TTA’s Spring Bigness: big raise for WHOOP, big buy for Anthropic, NYT’s big stumble on Medvi, big dissections of OpenAI, Carbon Health, big indictment of VA OEHRM former head, more!

April 10, 2026 | by | No Comments

Friday 10 April 2026

This week was a combination of big business news and big media news on healthcare and health AI. We had one stupendous raise for the WHOOP fitness/health tracker and a huge buy by Anthropic in the bio/research area. The Gray Lady’s attempt at AI hipness led to a stumble over Medvi, which may be the first billion-dollar AI created company but may have the lifespan of a fruit fly given its FDA and legal difficulties. The New Yorker’s long exposé of Sam Altman and OpenAI coupled with an equally long fresh dissection of Carbon Health’s February implosion are our Weekend Must Reads. Closing last week: the indictment of a former director of the VA’s Office of EHR Modernization on receiving and concealing cash and gifts from vendors.

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

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

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

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

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

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

Last Week’s Hot News (was very hot indeed!)

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

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

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

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donna.cusano@telecareaware.com

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

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

April 3, 2026 | by | No Comments

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

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

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

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

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

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

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

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

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

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

TTA is Hopping: Oracle’s 30,000 layoffs, Teladoc’s shareholder challenge, OpenAI’s $122B raise, eMed’s $200M, more

April 3, 2026 | by | No Comments

2 April 2026

For what is usually a quiet week, it hopped like the Easter Bunny chased by Elmer Fudd. The big news was Oracle finally announcing their largest global layoff ever, certainly affecting Oracle Health. Teladoc got an Easter Egg labeled “Unlock The Value!” from activist shareholder, Pineal Capital Management. OpenAI raised $122 billion, eMed $200 million with Tom Brady’s help. More deals next week.

We wish our readers a good Passover and Blessed Easter! 

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

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

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

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

Last Week’s Hot News, including a Perspectives

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

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

Drafted House bill may threaten VA/Oracle EHRM rollout

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

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

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

Contact Editor Donna for more information.

Help Spread the News

Please tell your colleagues about this free news service and, if you have relevant information to share with the rest of the world, please let me know!

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

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

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

April 2, 2026 | by | No Comments

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

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

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

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

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

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

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

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

March 31, 2026 | by | No Comments

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

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

What we know:

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

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

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

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

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

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

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

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

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

What does this mean?

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

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

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

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

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

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

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

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

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

TTA’s Spring 2: Doctronic’s “AI doc” gets $44M & questions, UnitedHealth sued by religious charity, Oracle may get more VA EHRM scrutiny, Qualified Health’s $125M raise, Cerebral buys ADHD therapy app, more!

March 26, 2026 | by

 

26 March 2026

It was another quiet week, with less funding and M&A activity. The only Oracle news (but plenty of held breaths re the layoffs) is our third below–the House VA Committee is willing to at least discuss further guardrails and reviews put on Oracle as a vendor based on EHRM performance. 2026 rollouts are critical–yet that area faces cuts. UnitedHealth gets more flak from a Catholic non-profit founded by nuns. In funding, Doctronic is getting a big bet on pulling off a human-less AI chatbot for routine prescription renewals. And the Blue Side Turned Up for Qualified Health, Flourish Care, and the death-defying Cerebral.

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

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

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

Drafted House bill may threaten VA/Oracle EHRM rollout

Last Week’s Hot News, including a Perspectives

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

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

And from earlier this month re Oracle:

Oracle’s ‘beat the Street with a club’ Q3 performance

Oracle’s rock-and-hard place in Abilene TX: building out a data center with Nvidia chips that are already obsolete–and the financing it takes (updated)

Breaking–Oracle to lay off thousands due to AI data center cash crunch, possibly as early as next week. What’s next? (Updated)

Breaking–Oracle Health loses five executives sent there to fix Cerner: report. And what is it telling us?

Summing up the speculation: will Oracle sell off Oracle Health/Cerner to finance $300B OpenAI datacenter buildout?

Oh yes, one more….So why is there a ‘100% Written by a human’ flag in the header?

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Advertise on Telehealth and Telecare Aware
Support not only a publication but also a well-informed international community.

Contact Editor Donna for more information.

Help Spread the News

Please tell your colleagues about this free news service and, if you have relevant information to share with the rest of the world, please let me know!

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

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

Drafted House bill may threaten VA/Oracle EHRM rollout

March 25, 2026 | by | 1 Comment

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

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

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

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

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

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

Breaking–Oracle to lay off thousands due to AI data center cash crunch, possibly as early as next week. What’s next? (Updated)

March 6, 2026 | by

We now know another piece of the puzzle on why so many Oracle Health top executives have departed. Bloomberg’s Brody Ford has followed up his earlier report on five departures  of key executives at Oracle Health [TTA 3 Mar] with the not-unsurprising news that there will be thousands of layoffs at Oracle, starting as early as this month. The reason why is Oracle’s aggressive expansion into data centers and the shortage of free or loaned cash available for that expansion, necessary to remain competitive in cloud computing with Amazon and Microsoft. (That situation, and the speculation around it, is explored in more detail in our article here.)

The pennydrop was as early as last September in a filing, according to Mr. Ford. It was estimated in the filing that $1.6 billion in restructuring costs will hit this FY, which ends in May. Oracle as of last May had 162,000 employees worldwide.

According to Mr. Ford’s sources, the layoffs will not be the ‘usual’ rolling layoffs, but wider reaching. He cites an internal announcement that “it would be reviewing many of the open job listings in its cloud division.” Some of the cuts will be targeting jobs Oracle needs fewer of because of AI. He cites the reception of Microsoft’s AI-related layoffs and Block, Inc, founded by CEO Jack Dorsey, laying off nearly half of its staff due to supposed leaps in AI (but more likely due to ballooning hiring not compatible with cash flow).

The scuttlebutt on Reddit indicate the cuts could be as high as 20% with the US operation hard hit, and strike as early as next week. Since Oracle has not been shy about cutting jobs over the years (see Mr. Ford’s article), this high number is a surprise. Another bit of information gleaned off Reddit is that the OHAI reporting line has changed from TK Anand to “Clay”–possibly co-CEO Clay Magouyrk, versus Mike Sicilia who testified before Congress two years ago when the VA implementation cratered?

Editor’s analysis and opinion: With five major executives leaving OHAI (Oracle Health and AI), she continues to believe that many of the cuts will hit the health area. Yet OHAI is the area that has taken tons of flak from current customers, from Congress on Veterans Health, from the VA, and from health systems. 

  • Oracle has major Federal contracts. The prominence of the VA contract and rollout timing makes cuts in this area problematic. Just because EHR problems have supposedly been fixed and that both the VA and Oracle are set to roll it out, VISN by VISN, does not mean that AI can do it. It is a long and customized implementation due to the sheer number of VA locations and diversity of functions [TTA 8 Feb]. And for that, you need people with deep experience and buckets of patience who know the system and can get along with their Federal counterparts. VistA in over two decades of implementation was so highly customized for both patient care and additional areas such as research that Oracle, in replacing it to VA satisfaction and to be better than VistA, has to accommodate a lot of, shall we say, discovery along the way.
  • In health systems, the discontent with Oracle was about declining vendor partnership and communication. This points to problems with people and continuity. This was highly apparent in the KLAS survey from October 2025 cited here. When half of the interviewees tell KLAS that they would not buy the system again, that is disastrous.

Apparently missing in action is Seema Verma, the general manager of OHAI.

When your current customers providing your business and cash flow are restive, yet what’s coming out of Oracle has been about 1) refocusing on cloud computing and AI datacenter contracts, not health, 2) massive job cuts to pay for them disproportionately affecting Oracle Health, 3) rumors about a sale of Oracle Health to pay for the datacenters, and 4) still paying a $1.4 billion dividend to shareholders that largely benefits Larry Ellison, holder of 40% of stock–what are the next pennies to drop? Stay tuned!

Sources for this article: Bloomberg, Investor.com

Updated 9 March. SimplyWallSt pegged the layoffs at 18%. One of Oracle’s data center contracts is with OpenAI, but they canceled a large planned AI data center expansion in Texas. Other potential tenants, including Meta, reportedly are interested in the site. Their analysis depicts Oracle as “trying to reconcile very large capital commitments to AI data centers, negative cash flow pressure, and debt and equity raises, with the operational reality of supporting customers such as OpenAI, xAI and Meta.” Yet they are aggressively pushing AI through promotion in healthcare, F1 racing, and construction. Their rock-and-hard place is making commitments versus not having the cash to quickly fulfill them. This returns to our 5 February report. Tuesday is the day that Oracle reports results.

Oracle’s Ellison set last quarter the company’s transformation as three steps: From the Fortune article:

  • Oracle making its database available inside its competitors’ clouds, including Amazon’s AWS, Alphabet’s Google, and Microsoft’s Azure.
  • “Vectorizing” the data to make it readable by AI models, which makes the data customers have in Oracle’s systems more valuable.
  • Building an “AI Lakehouse,” which vectorizes all a company’s data and not just what’s in Oracle databases or applications.

But what if you don’t want your data ‘vectorized’ to be read by AI models? Something called proprietary information and data comes to mind, like business and marketing plans. What about PHI and PII? Those could be the danger points to consider in this ‘transformation’. (Forgive me for being oh-so-tired of ‘transformation’–the last time Mr. Ellison trumpeted this was for…Oracle Health, which may be hollowed out to finance this.)

Breaking–Oracle Health loses five executives sent there to fix Cerner: report. And what is it telling us?

March 3, 2026 | by | 2 Comments

An interesting follow up on last month’s rampant speculation of an Oracle Health sale. Bloomberg News’ Brody Ford broke the news coursing through Reddit’s Oracle threads last week about the departure of two more Oracle Health executives, SVP Product Management for Clinical and Healthcare AI Suhas Uliyar and EVP of Health and AI Sanga Viswanathan. This follows on three earlier departures at the SVP level: Quais Taraki, general manager of Oracle Health and AI; Ofer Michael, cloud product development; and Max Romanenko, engineering for Oracle Health and AI. The departures of Messrs. Uliyar and Viswanathan have not been publicly disclosed by Oracle; the reporting is from internal sources. Oracle did not comment to Mr. Ford on these departures. Becker’s Hospital/Health IT

What they all had in common, according to Mr. Ford’s report, was that all five were long-time, senior leaders in Oracle’s cloud infrastructure areas, and had specifically been transferred to modernize the 2022 $28 billion bet to “transform healthcare” that was second-place EHR Cerner. Mr. Uliyar in fact had dual positions in Health and in the OCI cloud platform. Messrs. Taraki and Romanenko have since gone to EDB, a database software and AI company.

Mr. Ford’s article goes into greater detail, such as Larry Ellison, Oracle’s 81-year-old (but still quite active) CEO with a passion for longevity research, stating that Oracle had almost completely rewritten Cerner’s software code and had expanded into other hospital systems including accounting and HR. Read his post on LinkedIn. Article for Bloomberg subscribers here. 

Again, it is well known that Oracle purchased the antique EHR that was Cerner in order to sell other Oracle systems into the hospital and large healthcare system market, plus to increase its foothold into the Federal government through the VA and MHS EHR modernization contracts. Our Readers know how that has fared: MHS, with Leidos in a smaller system transitioning from AHLTA, has succeeded, while the far larger VA EHRM, transitioning from VistA, has struggled spectacularly. [TTA 8 Feb latest update]

Oracle’s success with health systems hasn’t been stellar. According to KLAS in a 21 August 2025 premium report (while your Editor was on leave), Oracle Health has lost 57 acute care customers since 2022, including 12 health systems with more than 1,000 beds. Other findings were equally unattractive. In other words, falling behind. From KLAS:

  • Oracle Health has made big promises but has not enhanced the customer experience.
  • Customers report that communication has been lacking and that the vendor partnership has declined.
  • Several large, well-known customers have left Oracle Health.
  • Clinical AI Agent has caught customers’ attention as the first among recently promised enhancement to be delivered.
  • Customers still have lingering questions about Oracle Health’s road map.

Quoted from Becker’s Health IT’s report:

  • About half of those interviewed told KLAS they would not buy the EHR again.
  • Customers cited improvements in code quality and were optimistic about Oracle Health’s Clinical AI Agent, which they say has reduced documentation time and allowed physicians to see more patients each day. Early adopters of the tool described it as a meaningful advance, though broader adoption is still in its early stages.
  • KLAS found mixed reactions to other new and updated products, such as Oracle Health’s revamped EHR and its patient accounting system, RevElate. Some leaders described these efforts as promising, while others expressed skepticism about their ability to address long-standing challenges.

Strictly anecdotal, but when this Editor attended last month’s HealthIMPACT, it was a given that Epic was the hospital system that was the standard, and Oracle Health had fallen away somewhere in the mists. It wasn’t a Hertz and Avis rivalry anymore.

So what does this scatter of tea leaves mean? Returning to Mr. Ford’s article, Oracle expects Oracle Health bookings and revenue to accelerate in 2026, based on a December earnings call.  Mike Sicilia, who is co-CEO, is the face on the calls, but from early 2024, Seema Verma has been general manager and EVP of Oracle Health, reporting to Mr. Sicilia–and has been notably quiet. Remaining in the mix is Oracle Health’s product development head, Oracle veteran TK Anand. One can imagine the pressure on both of them to sell the heck out of the updated EHR and associated systems, especially new ones such as documentation and accounting.

Fun fact: Mr. Ellison, co-founder of Oracle, remains its largest individual shareholder with about 40% of common stock, and his cash flow is dependent on Oracle dividends even though Oracle is ‘torching through cash’ to finance AI datacenters. $1.4 billion was paid in dividends at the end of January. Yahoo Finance

But ditching five senior managers, long time techs with deep knowledge of Oracle cloud and product development, either indicates that their ‘job is done’ — or something else. Why do rumors of layoffs persist when major problems with health systems cluster around communication and partnership? Why when the VA EHRM, which required tremendous fixes, where lack of communication and contacts were repeatedly cited in the VA’s OIG and Federal GAO reports, is about to go into rollout?

Is there a turnaround in the offing for Oracle Health?

Or has Larry Ellison’s focus moved towards AI and building out datacenters for OpenAI, Meta, and Nvidia?

Has Ellison tired of pouring more cash into a second-place EHR?  Has it served its purpose in getting healthcare data? Is Oracle Health, in parts or wholly, being leaned out in preparation for sale or spinoff to finance datacenters?   Stay tuned….

What’s happening now with the VA on the Oracle EHRM rollout?

February 8, 2026 | by

Planning for April–but are the problems that derailed it three years ago solved? The US Department of Veterans Affairs is still stoutly maintaining an April start date for resumption of its EHR Modernization (EHRM) rollout. In last week’s updated schedule issued by the EHR Modernization Integration Office (EHRM-IO), the new strategy is to keep the rollouts within a fairly tight geographic area in the same VA region, or in VA-speak, VISN, and roll out every two months. Thus the first four systems are VISN 10 in Michigan: Detroit, Saginaw, Ann Arbor, and Battle Creek (system) in April. Two months later in June, an additional four in VISN 10 will roll out: Dayton Ohio, Chillicothe Ohio, Cincinnati, and Cincinnati-Fort Thomas Kentucky. Another three in VISN 10 will start in August and the last two for the year, Louis Stokes-Cleveland in VISN 10 and Alaska (Anchorage) in VISN 20, will be started in October.

And the reservations are… At the end of January, the VA’s Office of Inspector General in their FY 2025 report on VA’s Management and Performance Challenges detailed five major challenges in the agency. While healthcare services was #1, that section concentrated on staffing and community care delivery coordination, touching on the veteran scheduling/appointment problems that are part of the EHRM, including the Veterans Self-Scheduling (VSS) process.

Most of the EHRM discussion was in #4, information systems and innovation. The VA was scored on using existing systems and incorporating emerging technologies to manage veterans’ medical records, benefits determinations, financial disclosures, and education documents. EHRM and its major performance incidents were detailed first, along with Caseflow (claims and appeals) lacking an enterprise governance structure. The system failures also affected patient care, with clinicians being unaware of critically important patient data and communication breakdowns between VA and community care providers leading to delayed diagnoses and treatment. The OIG also noted a background of decades old cybersecurity and data-integrity problems, with critical vulnerabilities that allowed staff bypass of security protections that left about 3.3 million veterans’ records unencrypted at one facility. In implementing the OIG’s recommendations on the EHRM: 

Regarding VA’s ongoing electronic health records overhaul, VA strengthened the contractor agreement by enhancing performance credit clauses (provisions that establish financial penalties if the contractor fails to meet performance standards) and tighter incident metrics. It created limited real-time system dashboards to help monitor performance at sites going live with the system. However, there remain 32 OIG recommendations that are not fully implemented as VA resumes system deployments. (Editor’s emphasis)

The original ten-year Cerner agreement to replace the venerable but non-interoperable VistA eight years ago (May 2018) was a $10 billion contract, later revised to over $16 billion. After the failures of four years ago, it was rewritten at the five-year point in 2023 to, frankly, bring Oracle Cerner to heel. The 2020 and 2022 implementations were disastrous: Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022. The only 2024 implementation was joint with the DOD Military Health System at the Lovell Federal Health Care Center in Chicago, which went relatively smoothly. A year ago, continuing the rollout looked questionable [TTA 26 Feb 2025]. Now VA has committed to a timeline for 13 health systems/centers this year. Not accomplishing it, and smoothly, will be a bottle of black ink all over VA–and Oracle.

Further complicating matters is Oracle Health’s uncertain status. Will it be cashed out to build AI Datacenters? It depends on an uncertain funding environment and the generosity of banks. And doesn’t relieve the new owner of this Federal contract. [TTA 5 Feb]

Summing up the speculation: will Oracle sell off Oracle Health/Cerner to finance $300B OpenAI datacenter buildout?

February 5, 2026 | by

Even Oracle can’t get all the money it wants for AI. The speculation has been building since late last week, kicked off by a report from financial analyst TD Cowen that percolated through financial media first. It centers on the five-year, $300 billion contract Oracle has with OpenAI (ChatGPT) that requires extraordinary financing to fulfill. According to the report (not publicly available), the capital expenditure needed is estimated at $156 billion to build or lease datacenters. To raise this, TD Cowen projects that the former Cerner, now Oracle Health, would have to be sold, as well as a potential cut of 20-30,000 jobs, about 10-15% or more of the current workforce, saving $8 billion to $10 billion in cash flow.

Why doesn’t Oracle go to the markets and banks, hold out the cup to finance this capital expenditure, and let them fill it? US lenders are apparently growing shy on lending for more AI datacenters, while Asian lenders are willing to lend funds albeit at premium rates. In TD Cowen’s analysis, Oracle is having great trouble financing this massive buildout. Investor nervousness shows in Oracle’s credit default swap (CDS) spreads tripling, as well as pressure on their stocks and bonds.

Let’s look at some factors why across several reports:

  • Oracle’s already raised $58 billion in the past two months: $38 billion for facilities in Texas and Wisconsin, and $20 billion for New Mexico. 
  • Since September, lenders have doubled their interest rates on these Oracle projects to near non-investment grade levels.
  • Oracle’s credit default swap (CDS) spreads have tripled,
  • Private datacenter operators can’t get financing, so Oracle can’t fill the gap with leases, even though a few months ago Oracle was able to lease 5.2GW of US data-center capacity across Texas, Wisconsin, Michigan, and New Mexico specifically for OpenAI.
  • On top of OpenAI, Oracle is also building datacenters for Meta and Nvidia in a $523 billion total commitment

Oracle is tightening the purse strings to reduce capital needs. They now require for new customers 40% upfront on building infrastructure. Another strategy being explored: requiring customers to buy their own hardware in BYOC (bring your own chip) arrangements which moves that expense off Oracle’s books and onto the customer’s. 

It appears to this Editor that Oracle is caught in a squeeze play. If the company doesn’t build the datacenters, it risks falling behind its massive strategy to dominate the AI datacenter business. Yet the price of this is to abandon its massive investment in healthcare, a linchpin strategy, and the customers there. And there are Federal consequences: the completely incomplete VA implementation scheduled to resume this year and the complete, but still in progress, Department of Defense system.

Let’s look at what the effect may be on Oracle Health. Oracle bought Cerner back in December 2021 for $28.3 billion–after Cerner’s troubles with the VA EHR implementation and in the midst of the Department of Defense rollout. Oracle now is a fading number 2 in health system EHR implementations. It was all Epic, all the time for the health systems attending HealthIMPACT, the conference this Editor attended over the past two days. If Oracle Health is sold, it represents a major strategic reversal for Oracle and personally for CEO Larry Ellison. Both have pumped and promoted changing healthcare through data and systems integration for the past five years. Perhaps Oracle and Ellison have gotten the data “milk” they want and will sell the ‘cow’ now that Old Bossy is not in great shape. Can the ‘cow’ on the block even get the $28 billion paid for it?

Sell, but to whom? Microsoft is the most probable since it is massively integrated into healthcare in multiple systems. The other two under speculation are Google and Amazon. What they have in common are recent and money-losing experiences with healthcare, closing down and selling various ventures. Google Health was shut down and scattered to the winds in August 2021, and Alphabet’s Verily, pivoting like  Nureyev over a decade, is now a ‘precision health’ entity. Amazon, in the midst of layoffs, has done well with Pharmacy, but One Medical. bought during the 2022 Practice Gold Rush, remains a lump of undigested matter in Amazon’s e-commerce digestive tract. Their agita with integrations such as with kiosks for Pharmacy [TTA 9 Oct 2025] and with Prime deserve Pepto-Bismol. Unlikely: any health insurer, for both cash and regulatory reasons. Spinoff? That won’t raise cash.  To be continued….

Sources for this article: CIO, The Register, and Fred Pennic at HIT Consultant, who broke it in the health tech press.

News roundup: VA’s 2025 EHR budget + vendor breach, Neuralink robot arm study, linking mood prediction to sleep, CoachCare buys Revolution Health RPM/CCM, Seen Health’s $22M launch, Spectrum.Life in Deloitte Ireland’s Fast 50

December 5, 2024 | by

It’s $869 million for the EHR budget. The total budget for the Department of Veterans Affairs for FY2025, which started back on 1 October but is still unapproved by Congress, is $369 billion.

  • The overall EHR budget of $869 million includes current operations of VistA, Oracle Health, and exchange with the DOD/MHS system
  • Drilling down, the budget section for Oracle Cerner for the EHRM (EHR Modernization) has $375 million earmarked for the federal EHR contract. This addresses clinicians’ issues and supports healthcare deployment strategies that optimize resources throughout procedures.

VA decided in FY2023 that there would be no further deployments of Oracle Health’s EHR until the current multiple issues present at the existing six facilities using the Oracle Cerner EHR as well as the James Lovell joint MHS/VA implementation completed earlier this year were at least on a pathway to resolution. However, VA Secretary Denis McDonough said in April during early House Veterans’ Affairs Committee hearings on FY 2025 and 2026 budgets that there was the possibility that implementation may resume before the end of FY2025 using carryover funding, not FY2025 allocated funding. Whether Secretary McDonough will be remaining under the Trump Administration is, of course, subject to change.

In June, VA extended its contract with Oracle Health for another 11 months, not having much of a choice. In July, VA was sued by Laurette Santos, a VA clinical social worker in the White City, Oregon facility, over worker accessibility standards and lack of Federally mandated assistive technology in the Oracle EHR.

Additional funds are on request for IT–$6.2 billion for IT systems–and $10 million for AI research and development. ExecutiveGov

VA’s breach problem. It’s located with a vendor for medical transcription, DBP, Inc. According to the Veterans Health Administration release, the attack on DBP’s server encrypted files that were then potentially copied by the hacker. DBP shut down the server and disconnected it from the internet, preventing additional attacks. The vendor purchased new hardware and implemented new security controls. 2,302 veterans were affected with some or all the following information exposed: full name, medical record information, or Social Security number. It was also geographically wide: Maine, Boston, Connecticut, Baltimore Amarillo TX, and Minneapolis MN.

Neuralink moves forward with feasibility study with a robotic arm. Four months after Elon Musk proposed the N1 implant be capable of moving an Optimus (Tesla Bot) robotic arm or leg, Neuralink has an approved feasibility study, code named CONVOY, to investigate whether the N1 implant can move an Optimus robotic arm. Start date is not disclosed. This follows on the announcement of the clinical trial with Health Canada for the “Canadian Precise Robotically Implanted Brain-Computer Interface” (CAN-PRIME) for N1 brain implant and its R1 robot, which is used to place the 64-thread implant into the brain, and approval last month for Blindsight, an implant for sight restoration. [TTA 27 Nov]. Mobihealthnews

Quantifying the link between sleep and predicting moods. This relatively lean bit of research from South Korea uses machine learning (ML) to predict mood episodes in mood disorder patients using only sleep and circadian rhythm data from wearable devices including smartphones used by 168 patients generating 267 days of data. The researchers derived 36 sleep and circadian rhythm features to enable accurate next-day predictions for depressive, manic, and hypomanic episodes. A key finding that daily circadian phase shifts were the most significant predictors: delays were linked to depressive episodes, advances to manic episodes. The study has implications for symptom evaluation and for treatment effectiveness. Mobihealthnews, NPJ Digital Medicine

Acquisitions and funding:

CoachCare acquires Revolution Health Solutions in the busy RPM/CCM space. Both companies offer chronic care management (CCM) services enhanced by remote patient monitoring (RPM) and outsourced teams. CoachCare’s acquisition cost and staff transitions were not disclosed. CoachCare, based in NYC, has raised about $49 million over five rounds in an unusual way–four under $1 million, then in July a private equity round of $48 million from Topmark Partners and Integrity Growth Partners. They claim 150,000 patients and hundreds of healthcare organizations along with five other acquisitions. Revolution Health Solutions, based in Dallas, had no funding rounds listed on Crunchbase. They were founded and led by Jenn Gillette Tompkins who positions it as a partnership (her LinkedIn post).  Release

Seen Health comes out of stealth with $22 million. The Series A has five investors: Virtue, 8VC, Basis Set Ventures, Prime Time Partners, and Astrana Health. Seen is leveraging off the PACE model (Program of All-Inclusive Care for the Elderly) that helps chronically ill and infirm older adults remain in their homes and out of a nursing home by constructing a care team containing a social worker, nurse, dietician, primary care provider, and others. PACE models that started in San Francisco’s Asian and Pacific Islander communities in the 1970s have also been supplemented with digital health telemonitoring, such as QuietCare in 2006-9 (Editor’s note). Despite their advantages, PACE programs only cover 5% of older adults. Twin brothers Xing and Yang Su decided to build on PACE, creating culturally apt physical centers and equipping them with technology such as an EHR and geofencing that prevents wandering. Their programs will also include care at home coordinated with local agencies to provide low or no-cost care. The financing will be used to build out their first center in Los Angeles County’s San Gabriel Valley that focuses on the Asian and Pacific Islander (API) communities along with the needed technology and to build out their team. MedCityNews

Some nice recognition for Ireland’s Spectrum.Life. It ranked #41st in Deloitte Ireland’s 2024 Technology Fast 50 Awards, which recognize the fastest growing Irish tech companies. Spectrum.Life’s digital platform supports digital health, mental health, and wellbeing for employers and employees in the workplace, insurers, and educators. Their services are used by 9.8 million insurance members, 3,000 corporate clients, 60+ universities and 650,000 university students. WireNews

Is Oracle Health’s Big Vision smacking into the wall of Healthcare Reality? Their business says so.

May 15, 2024 | by

Once again, ‘healthcare transformation’ may be A Bridge Too Far but definitely a Long Slog for Oracle. A highly critical Bloomberg report details the flat and deteriorating business of Oracle Health, the division that includes the former Cerner. Since their much-touted acquisition of Cerner two years ago [TTA 14 June 2022], Oracle has not righted the basic health system EHR business. Revenue and clients have stagnated with high-profile losses, versus the massive gains predicted only two years ago, and Cerner falling further behind the hospital/practice EHR leader, Epic, with a 26% hospital bed share compared to Epic’s 48%. 

  • Bloomberg’s internal sources indicated that sales reached $5.9 billion in 2023, but are projected to slip to $5.6 billion both in 2024 and 2025.
  • In 2023, 12 accounts did not renew and announced they would replace Cerner with Epic. These are major names such as Northwell Health and Boston Children’s Hospital. In 2022, clients with a combined capacity of 4,658 patients were lost, according to KLAS Research. This is despite the fact that EHRs are not moved lightly. The average commitment is 15 years or more since the ramp-up is taxing and costs are astronomical.
  • Common complaints cited by KLAS center around Cerner’s legacy software and the Cerner transition: tracking clinical revenue, tool integration, technical glitches, and uncertainty or worsened service associated with the Oracle takeover.Boston moved to improve data exchange with surrounding hospitals and Northwell for Epic’s set of better integrated tools.

Oracle laid off many involved with customer accounts. The consulting and sales area laid off 3,000 in one year from March 2023 to February 2024, according to Bloomberg. These may have been as early as May 2023. In June 2023, there were reports that the VA’s pause of Cerner Millenium for at least a year coupled with the completion of MHS Genesis triggered 500 to 1,200 additional Federal service area layoffs plus rescinded job offers. The layoff total may be as high as 4,200 on a pre-acquisition employee base of 28,000, with salaries and promotions frozen. On the executive level, Don Johnson, who once was a successor to CEO Larry Ellison, departed from leading Oracle Health and AI. Reportedly, Dr. David Feinberg, who briefly headed Cerner prior to the sale, is now a ‘ceremonial’ chairman of Oracle Health. [TTA 18 May 2023] Dr. Feinberg also joined Aegis Ventures as a senior advisor and is on Humana’s board, which sounds like a winddown of Oracle responsibilities [TTA 11 Jan]. The layoffs and freezes have improved the former Cerner’s operating margin from 22% to 33%, but not as high as Oracle’s 46% margin.

Since the acquisition and chairman Larry Ellison’s Big Vision promises of creating ‘healthcare transformation’ and ‘better information’, Oracle’s challenge with Cerner has been not only to move their legacy systems onto the cloud but also to integrate Cerner systems with Oracle–and Oracle may have underestimated that complexity as well.

  • Oracle has stated that most customers have been moved to Oracle’s cloud, but inside sources have qualified them as Oracle Health’s smallest and least technically complicated. The big systems with their own domains have yet to be touched.
  • Cerner applications had about 8,000 bugs to be fixed.
  • On the people management/integration side, there are substantial differences between ‘legacy’ Cerner and Oracle people, often centering around not understanding the nuances and complexities inherent in healthcare–as well as compensation and working conditions. This Editor, who as a marketer has had to deal peripherally with ‘legacy systems’ (to the point of tears) through acquisitions on the payer side, knows this is common.

Where Oracle has had success with Cerner’s EHR is in international markets less saturated with EHRs or with home-grown systems, winning contracts in Sweden, the UK and Saudi Arabia. As previously noted, they are a supplier for the NHS. Oracle has moved forward on population health software,  modernizing Cerner’s revenue-tracking tool, and planning for an AI-assisted ambient listening voice note system. 

What remains up in the air is if the VA will restart Millenium transitioning from VistA this year. Oracle is pushing to restart it and its revenue stream this summer as projected last year [TTA 18 May 2023]. This counters VA Secretary Denis McDonough’s testimony last month to the House Veterans Affairs Committee that the VA does not intend to resume deploying it until FY 2025, which does not start until October 2024, and use carryover funding. This FY, there are no funds or plans allocated except for Lovell FHCC, which seems to be going well. The contract, already tightened last April with multiple metrics, demanded improvements, oversight, and annual renewals, is running into more Congressional headwinds this year. Three senators on the Senate Veterans’ Affairs Committee called for the VA “to use the opportunity the new contract structure provides to re-review terms and add additional accountability and oversight provisions to protect veterans and taxpayers.” pointing to the OIG report issued in March. The contract is up for renewal this coming Thursday 16 May. NextGov, Becker’s

The final burden on Oracle–only alluded to in the article–is the debt load undertaken to finance the $28 billion Cerner acquisition. A complex set of bridge and term loans were used to finance the buy [TTA 27 Oct 2022]. At the time, Oracle’s $90 billion debt load was one of the largest in tech. While Oracle’s stock value has been buoyed by its investments in AI, in the current environment, this debt load becomes suspect. Yahoo Finance, Quartz

News roundup: UHG CEO’s Bad Day at Capitol Hill; Kaiser’s 13.4M data breach; Walgreens’ stock beatup; Cigna writes off VillageMD; Oracle Cerner shrinks 50%; Owlet BabySat gets Wheel; fundings for Midi, Trovo, Alaffia, Klineo

May 2, 2024 | by

It was a Bad Day at Boot (Capitol) Hill for UnitedHealth Group’s CEO Andrew Witty. On May Day, he was the Man In The Arena facing two Congressional grillings–the first from the Senate Finance Committee in the morning, and the second in the afternoon from the House Energy and Commerce Committee’s Subcommittee on Oversight and Investigations. The precipitating event was the Optum/Change Healthcare data breach and system hacking by ALPHV/BlackCat, a disruption which is as of today not fully resolved.  Millions of patients may have had data stolen and exposed–a number that has yet to be determined, but an outcome for which UHG, while paying the ransomwaristes, has prepared. Already, the VA has notified 15 million veterans and families of that possibility.

This Editor will be linking below to multiple articles and Mr. Witty’s prepared testimony. Interested Readers can also refer to YouTube for extensive links to video testimony. Highlights:

  • Both houses criticized the slow response and amount of financial assistance given to providers after the shutdown of Change’s systems prevented (and still is preventing) timely claims processing and payment. While ‘near normal’ volumes of medical claims and 86% restoration of payment processing sounds good, that leaves a lot of wiggle room on over two months of totally disrupted processing and payment. The billion or so cited sounds impressive but much of this is in loans. Most practices and groups simply do not have the financial cushion or billing skillset to bridge this disruption, to pay back loans, or to bookkeep this.
  • Also criticized at this late date was UHG being unable to determine how many individuals had PHI exposed in the breach.
  • As to cause, the description of UHG finding that surprise, surprise, Change’s systems were way out of date, stored on physical servers versus the cloud, and used Citrix remote access without multi-factor authentication (MFA) was utterly savaged. According to Mr. Witty, ALPHV after days of knocking around got in on the one server that did not have MFA authentication.

The blunt fact is that UHG had close to two years (January 2021-Oct 2022) before the buy closed. Due diligence consisting of a full audit had to have been done on Change’s IT systems. They processed what UHG wanted to buy. In this Editor’s estimation, Job #1! for UHG should have been ensuring that Change’s systems were hardened, then upgrading to what Mr. Witty called UnitedHealth’s standards. This Editor will go further. A minimum requirement for the sale should have been security hardening. There was time before the closing.

Senator Thom Tillis, R-North Carolina, had the best riposte. He brought a copy of “Hacking for Dummies” to the hearing, highlighting MFA. I doubt he was much moved by UHG now bringing in cybersecurity company Mandiant to both investigate and harden their systems, nor by UHG having to pay ransom, without knowing whose data was compromised.

  • Beyond the breach, UHG was called ‘monopolistic’ by both Republican and Democrat Members. There were calls to break up UHG as not ‘too big to fail’. UHG has grown by acquisition and consolidation of services. As this Editor has speculated, this is likely coming to an end with the new, much more stringent Merger Guidelines. This sentiment paints a large, unmissable target on UHG’s back for aiming FTC’s and DOJ’s missiles. (DOJ also has a huge score to settle with UHG dating back to the failure to block the Change sale.)

By the end of the day, Mr. Witty looked quite the worse for wear–tie and collar askew, slightly sweaty, versus the perfect poses of the various Members. Becker’s, FierceHealthcare, Axios, HealthcareDive    Mr. Witty’s Senate testimony statement, House testimony statement

Speaking of data breaches, Kaiser Permanente reported a big one to Health and Human Services (HHS). This relates to ad tracker information shared with third-party advertisers such as Google, Microsoft, and X. Kaiser used it in secured areas of their website and mobile apps. Information disclosed could be name and IP. Kaiser reported it on 12 April but only disclosed on 25 April that 13.4 million records may have been affected. The ad trackers have since been removed. TechCrunch, FierceHealthcare 

Walgreens stock not recovering. April was WBA’s worst month in five years and May is no better, with the stock muddling around $17.50. The month slid around 18%. Their 52-week high was $33. As of now, CEO Tim Wentworth’s actions such as closing locations and writing down VillageMD haven’t convinced Mr. Market of WBA’s worth, but in fairness it’s early in his tenure. In the Insult to Injury Department, it was revealed that the IRS is seeking to claw back $2.7 billion in unpaid 2014-2017 taxes. Crain’s Chicago Business

Cigna is also writing down its interest in VillageMD. Almost forgotten is that in late 2022, Cigna invested $2.5 billion into VillageMD. They have now written down $1.8 billion of that ‘low teens’ ownership. The planned tie was connecting Village Medical into Evernorth, Cigna’s medical services area. It was also supposed to provide Cigna with an annual return on investment, but one assumes it did not. The writeoff threw Cigna’s Q1 into the red with a net loss of almost $300 million versus a prior year profit of $1.3 billion, despite a strong quarter that grew revenue 23% versus prior year to $57.3 billion. Healthcare Dive

Oracle Health has been successful–in shrinking Cerner by close to half. Records of employment at Cerner’s Kansas City-based operation have declined from 11,900 people in 2022 (Kansas City Area Development Council) to a current 6,400 (internal documents). Cerner itself reported 12,778 local full-time-equivalent employees in 2022. Oracle had multiple layoffs of Cerner affecting Kansas City workers and has consolidated multiple office buildings and campuses. Becker’s

In more cheerful news:

Baby monitor Owlet announced a strategic partnership with Wheel for Owlet’s BabySat. BabySat is Owlet’s FDA-cleared prescription vital signs monitor for infants 1-18 months. Wheel clinicians can now prescribe BabySat which enables parents to order BabySat from Owlet and other suppliers. With Wheel, BabySat also integrates with durable medical equipment (DME) suppliers who accept and can bill for the product through many insurance providers for partial or full reimbursement. Wheel is a virtual care platform and physician/nurse-practitioner online network available direct to consumer and to enterprises. Owlet release

And rounding up funding:

MidiHealth closed a $60M Series B funding. This was led by Emerson Collective with participation from Memorial Hermann, SemperVirens, Felicis, Icon Ventures, Black Angel Group, Gingerbread Capital, Able Partners, G9, and Operator Collective for a total of $99 million in funding. Midi provides virtual support for women going through peri- and full menopause. The fresh funding will help them expand national insurance coverage, hire and upskill an additional 150 clinicians by end of year, diversify service lines, and scale to care for 1 million+ women per year by 2029. Release

Trovo Health launched with $15 million in seed funding, led by Oak HC/FT. The NYC-based AI-powered provider task assistance platform will use the funding to build its technology platform, clinical operations, and leadership team. Mobihealthnews 

In the same roundup, NYC-based Alaffia Health scored a $10 million Series A round. This was led by FirstMark Capital with participation from Aperture Venture Capital. Alaffia creates generative AI solutions for payment integrity in health insurance claims operations, with the aim of eliminating insurance fraud, waste, and abuse for health plans, third-party administrators, self-insured employers, stop-loss carriers, and government agencies. Their total raise to date is $17.6 million. Paris-based Klineo also raised €2 million for its oncology clinical trials search platforms, assisted by AI, for the use of doctors and patients. BPIFrance and business angels participated in the round.

Short takes: Orion digital pain therapeutic to be commercialized by Newel Health; Verma to head Oracle Health; CVS to shut 25 LA-area MinuteClinics

February 2, 2024 | by

Orion Health licenses its chronic pain therapeutic to Newel Health. Orion’s ODD-533 (Rohkea), classified by FDA and the EU MDR as software as a medical device (MDSW or SaMD) will be developed, manufactured, and commercialized by Newel. Newel, located in Salerno, Italy, designs and commercializes digital medicine and digital therapeutics (DTx) for the US and EU such as Soturi, a digital therapeutic app for Parkinson’s Disease [TTA 23 Feb 23], Orion, located in Espoo, Finland, develops primarily human and animal pharmaceutical products. Orion release

Oracle wastes no time in finding a new Oracle Health head, Seema Verma. Conveniently in-house, the former head of the Center for Medicare and Medicaid Services (CMS) from April 2017 to January 2021 joined Oracle in April last year as senior VP in charge of life sciences.  As executive VP, she will oversee both Oracle Health and life sciences as general manager. Verma’s appointment was announced internally in December, according to Bloomberg. In January, Oracle Health’s general manager, Travis Dalton, announced his departure effective 1 March to join MultiPlan as CEO and president. Verma’s government experience will come in handy, as she has the difficult situation of the stalled Millenium EHR at the VA as well as finalizing the Military Health System rollout, ensuring interoperability–as well as growing the faltering hospital EHR business. By combining the positions, Oracle also eliminates one large C-suite salary. Becker’s

And confirming signs of softness in the clinic business [TTA 24 Jan, JPM’s new reality], CVS announced the closure of 25 MinuteClinics in the Los Angeles area. Closing date is 25 February. They will retain 11 MinuteClinic locations in the Los Angeles area, including an on-demand virtual care practice. Clinics are losing out to virtual care and for more immediate needs, urgent care. This follows Walgreens’ closure of a planned 60 VillageMD adjacent practice locations and softness in their CityMD clinic group. List of 25 closures (LA Times), Becker’s

Wrapping up many changes at Walgreens, VillageMD, CVS Health, Oracle Health

January 11, 2024 | by

Walgreens’ multitudinous c-c-c-changes from the suites to the streets. Financially, Walgreens’ US Healthcare segment in Q1 2024 (Oct-Dec 2023) grew sales to $1.9 billion versus prior year’s $989 million. This included VillageMD’s revenue from Summit Health and some growth at CareCentrix (home care) and Shields Health Solutions (specialty pharmacy). But losses continued, with an operating loss of $456 million and adjusted operating loss of $96 million, reduced from the prior year’s $152 million loss. This is also after their November layoff of several senior staff and 5% of corporate workers following a May layoff [TTA 10 Nov 2023]

  • On the earnings call, new CEO Tim Wentworth confirmed that VillageMD has closed 27 under-performing clinic locations. This is a little less halfway through the 60-location previously announced closure. This is a key part of the $1 billion in 2024 cuts announced at the end of last quarter by then-acting CEO Ginger Graham [TTA 18 Oct 2023]. Healthcare Dive
  • VillageMD’s weakness has been filling physician ‘patient panels’. A patient panel is one doctor’s patient count treated over typically 12 to 18 months. This can be as high in primary care as 2,500 patients, though no numbers were cited for VillageMD. According to Wentworth, VillageMD is now “on a diet”; fewer locations, more patient concentration at available clinics, patient panels and profitability goes up. Or so the math goes. Forbes
  • Walgreens also has trouble in the IT department. Key indicators: Neal Sample is their third CIO in a year, layoffs in staff among employees and contractors, departures of key managers, and the need for new technology including AI to support operations. Graham has cited the new pharmacy inventory system to more accurately forecast demand using AI as an example of the direction she sees IT taking. (Let’s hope it will quiet the rebellious pharmacists.) The former CIO, who departed in September, stocked up on AI and engineering talent at the expense of other needed roles. The Wall Street Journal’s deep dive from December.

Year’s end brought a stop to some of the musical chairs in the CVS Health C-suite. CFO and appointed president of Health Services Shawn Guertin turned his leave of absence due to family health reasons into a formal departure at the end of May. Interims Tom Cowhey moves from SVP corporate finance to CFO and Mike Pykosz, the CEO of Oak Street Health, becomes president of Health Care Delivery. Release, FierceHealthcare

Oracle Health also has the music up and the chairs out.

  • General Manager Travis Dalton is departing on 1 March to join MultiPlan as president and CEO. He succeeds Dale White, who moves to executive chairman replacing the retiring chairman Mark Tabak after 23 years with the company. MultiPlan is a payer cost management company that serves about 700 payers in payment and revenue integrity, network-based and analytics-based services. Dalton is the fifth of 10 senior executives from Cerner to depart after the late 2021 sale to Oracle.MultiPlan release, HIStalk 1/5
  • Oracle Health’s chairman, Dr. David Feinberg, has also been making some transitional moves of his own, joining Aegis Ventures as a senior advisor while remaining at Oracle. His role is to help Aegis work with a consortium of health systems on developing and launching digital health products. Interestingly, there has been no disclosure of the percentage of time he will spend at Oracle versus Aegis. Dr. Feinberg also is a Humana board member. He joined Cerner from Google Health and within a few months, Cerner was sold.  Modern Healthcare