TTA’s Here Comes Summer: two data breaches and a warning, six raises, Validic bought, Silicon Valley’s ‘Cargo Culture’, OpenEvidence scored in study, ‘off the books’ AI in healthcare, more!

June 26, 2026 | by | No Comments

 

Friday 26 June 2026

Summer started and the doldrums lifted. We have not one but two data breaches with a big warning from Five Eyes that AI-powered breaches are coming. Six raises from seed to Series C–including in Brazil–and Validic after many years is bought. But scrutiny is piling on AI and AI clinical tools, from the economics to Silicon Valley ‘Cargo Culture’ to OpenEvidence’s performance to ‘off the books’ AI in healthcare. We also touch on the current status of the Luigi Mangione NY State trial, 18 months after the murder of UHC’s Brian Thompson.

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

Chutes & Ladders: Xsolis data breach affects 1.4M records, Five Eyes warns of AI-supercharged hacking; FDA closes Whoop BP warning, Centene adds HR/finance exec to board; $120M raises for Assort Health, $46M for xCures

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

Short takes: Bain report on anemic AI ROI, SVB report on women’s health, Ladder Health pedes virtual health raises $7M, an update on the Luigi Mangione trial

Amazon’s One Medical Seniors hacked by ShinyHunters, issues “final warning” on 8.8 TB of patient data

News roundup: Validic bought by ChartSpan; raises for Cadence, Prosper AI, Telepatia; Epic MyChart portal messages doubled in 5 years–study    

Perspectives: The most aggressive AI adoption in healthcare is happening off the books

Last Week’s Headlines

Chutes, and chutes: Microsoft’s $3B Oracle cloud leasing deal goes sideways, Defense Health Agency to replace Leidos as system integrator for MHS’ EHR, Centene offering voluntary buyouts to most employees

Tuesday 23 June–UKTelehealthcare webinar/virtual event: Keeping People at Home, Supported by Technology (this is now available on video–check the UKTelehealthcare website and LinkedIn)

Perspectives: Virtual Care, AI, and the Future of Autism Therapy

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

June 25, 2026 | by | No Comments

More than tart takes, these come with 8 ounces of distilled vinegar! Sip slowly and savor this weekend.

The always controversial Ed Zitron goes there. Way out there to challenge your preconceptions. If you’ve ever awakened at 3am wondering where in blue blazes AI is going, agonizing over where it fits in your platform or services, who is it really benefiting other than OpenAI and Anthropic, why VCs are so stingy because your tech isn’t AI All Over, and why despite the hype billions are going down a rabbit hole seemingly with no bottom [TTA 2 June, 25 June] –this article (not premium paywalled) is for you.

“Cargo Culture” refers to the cargo cults of the South Pacific. They originated after native contact with Westerners, usually Americans who landed in ships or built airstrips, mostly during WWII. When the Americans left, the indigenous peoples tried to recreate the “magic” of goods coming off the ship or from airplanes by creating a religion and ritual around these ‘miracles’ without, of course, the corresponding methods of delivery. Your Editor also found an IT version of this called “cargo cult programming“defined in a Wikipedia entry as “computing slang to describe the inclusion of code that serves no purpose in a program, indicating a lack of understanding of the program structure by the programmer.“

Mr. Zitron’s “Cargo Culture” refers to Silicon Valley. The endlessly reinforced belief system of the interlocked software, venture capital, and private equity businesses was built on decades of mythology of endless growth and endless Christensenian “disruption”. They want to believe that there will always be hypergrowth tech companies, always another ‘disruptor’. And the money to fund them will be equally endless. (Forgotten are the failures like Theranos and the billions down the drain.)

The reality, as he painstakingly explains, is that Silicon Valley and tech are, right now, fresh out of ideas. Worse, the software industry is declining. There’s no Google Search or iPhone waiting to be plucked from the ether. There is no New Big Transformative Idea. Company growth is incremental at best, declining or failing at worst. But instead of adjusting, the mythology is ingrained, and to doubt is heretical.

Any dissension, whether corporate or media, means you are Voted Off The Island.

The AI Bubble fits neatly and virally into Silicon Valley’s Cargo Culture and need for a disruptor. It’s a viral product, it was different, it meets a need for automating processes. It makes search a lot quicker. But will LLMs and agentic AI actually change anything other than make it faster, or reduce the need to perform your own logic in building a case/article–at amazingly high expense? Other than the spend, what’s exponential about it? Everyone’s buying a lot of GPUs–heck, Oracle at Larry Ellison’s behest is betting the company on moving out of software, including that ever-so-sticky EHR–and becoming a data center constructor and lessor to Open AI and Meta lest Microsoft eat his lunch. After a certain point, the beliefs become circular and self-reinforcing. 

Mr. Zitron argues the points at length. It’s minimum a 30-minute read and not an easy one. Stay with it. It challenges a lot of premises. It will make you think differently the next time you’re pitched on a company’s miraculous AI software–or if you are a developer, understanding your customer’s needs and likely confusion. It is 100% guaranteed to make you think about Silicon Valley, their modus operandi, and how it’s inflated the whole AI bubble.

Sergei Polevikov shines a light on a recent Nature Medicine study comparing specialized clinical LLMs against the generics–and finds that the generics win. The peer-reviewed study pitted specialized clinical tools like OpenEvidence and Wolters Kluwer’s UpToDate ExpertAI against general-purpose AI tools–ChatGPT-5.2, Gemini 3.1 Pro, and Claude Opus 4.6–using three different benchmarks*. The specialized tools lost every time. What was worse was OpenEvidence’s unprofessional overreaction on social media, namely X. Instead of responding directly to Nature Medicine as a comment, then publishing a peer-reviewed paper refuting the Nature Medicine team findings, citing their own research from independent studies, conducting fresh research, even better admitting that some of the research team’s findings were valid and appreciated, their ‘Twitterstorm’ only created more PR blowback. Social media amplified the damaging reach of one academic study. (Having managed a few ‘crisis communications’ as a marketer, the worst thing that you can do is bang back in anger, though cooling corporate tempers might require a Titanic-sized iceberg of ‘splainin’.)

Mr. Polevikov’s free excerpt of his lengthy article, OpenEvidence Goes Hippocratic AI, is published on LinkedIn, but why not kick in a few $$, support his independent journalism, and subscribe to AI Health Uncut (Substack)?

The Hippocratic AI reference is to that company’s ‘bare knucks’ approach to any criticism of their platforms. 

*FTA Nature Medicine: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. 

A Must-Read potpourri: the ‘math’ of AI data center builds, healthcare AI failures, telehealth in schools, Hippocratic AI’s problems, the loss of empathy.

May 14, 2026 | by | 1 Comment

Your Editor will be Away From The Desk more than a bit over the next two weeks that lead up to the US Memorial Day holiday. I’ve collected seven articles to read and consider over the next few days. Enjoy!

Where Are All The Data Centers?

Author: Ed Zitron.  Self-published on Where’s Your Ed At?

If you’re puzzled about the ‘math’ of data centers–what capacity is available now, what is actually online/operational, and what’s the pipeline like–you will appreciate the detail that Mr. Zitron has gone to in cataloging those and much more. It turns out that we are not in the Land of Math, but in the Land of Myth, ruled by the Great Oz.

Despite what the builders say, and Microsoft’s and Oracle’s ever-cheery press releases, operational data centers are a fraction of what’s needed now or projected. The centers take 18-24 months to build and then many more months to complete–to fit out with chips, cooling, power, and networking that links sites and the end users. The AI giants, despite all the money flowing their way, will run out of money before the operating capacity they need gets online. Every data center takes 18-24 months to build, and even with retrofitting older data centers, the capacity is not there, nor for some time to come. In other words, the cavalry is in a neighboring country, much less the next state. Nobody has yet built an operating 1 GW data center. Centers are in megawatts and that, not many MWs. 

FTA:

  • “Oracle is building 7.1GW of total capacity for OpenAI, and keeps — laughably! — saying 2027 or 2028, when at this rate, Stargate Abilene won’t be done until mid-2027, and the rest either never get finished or are done in 2030 or later.”
  • “This is setting up a horrifying situation where Oracle desperately needs OpenAI to pay it for capacity that doesn’t exist, and if it ever gets built, it’s likely to be years after OpenAI has run out of money, which is the same problem that Microsoft, Google, and Amazon have with their $748 billion of deals with Anthropic and OpenAI, though thanks to the $340 billion or more necessary to build the Stargate data centers, Oracle’s problems are far more existential.”

The article also makes the point that Oracle does not have the fallback businesses that Microsoft, Google, and Amazon have to cushion the blow of AI failure. Oracle has the bottomless pit of Oracle Health, only one part of which is the VA EHR. It has a crushing burden of a massive debt load, the most recent being financed by a large bond fund since banks wouldn’t touch it. It kicked 30,000 employees and their expertise  to the curb. Will Larry Ellison sell a yacht or an island to help finance this as a 40% owner? More in Oracle Steps Back From The Debt Brink and Oracle’s Rock and Hard Place in Abilene

This is one long, well-written, and researched analysis by Mr. Zitron, whose expertise is in PR and is a well-known Silicon Valley critic. 

Telehealth in Schools: Expanding Student Access in a Hybrid Health Care System

Author: Paul Samargedlis. Published on Telehealth.org

Healthcare shortages across the US are affecting K-12 schools and children’s health. School-based telehealth programs can reduce absenteeism, expand access to mental health care, and deliver preventive care, bringing that care to where children already are. School-based telehealth programs in states such as Texas and North Carolina have demonstrated measurable improvements in attendance and emergency department utilization. Much will have to change in coordinating efforts and obtaining funding among school systems, local providers, and governments.

Artificial Intelligence Acquisitions: Agencies Should Collect and Apply Lessons Learned to Improve Future Procurements

Author: Government Accountability Office (GAO) Report to Congressional Requesters. April 2026 (49 pages)

Federal agencies reportedly more than doubled their use of artificial intelligence (AI) from 2023 to 2024, and they used a range of approaches to acquire additional AI capabilities through fiscal year 2025. In April 2025, the Office of Management and Budget (OMB) issued guidance to help agencies acquire AI responsibly, but agencies have not by and large shared that knowledge. This paper attempts to fill this gap in part. GAO identified trade-offs, challenges and benefits. The paper identifies approaches agencies made in acquisition and makes recommendations. The recommendations most impact DOW, DHS, GSA, and the VA.

Top AI Failures in Healthcare

Author: Dmitrii Gorbunov. Published on LinkedIn.

Mr. Gorbunov sums up five costly failures (or about to be failures) where AI has been used in healthcare: physician decision overrides (UnitedHealthcare), claims denials (Cigna), fabrications of consent documents (Sharp Healthcare), and adding diagnostic codes without physician confirmation (Kaiser Permanente). The fifth one, Doctronic, was spoofed by Mindguard to issue triple the dose of Oxycontin [TTA 26 Mar]. The lack of rules, audit and audit trails that can be confirmed and trusted will cost healthcare organizations money and already are having legal consequences.

The next may require subscription to view on Substack

The Architecture of Voice: Why AI Tools Can Mimic Style But Not The Voice

Stuart Miller (Haverin Consulting)’s fourth article on AI’s effect on language and writing. An AI LLM can partly fill two parts of the Competence Framework–Skills and Knowledge–but it does not have Experience. It is incomplete in these three points of Context, and Voice represents the accumulation of Context. FTA: “The dangerous part is the assumption that accelerated Knowledge substitutes for Experience, when in fact accelerated Knowledge, and improved Skills untethered from time, is precisely the recipe for the Builder’s Mirage. The Builder’s Mirage is the illusion of competence, produced without the underlying thing being present.”

Sergei Polevikov’s Substack under AI Health Uncut will require subscription to fully view. His latest are:

Hippocratic AI Fires Its International Sales Team

It’s turning into Theranos 2.0. FTA: “Revenue is an estimated $17–20M ARR. Burn rate is $404M.” Their customers are also their investors. and “Hippocratic AI has quietly withdrawn from all of its international markets, terminated every international contract, and let go of the international sales team that built those relationships.” Contracts were sold without country language versions, adequate GPU infrastructure, and compliance.

Christina Farr: “Where is all of our empathy? Where did it go?”

Christina Farr is the former CNBC healthcare tech reporter, founder of  Second Opinion Media, and is a funder/advisor in the field. The article is derived from his and Alex Koshykov’s interview for their podcast Digital Health Inside Out (48 minutes, go to YouTube, no paywall). “A no-holds-barred conversation about what’s broken in healthcare media, what’s about to break in digital health, and why she’s not coming back to journalism.”

Until next week….

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)