to Centivo, but there is no other indication of employee transition.  Release, FierceHealthcare

CMS clarifies telehealth policy expansion for Medicare in COVID-19 health emergency, including non-HIPAA compliant platforms (US)

March 18, 2020 | by

Today (17 March), the Center for Medicare and Medicaid Services (CMS) issued a Fact Sheet and FAQs explaining how the expanded telehealth provisions under the Coronavirus Preparedness and Response Supplemental Appropriations Act and the temporary 1135 waiver will work. The main change is to (again) temporarily expand real-time audio/video telehealth consults in all areas of the country and in all settings. The intent is to maintain routine care of beneficiaries (patients), curb community spread of the virus through travel and in offices, limit spread to healthcare providers, and to keep vulnerable beneficiaries, or those with mild symptoms, at home. Usage is not limited to those who suspect or already are ill with COVID-19.

Previously, only practices in designated rural health areas were eligible for telehealth services, in addition to designated medical facilities (physician office, skilled nursing facility, hospital) where a patient would be furnished with a virtual visit. 

The key features of the 1135 telehealth waiver are (starting 6 March):

  • Interactive, real-time audio/video consults between the provider’s location (termed a ‘distant site’) anywhere in the US and the beneficiary (patient) at home will now be reimbursed. The patient will not be required to go to a designated medical facility.
  • Providers include physicians and certain non-physician practitioners such as nurse practitioners, physician assistants and certified nurse-midwives. Other providers such as licensed clinical social workers (LCSW) and nutritionists may furnish services within their scope of practice and consistent with Medicare benefit rules.
  • Surprisingly, there is ‘enforcement discretion’ on the requirement existing in the waiver that there be a prior relationship with the provider. CMS will not audit for claims during the emergency. (FAQ #7)
  • Even more surprisingly, the requirement that the audio/visual platform be HIPAA-compliant, as enforced by the HHS Office of Civil Rights (OCR), is also being waived for the duration (enforcement discretion again), which enables providers to use Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype–but not public-facing platforms such as Facebook Live, Twitch, or TikTok. Telephones may be used as explicitly stated in the waiver in Section 1135(b) of the Social Security Act. (FAQ #8) More information on HHS’ emergency preparedness page and OCR’s Notification of Enforcement Discretion.
  • On reimbursement, “Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.”

Concerns for primary care practices of course are readiness for real-time audio/video consults, largely addressed by permitting telephones to be used, as well as Skype and FaceTime, and what services (routine care and COVID-19 diagnosis) will be offered to patients.

This significant expansion will remain in place until the end of the emergency (PHE) as determined by the Secretary of HHS.

In 2019, CMS also expanded telehealth in certain areas, such as Virtual Check-Ins, which are short (5-10 minute) patient-initiated communications with a healthcare practitioner which can be by phone or video/image exchange by the patient. This could be ideal for wound care where this Editor has observed, in one of her former companies, how old phones are utilized to send wound images to practices for an accurate ongoing evaluation via special software. E-Visits use online patient portals for asynchronous, non-face-to-face communications, initiated by the patient. These both require an established physician-patient relationship. Further details on both of these are in the Fact Sheet, the FAQs, and the HHS Emergency Preparedness page with links.

The American Medical Association issued a statement today approving of the policy changes, and encouraged private payers to also cover telehealth. The American Telemedicine Association didn’t expand upon its 5 March statement praising the passage of the Act but advocated for increased cross-state permission for telehealth consults.

Additional information at HISTalk today and Becker’s Hospital Review.

100% increase in physician telehealth and virtual care usage in three years: AMA study

February 13, 2020 | by

The American Medical Association’s newest physician survey has a lot of good news for those of us in healthcare tech. It found greater across-the-board physician adoption of digital tools, whether virtual consults, patient visits, adoption of patient portals, workflow enhancements, or clinical decision support.

While current usage was greatest for other tools, the greatest increases were virtual visits via telemedicine, doubling from 14 percent to 28 percent, and remote monitoring for improved care from 13 percent to 22 percent of the over 1,300 physicians surveyed in both years. 

AMA last surveyed physicians on their digital health adoption in 2016. Both the 2019 and 2016 surveys were performed by WebMD and examined seven key digital tools. In current use, 2019/2016:

  1. Remote monitoring for efficiency: 16%/12%
  2. Remote monitoring and management for improved care: 22%/13%
  3. Clinical decision support: 37%/28%
  4. Patient engagement: 33%/26%
  5. Tele-visits/virtual visits: 28%/14%
  6. Point of care/Workflow enhancement: 47%/42%
  7. Consumer access to clinical data: 58%/53%

Also notable was that primary care physicians (PCPs) see greater advantages in digital health more than specialists, though in top two boxes, they are equal. Multi-specialty groups like digital health best.

Providing remote care is also a driver for digital health adoption, the only one which increased several points in the very/somewhat important indicator.

Not surprisingly, older physicians are less enthusiastic about digital health, but they have increased adoption much in line with younger cohorts.

And way back in the appendix of the study, doctors look to emerging technologies to assist them with their chronic care patients, with millenials not that far behind.

Articles: Health Data Management, HealthLeaders
Study: Summary, AMA Digital Health Study 2019

Now EHR data entry 50% of primary care doctors’ workday: AMA, University of WI report

September 15, 2017 | by | 4 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/09/EHR-burden-Robert-Wachter.jpg” thumb_width=”200″ /]Where’s the doctor? Typing away! A fact of life doctors have agonized on over the past ten years–even great advocates like Robert Wachter, MD above at NYeC last year–is the clerical burden of EHRs and patient data entry. A late 2016 time and motion study in the ACP Annals of Internal Medicine (AMA, Dartmouth-Hitchcock, Australian Institute of Health Innovation) noted a mere 49.2 percent of ambulatory physicians’ time spent on EHR and desk work. Mayo Clinic (above) has been tracking both the burnout and the burden as 50 percent (above).

Now we have a new three-year study published in the Annals of Family Medicine led by the University of Wisconsin Medical School tracking EHR data entry as 52 percent: 5.9 hours of an 11.4 hour workday. This includes allied clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounting for 2.6 hours, close to 50 percent of the 5.9 hours daily.

Is there a way out? The study’s recommendations were:

  • Proactive planned care
  • Team-based care that includes expanded rooming protocols, standing orders and panel management
  • Sharing of clerical tasks including documentation, order entry and prescription management
  • Verbal communication and shared inbox work
  • Improved team function.

Much of this sounds like burden shifting to deal with the EHR, not a redesign of the EHR itself, but the commentary in AMA Wire makes it clear that it was shifted in the first place by the EHR designers from other staff to the doctor for direct entry. Other time savings could be realized through moving to single sign-on (versus dual entry passwords) to advanced voice-recognition software. (UW release)

The earlier ACP study excerpt in NJEM Journal Watch has physician comments below the article and they blast away: (more…)

The End or Beginning? Anthem ends Cigna merger, won’t pay breakup fee, seeks damages (updated)

May 15, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/05/The-End-Pic-typewriter.jpg” thumb_width=”175″ /]Updated. Anthem on Friday 12 May beat Delaware Chancery Court’s Judge Travis Laster’s ticking clock [TTA 11 May], and finally, formally called off its merger with Cigna. Instead of sighs of relief and seeking oblivion in a few bottles of adult beverages, Anthem still won’t stop and let Cigna go. Anthem now refuses to pay the breakup fee per their agreement, claiming once again that Cigna sabotaged the merger, and wants blood from that rock. From the Anthem announcement:

In light of yesterday’s decision and Cigna’s refusal to support the merger, however, Anthem has delivered to Cigna a notice terminating the Merger Agreement. Cigna has failed to perform and comply in all material respects with its contractual obligations. As a result, Cigna is not entitled to a termination fee. On the contrary, Cigna’s repeated willful breaches of the Merger Agreement and its successful sabotage of the transaction has caused Anthem to suffer massive damages, claims which Anthem intends to vigorously pursue against Cigna. (Editor’s highlight)

Now we have Anthem seeking damages from Cigna, which is a matched set with Cigna’s Funny Valentine of 14 February adding over $13 bn in damages to recoup the unrealized premium that shareholders did not earn as a result of the merger failure. Anticipating Anthem’s position even at that time, they flipped a wicked backhand in their statement:

Anthem contracted for and assumed full responsibility to lead the federal and state regulatory approval process, as well as the litigation strategy, under the merger agreement. Cigna fulfilled all of its contractual obligations and fully cooperated with Anthem throughout the approval process.

Our Readers will also recall that in March, Cigna joined with Anthem in supporting Anthem’s appeal to the DC Court of Appeals, an unusual move in this light, but one that further reinforced their non-saboteur ‘we’re just innocent victims here’ position. Cigna has not yet publicly responded. The AMA cheered its apparent complete victory in the name of doctors and patients.

They hate each other and have from the start. The real victims here are the policyholders–patients–of both companies, with both companies distracted by a legal battle. How different they are from both Aetna and Humana, which (at least publicly) politely ended all efforts after the merger denial, paid out their breakup, and went back to business, which right now presents challenges with ACA hitting the long-predicted Actuarial Brick Wall. (Aetna exiting ACA individual exchange plans in 2018)

Judge Laster’s plans for a restful summer on Delaware’s beautiful beaches and bays are likely to have gone the way of the mouse in Robert Burns’ poem ‘To A Mouse’ (stanza 7). He is not alone in Indianapolis or Bloomfield, Connecticut:

But Mousie, thou art no thy-lane,
In proving foresight may be vain:
The best laid schemes o’ Mice an’ Men
Gang aft agley,
An’ lea’e us nought but grief an’ pain,
For promis’d joy!

See you in court! Fortune, Modern Healthcare, Healthcare Dive. Interested in the previous details? See our coverage here, including our take on ‘whither the policyholders (patients) and corporate buyers’.

Wearables and mHealth: a few observations

July 13, 2014 | by

The Telegraph reports on the creation of Amazon UK’s wearables store, following on from their US launch that we covered on April 30th. Unlike in the original US launch, locating the store is not that challenging, however it is very much a jumble of products: if you know what you want then you probably don’t need a store to find it; if you don’t, there’s precious little to guide you to find the right product.

One of the wearables they’ll doubtless think carefully before stocking is (more…)

Politico: massive hacking of health records imminent

July 2, 2014 | by

Politico is a website (and if you’re in Foggy Bottom-ville, a magazine) much beloved by the ‘inside government’ crowd and the media ‘chattering classes’. With some aspirations to be like Private Eye but without the leavening sharp satire, the fact that they’ve turned their attention to–gasp!–the potential hackathon that is health records is amazing. They mention all the right sources: Ponemon, HIMSS, the American Medical Association, BitSight, AHIMA. In fact, the article itself may be a leading indicator that the governmental classes might actually do something about it. This Editor applauds Politico for jumping on our battered Conestoga wagon with the other Grizzled Pioneers. We’ve only been whinging on about data breaches and security since 2010 and their researchers could benefit from our back file.

And speaking of 2010, the Department of Health & Human Services (HHS) is doing its part to close the budget deficit by collecting data breach fines–$10 million in the past year. A goodly chunk will be coming from New York-Presbyterian Hospital/Columbia University Medical Center: $4.8 million for a 6,800 person breach (iHealthBeat) where sensitive records showed up online, readily available to search engines. And yes, we covered this back on 29 Sept 2010 when breaches were new and hushed up. Politico: Big cyber hack of health records is ‘only a matter of time’

Oddly, there is nary a mention of Healthcare.gov.

Project ECHO using telemedicine to limit, treat hepatitis C virus

June 21, 2014 | by

Two US government agencies plus the American Medical Association (AMA) are piloting a program to better diagnose and treat the hepatitis C virus (HCV). The Centers for Disease Control (CDC) is the lead in this Arizona and Utah-based project, with the Office of the National Coordinator for Health IT (ONCHIT) and the AMA creating new clinical quality measures and clinical support tools. The objective is to identify what works to treat HCV infections and then develop a scalable methodology. The program will integrate telemedicine (video consults), public health data analysis and outreach  to primary care physicians, academic centers and public health officials. CDC/ONC release/blog posting,  iHealthBeat, Health Data Management. Hat tip to Editor Toni Bunting.