TTA’s May Holiday Triple Feature: VA’s $840M ‘need for speed’ in the EHRM budget, Commure’s $70M raise, Innovaccer buys CaduceusHealth, Doximity vs. OpenEvidence, and two Perspectives on AI

Friday 23 May 2026

Leading up to two holidays–Memorial Day in the US and the UK late May bank holiday–healthcare news remains light. Our roundup includes Congressional hearings on VA’s need for speed–needing 25% more in the EHR budget, an update on the recent VA fraud indictment, two fundings/M&A, and a long Must Read on the ongoing Doximity-OpenEvidence feud worthy of the Corleones and the Barzinis. Rounding it out are two Perspectives: the first on managing the risk of hallucinating AI chatbots and the second on moving AI tools from pilots to full operations.

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

Holiday weekend roundup: VA asks for ‘cyberspeed’ 25% EHR budget bump, update on EHRM fraud indictment; Commure raises $70M; Innovaccer buys Caduceus, lays off staff; Doximity, OpenEvidence slugfest gets hot

Perspectives: AI Hallucinations in Behavioral Health–Why Access Needs Better Infrastructure, Not Better Chatbots

Perspectives: The Next Phase of Healthcare AI Will Depend on Operational Execution

Last Week’s Headlines

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.

US Senate Committee on Aging hearings on senior safety 20 May–available online

Plus…

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

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

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

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Holiday weekend roundup: VA asks for ‘cyberspeed’ 25% EHR budget bump, update on EHRM fraud indictment; Commure raises $70M; Innovaccer buys Caduceus, lays off staff; Doximity, OpenEvidence slugfest gets hot

A slower news week preceding the Memorial Day holiday in the US and the UK late May bank holiday.

Federal budgets for 2027 are in the Congressional washing machine, and the cycle is on ‘agitate’. VA Secretary Doug Collins has tagged a 25% increase in the EHR Modernization budget for FY 2027 over what is currently in the 2027 Military Construction and Veterans Affairs Appropriations bill –$4.2 billion versus $3.4 billion, an increase of $840 million. He testified on Wednesday 20 May to the Senate Veterans’ Affairs Committee and Thursday 21 May to the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related. Apparently, the biggest problem VA has with the much-repaired and now standardized Oracle EHR is that every VA executive director wants it now, not later. An additionally funded EHRM would speed up the cutover for VA facilities to go from ‘dial-up’ to ‘cyberspeed’ internally, in communicating with other VA hospitals, community care, and in record sharing with the military system and civilian health facilities.

Difficulties reported to date (April for four sites in Michigan, VISN 10) are around transferring health records between VA and Department of War facilities. DoW healthcare also uses Oracle, but a different version suited for their needs that has been fully implemented. 

While the House has already passed the bill at the lower budget number and sent it to the Senate, the subcommittee chair John Carter (R-Texas) during the hearing said they’re “not through with the possibility of getting you some more money”. 

VA’s implementation timeline is 19 before the end of this year (13 new and the 2020-24 six), 26 new sites in 2027 and 28 VA Medical Centers in 2028. Even sped up, there are still 90 more to go and the deployment is not expected to be complete till 2031. FedScoop 21 May, 30 April

Update on the fraud indictment of the former EHRM director, John Windom. Surprisingly, there has been little to no mainstream media coverage of the Federal charges against John Windom, who was indicted on 25 March in the Federal District Court for the District of Columbia. The three counts related to accepting cash and gifts from vendors plus failure to report them could bring a maximum of 35 years. This article on conservative news website PJ Media is the most recent (re)telling of the tale and links to nearly all the same sources this Editor included in our 3 April article. It is more colorful than our reporting but brings up an important point I overlooked: where, oh where, are the indictments of some of the vendors who doled out cash, gifts, and maybe more, and in return got prime and sub-contracts. He knew, they knew to keep quiet–‘loose lips sink ships’. Because any Federal contractor–I worked for two, Viterion Digital Health and Collaborative Health Systems, then part of WellCare Health Plans–receives compliance training on working with their Federal agency counterparts. 

Perhaps there are investigations and indictments to come, as I’ve seen in Federal Medicare fraud cases that peel like an endless onion over years. According to the VA inspector general, Mike Missal, who served from 2016 until January 2025, evidence was being gathered internally back during the Biden administration. This fits the timeline of the US Attorney requesting a grand jury be summoned then sworn in on 30 October 2025. Mr. Missal was fired along with 16 other inspectors general by the incoming Trump administration.

Since Mr. Windom was deeply engaged in the choice of Cerner for the VA EHR in 2017-2018, and in the disastrous implementation of VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022, resulting in the rollout’s termination in 2023, Oracle would be unwise to not prepare for a few questions about Cerner’s relationship with Mr. Windom, as I wrote at the time. 

The PJ Media article also references the comprehensive article in the 27 March Spokane Spokesman-Review, which has been on the Cerner/Oracle implementation story since the implementation failure in the region’s Mann-Grandstaff VA facility. Their check of the OEHRM website as of that date confirmed that Mr. Windom was still listed as the deputy director of the Federal Electronic Health Management Office, the joint VA-DOD initiative in the role he assumed in January 2022 after the Mann-Grandstaff problems detonated and the then-Secretary reorganized the department. (Heads did not roll, but they rarely do with SES members). FTA: “The Federal Electronic Health Record Modernization Office did not respond on Thursday (26 March) when asked if Windom remains employed there.” The article by Orion Donovan Smith is a recommended read.

In the funding/M&A department

Healthcare software integrator Commure received a $70 million funding from current investors. Commure’s lead investor is General Catalyst. Commure now has $750 million raised and a $7 billion post-money valuation for its AI infrastructure development. Its subsidiary, Athelas, provides AI-based revenue cycle management and clinical workflow tools. The General Catalyst funding of $200 million plus is an interesting scheme, in that GC fronts the cost of sales and marketing and, in return, receives a share of the revenue from new customers generated by that investment, up to a fixed cap. The new funding will be used for scaling its RCM and practice management platforms, advancing the ‘shared intelligence layer’ beneath Commure’s workflows, and expanding their AI infrastructure into global healthcare markets. Release, Mobihealthnews

Innovaccer acquires CaduceusHealth, a revenue cycle management (RCM) and management services (MSO) provider. Neither transaction cost nor management transitions were disclosed. Well-funded Innovaccer ($675 million through a Series F) has been growing in AI-centric healthcare IT services mainly through acquisition. CaduceusHealth is the fifth in their creating a “comprehensive agentic stack” for health systems and provider groups in their Flow suite. Innovaccer claims to serve over 200 health systems and payers, 95% of community pharmacies, and 80 million patient lives across the US. Release Unfortunately, their growth has been matched by a reduction in staff, with 340 layoffs in the US and India. It is their third layoff in four years as it applies its own AI to automate its own processes. (We are seeing a lot of this across the board, allegedly.) FierceHealthcare

We close with a major Must Read with the OpenEvidence-Doximity battle.

OpenEvidence and Doximity are slugging it out for the same market funding–and a third competitor has just sneaked into the ring. OpenEvidence is the upstart, founded four years ago, and the best valued ($12 billion) yet private healthcare AI company on the planet Earth and is generally thought of as the up-and-coming platform for physician information. Doximity is the mature company, public with a $3.6 billion market cap, proven revenue of $645 million, and (be still my heart) profitable with an EBIDTA margin of 55% and a stunning 49% free cash flow margin. It’s been dubbed ‘LinkedIn for doctors’ but is actually much more with tools for secure telehealth, news, reputation management, and free CME.

They are mutually litigious. Both OpenEvidence (OE) and Doximity tag-team each other in product offerings, use defamation tactics and key staff poaching, and in product development, copycat each other, with Doximity generally leading development and OE following shortly thereafter. Coming up is Doximity’s new product, an in-workflow e-prescribing, prosaically called Doximity Prescribe. Based on the pattern, how long will it be before OE develops a similar product?

Where they make their money is only indirectly from users. Both are supported by a fixed source–pharmaceutical advertising. They both slug it out for physician attention. While doctors love (or hate) both, if they become too similar, the balance will tip. Into this bout steps OpenAI with a new professional product, ChatGPT for Clinicians [TTA 30 April]. Lurking near the ropes is the AI-powered iteration of Wolters Kluwer’s UpToDate peer-reviewed medical content, integrated with Microsoft and Abridge, already in 70% of the largest enterprise health systems because it’s been around forever. OE’s vulnerability may be overpromising in claiming ‘no hallucinations’ of their AI-generated medical content–a claim that is structurally impossible, and results in deficits in completeness, communication quality, and systems-based safety reasoning.

Digging through all of this is the intrepid Sergei Polevikov on his Substack AI Health Uncut. Grab a cuppa and sandwich for this one. For most of the article (Part 1 of 2!), a subscription is required. Consider it money well spent for access to some of the best investigative reporting around with plenty of backup. OpenEvidence Prescribe Coming to Your Doctor’s Office This Month?

Perspectives: The Next Phase of Healthcare AI Will Depend on Operational Execution

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic is on moving AI tools from restricted pilots to full operational use, and what that entails in workflow design. The author, Inger Sivanthi, is the Chief Executive Officer of Droidal, an AI healthcare services company focused on revenue cycle and operational automation. His and the company’s work centers on responsible AI adoption that scales to real world clinical and operational workflows.

For the past few years, healthcare AI has been framed as a story about possibility. Leaders have asked which workflows could be automated, which decisions could be supported, and which longstanding bottlenecks might finally be addressed. Those questions were necessary, because they opened the door to experimentation and helped organizations test where AI might create value.

That phase is ending. The difference between organizations that will move forward and those that stall no longer lies in how many AI tools they pilot. It lies in how well they can embed AI into real workflows, governance structures, and enterprise systems. The next phase of healthcare AI will depend on operational execution, not on how advanced the models are.

Pilots rarely prepare you for real operations

Most pilots run under conditions that real operations never see. The workflow is narrow, the team is small, and someone is watching the numbers closely enough to catch problems before they compound. In that environment, even fragile AI tools can look impressive.

Production is different. Real healthcare operations are full of exceptions, staff changes, and system constraints. Tasks that start with simple data triage or routing quickly spread into clinical, scheduling, and financial workflows. The closer AI gets to patient care, safety, and financial outcomes, the more important the underlying operational design becomes.

A 2023 systematic review on barriers to AI in healthcare, published in PLOS Digital Health via the National Institutes of Health, shows that the main obstacles are not the algorithms themselves, but how they fit into existing workflows and governance structures. The model may work. The operational scaffolding does not.

Success depends on how you design workflows around AI

Healthcare AI becomes valuable only when it fits naturally into the way people already work. That requires more than a technical deployment. It requires clarity on who reviews the output, who handles exceptions, and how decisions are documented when the system is wrong.

When an AI system touches clinical documentation, care coordination, or billing decisions, the downstream consequences land on real people and real timelines. Delays or misrouted tasks can affect patient access, continuity of care, and financial performance. The closer AI gets to those outcomes, the more important it is to have a named person responsible for reviewing what the system produces and catching what it misses.

Connectivity between systems and teams is just as critical as the AI model itself. Point tools that sit outside the surrounding infrastructure often create new handoffs instead of removing work. The strongest operational use cases in healthcare are those that span pre‑service, clinical, and post‑service workflows. AI delivers the most value when it supports the full sequence, not just one isolated task.

Trust depends on how you govern AI in practice

Another reason execution is difficult is that organizations often treat adoption as an afterthought. Staff are expected to absorb new tools while maintaining the same pace, same targets, and same accountability. That usually leads to friction, workarounds, or quiet resistance.

AI changes the shape of work. It shifts who reviews information, who handles exceptions, and how quickly decisions move. People need clarity on those changes and confidence that the system supports them, not that it creates hidden complexity. The closer AI gets to high‑stakes decisions, the more important it is to have clear governance, oversight, and auditability.

The American Medical Association highlights that clear accountability, oversight, and governance are essential for AI to earn trust inside health systems. AI will not win trust through claims or marketing. It will earn trust by performing consistently inside real workflows, especially when pressure is high and staff have no time to compensate for gaps.

Operational execution is where AI succeeds or fails

The organizations that move ahead in healthcare AI will not be the ones running the most pilots. They will be the ones that turn AI into dependable operational infrastructure. That means embedding responsibility, transparency, and integration into the design from the start.

The next phase of healthcare AI will depend on how well organizations manage its operational execution, not on how advanced the models are. Healthcare leaders who treat AI as a workflow‑design problem, not just a technology problem, will be the ones for whom it actually works in practice.

News roundup: Bright Health now NeueHealth; breached patient records double, RCM as vector for hacking; Amazon’s CCM marketplace; JPM reflects the new reality; fundings for Vita Health, Turquoise, CardioSignal

Bright Health Group switches off, takes on NeueHealth name. Now that Bright Health has sold its remaining operating health plans to Molina Healthcare [TTA 3 Jan] with others closed down or insolvent like Texas [TTA 12 Dec 23], they have smartly pivoted to the name of their remaining value-based primary care operation, NeueHealth. (Inexpensive, too) Accordingly, on 29 January, their NYSE listing will convert from BHG to NEUE. The stock value closed today at $13.25, well down from its 52-week high of $79.04. NeueHealth’s operations are divided into NeueCare, which is comprised of their owned clinics and partnerships with affiliated providers, and NeueSolutions, which is a management services entity that organizes independent providers and physician groups into performance-based ACA Marketplace, Medicare, and Medicaid-based ACOs models, including the advanced performance ACO REACH program which covered 60,000 beneficiaries in 2023. Unsurprisingly, the company HQ is moving from chilly Minneapolis to much warmer Doral, Florida, nearer to three of their major clinic networks and 150,000 of its claimed 275-295,000 ‘health consumers’ forecast for 2023. 2023 revenue forecasts for NeueCare are $250-275 million and NeueSolutions $890 million. They have also stated that the corporate move will not affect jobs remaining in Minneapolis, which may be few.

As to the bills coming due for CMS liabilities and debt owed to New Enterprise Associates now that JP Morgan has been paid…not a word. We continue to hand it to Bright, now NeueHealth, for the Best Gordian Knots in Healthcare. Release, Healthcare Dive

Patient records exposed in data breaches doubled in 2023 versus 2022. According to an analysis by cybersecurity firm Fortified Health Security of HHS’ Office of Civil Rights (OCR), which tracks data breaches, in 2023 there were 116 million patient records exposed, topping the over 100 million of 2015, with over 655 breaches, a decrease from 2022’s peak of 721. Of that 116 million, over 112 million were from three health plan breaches: Anthem, Premera Blue Cross, and Excellus, Ten-year total? A stunning 489 million. What also increased over those 10 years by 143% were breaches stemming from business associates–vendors providing services to the covered entity. The just-published Horizon Report (free, available for download here) also reveals that the average recovery cost for a breach is $9.48 million. And health plans and systems are cutting IT staff?  Healthcare Dive

One way that hackers are finding their way into healthcare organizations is via ‘social engineering’, but not always of employees. They’re targeting business associates at revenue cycle management (RCM) companies serving health systems and hospitals. The American Hospital Association is warning members that hackers are cannily evolving their tactics to defeat security procedures such as multi-factor authentication and they have to anticipate hacker tactics. From Becker’s, hackers “steal the identities of revenue cycle employees or other finance staffers, calling IT help desks and correctly answering security questions. They then request to reset their passwords and enroll new devices, getting full access to the employees’ accounts and diverting payments to fraudulent bank accounts.” These are based in the US and then diverted overseas. The AHA recommends at minimum a call back to the employee on these new device enrollments, a call to the person’s supervisor, or as in the case of one health system, a physical appearance at the help desk. AHA article

Amazon enters the chronic care management field through a tried-and-true (for them) vector–e-commerce. Search for a health device like a glucose monitor, a blood pressure cuff, or pulse oximetry, and receive a ‘direction’ to a management service that they may be eligible for at no or low cost through their employer or private health insurance. The kickoff partner with Amazon is chronic care management company Omada Health in the diabetes prevention, diabetes, and hypertension categories. Omada claims 20 million eligible members across 1,900 enterprises. This mode may get better traction with Amazon shoppers than directly providing them with health services such as Amazon Pharmacy, One Medical (primary care), and Amazon Clinic (asynchronous telemedicine). Omada didn’t disclose the revenue model. Omada release, Healthcare Dive

Wrapping up the JP Morgan healthcare conference, the New Reality permeated it, even if some didn’t want to admit it. As this Editor projected back in December, the board is being cleared of the also-rans and never-should-have-beens. You see a general cleansing of the cant and hype infecting a sector, which is initially unnerving. We are cycling through this stage fairly rapidly to emerge…where, we don’t quite know yet. Unlike some other publications, MedCityNews can never be mistaken for an industry cheerleader (even if you have to read between the lines). Their extensive coverage confirmed this emerging view of 2024.

  • Katie Adams didn’t make it to SF for her article on nine JPM takeaways, but she sussed out that life sciences isn’t ready for AI, GLP-1 drugs won’t solve obesity, transactional telehealth for urgent and behavioral care is over, founders are trying to figure out fundraising timelines, and retail clinics are suddenly Not All That. And more.
  • Arundhati Parmar profiled a companyone of all too many–that cycled from high to low–Butterfly Health. They started in 2011 to develop the first point-of-care handheld ultrasonic probe using a semiconductor chip that connected to a smartphone, became a unicorn by 2018, went public via a SPAC in 2021 at over $19, cracked hard, and now trades around $1. Their new CEO used the JPM platform to explain that their 2023 revenue slide wasn’t so bad because they were working their way through the longer-than-they-ever-imagined adoption curve by cutting $200 million in costs out of the company and building up their cash reserve. They may survive, or not, given that competition has names like GE Healthcare, Philips, and Siemens. But their ideas around selling the technology of the semiconductor chip to healthcare companies outside of ultrasound and opening their POCUS to developers (like Apple) are clever. It sounds like a company that could fit into a PE portfolio, if only some wallets and checkbooks opened.

And another marker of the New Reality: Scripps Health in San Francisco, hit hard by a cyberattack in 2021, announced at JPM that they hired Todd Walbridge, recently retired from the FBI as their supervising agent in their San Diego cybersecurity hub, as senior director for corporate and system safety and security. He had worked with Scripps on their cyberattack during his diverse career with the FBI. Mr. Walbridge is not only in charge of cyber, but also of physical security as workplace violence and assaults on staff have soared. FierceHealthcare

And we’ll wind up with some fundings, modest ‘green shoots’ in winter:

  • Vita Health, based in Connecticut, secured $22.5 million from seven investors for their suicide prevention and therapeutic telehealth platform. An 2022 seed raise totaled $8.38 million. Release, Mobihealthnews
  • Turquoise Health, based in San Diego, gained a $30 million Series B investment from four investors for expansion of its healthcare pricing platform used by 160 healthcare organizations. 2021-22 seed and Series A raises totaled $25 million. Price transparency is a 2024 hot button issue from government to enterprises to payers. Release, FierceHealthcare  
  • CardioSignal raised another $10 million in a Series A from three investors, bringing total funding to $23 million. Based in Finland and Palo Alto, CardioSignal uses a smartphone’s accelerometer and gyroscope sensors to analyze precordial micro-vibrations caused by cardiac motion. The initial analysis is completed in one minute and after a transfer to their cloud site for additional analysis, is returned in about one minute. Release, Mobihealthnews

News roundup: Proteus dissolves with Otsuka, EHRs add 16 min. per patient, DrChrono mobile EHR raises $20M, CareBridge LTSS launches, ‘flyover healthtech’ soars

The much-touted partnership of Proteus Digital Health with Otsuka Pharmaceutical of Japan for a digital version of Abilify has ended prematurely. Abilify MyCite was the first drug cleared by FDA with a digital tracking system in November 2017 [TTA 14 Nov 17]. Otsuka was also going to fund Proteus for further development of drug tracking.

In the payout for the Proteus license, Otsuka has the right to use Proteus’ technology for its own mental illness drug research. Proteus will abandon its research in mental illness and cardiovascular conditions and concentrate on digital meds in cancer and infectious disease. Before the holidays, we saw reports that ‘Proteus may be no-teous‘ and that layoffs and office closures were in the works. STAT reports that the Proteus-Otsuka breakup is one of several recently: Sandoz and Pear Therapeutics, Sanofi and Alphabet’s Onduo.

Where does a doctor’s time go? EHR use, for one. A study of 155,000 ambulatory medical subspecialists and primary care physicians in 2018 clocked EHR use per encounter at over 16 minutes on average, with chart review, documentation, and ordering functions accounting for most of the time (33, 24, and 17 percent, respectively). Percentages changed by subspecialty. PhysiciansWeekly,  ACP Annals of Internal Medicine (abstract only

Speaking of EHRs, DrChrono, one of the first mobile-friendly EHRs/practice management/revenue cycle platforms, raised $20 million in a Series B led by ORIX Growth Capital. Its total funding in nine years tops $48 million. Crunchbase, Mobihealthnews

Long term care (LTC) has been ‘about to be hot’ for at least 10 years. Where the real money may be made is in the ‘back end’. This week, a new long-term support services (LTSS) firm, CareBridge launched out of Nashville, backed with $40 million in fresh funding with a BOD helmed by a former US senator and physician, Bill Frist. Created in part through the acquisition of two other companies, HealthStar and Sinq Technologies, it will concentrate on electronic visit verification by caregivers for in-home service delivery, provide real-time sharing of clinical information, support members with enhanced tablet-based telehealth services, and is building a predictive model for service support. BusinessWire

Flyover tech soars, indeed. We note that CareBridge is in Nashville, which snobs on both coasts demeaningly call ‘flyover country’. Well, there’s gold in Middle America’s hills when it comes to health tech, with some of the choicest high flyers at this week’s JP Morgan Healthcare Conference from places like Nashville, Minneapolis, Ann Arbor, Denver, and Iowa. Utah alone has enough tech to earn it the nickname ‘Silicon Slopes’. Utah’s highlighted company is one this Editor found back in 2013Owlet–still (baby) socking it to them, cutely. Others, unfortunately, are wince-worthy–the prize goes to the Ōmcare med dispenser, which makes darn sure via two Wi-Fi-enabled interactive cameras that those pills are not only being taken, but also being swallowed. Really. Observer