VA’s EHR goes live with four more centers; GAO criticizes VA, MHS on EHR cybersecurity collaboration

June 12, 2026 | by | No Comments

VA stays on schedule with four more EHR go-lives. On 6 June, right on schedule, the Oracle EHR went live at four more VA Medical Centers in Ohio and Kentucky: Cincinnati VA Medical Center, Chillicothe VA Medical Center, Dayton VA Medical Center, and the Cincinnati VA Medical Center-Fort Thomas. All are in VISN 10 (VISN=region). This second wave of 2026 transitions, according to the VA release, more than 107,000 veteran patients and 7,200 VA clinicians and staff. The next wave of three more VAMCs will roll out in August with a final two in October.

Interestingly, the VA release also scores the previous Biden Administration on holding up the EHR implementation for two years, starting after the well-publicized disastrous implementations of 2020-2023. Our Readers and this Editor remember that Congress, led by a Republican House and the Veterans committees (the House approves budgets), basically forced VA to end the deployments [TTA 26 April 2023] and renegotiate the next five years of the Oracle contract to contain performance metrics and requirements [TTA 18 May 2023]. At least some of the reforms noted in the release started under that previous administration, but the second Trump Administration starting in 2025 should be credited with accelerating what many of us observers considered a ‘dead in the water’ repair and rollout. The biggest change is the standardization of the system across the VAMCs; the previous deployments allowed for too much customization by facility, something Oracle wasn’t exactly equipped to handle with the legacy Cerner system.  Federal News Network

There’s also an enjoyable, locally made YouTube video of the go-live at the Dayton VAMC. It focuses on the IT team and how they are helping the clinical staff, including the first new patient entered into the EHR. Complete with an opening group prayer service and dancing–how can they lose? YouTube video, 3 minutes. 

What’s not going so well is VA-Department of War (DoW formerly DoD) cooperation on EHR cybersecurity issues. A new Government Accountability Office (GAO) report discusses how the Federal Electronic Health Record Modernization office (FEHRM) that is responsible for oversight and direction on joint functions is not adhering to “leading practices” in several areas. The Oracle EHR is not only used at the VA but also in a different version covers the Military Health System (MHS),  the US Coast Guard, and the National Oceanic and Atmospheric Administration (NOAA). The DoW has the primary responsibility for ensuring cybersecurity of the EHR systems. Where the agency fell short was in defining common goals, outcomes, and performance metrics, as well as communicating progress on EHR cybersecurity and privacy.

FTR:

GAO is making one recommendation to DOD and one to VA to direct the FEHRM to define common goals, outcomes, and associated performance measures, and monitor, assess, and communicate progress on collaboration efforts toward ensuring the cybersecurity and privacy of the federal enclave. DOD disagreed with our report and VA neither agreed nor disagreed with the recommendations. GAO maintains its recommendations are valid, as discussed in this report.

The GAO is required by the Further Consolidated Appropriations Act of 2024 to conduct performance audits; this one covers June 2024 to June 2026. GAO summary with links to full report, Healthcare IT News

TTA’s It’s June: Anthropic’s pending IPO, the AI Hype Curve, Oracle Health for sale, Schoenberg’s move to Amazon, Mass. sues UnitedHealthcare, Signos/H1 raises, more!

June 4, 2026 | by | No Comments

Thursday 4 June 2026

This Editor is closing and sending out Alerts a little early this week as off to an event. Most significant this week is Anthropic’s confidential, unpriced IPO filing on top of a $65B raise, a sure mark of Peak AI and the next stages of the Gartner Hype Curve. The other is an analysis of the potential market for a sell-off of Oracle Health’s EHR and what that entails–oddly coinciding with Roy Schoenberg’s move to Amazon Health. More about raises, UHG’s senior MassCare plans accused of fraud, and new Teladoc business. From last week–our Must Reads about the societal impact and the divinity of AI.

Enjoy your week and weekend!

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

Chutes & Ladders: MA sues UHG on Medicaid fraud, Teladoc joins Walmart’s Better Care Services, raises for Signos and H1

Breaking: Anthropic files confidential S-1 with SEC for IPO, less than one week after $65B raise. But is this Peak AI?

Selling Oracle Health’s EHR–what are the potential buyers, their odds, and price?

Breaking: Roy Schoenberg moving to Amazon to lead Health Services; Neil Lindsay to depart

Last Week’s Headlines

Weekend Must Reads on AI: its societal and economic effects, and why its developers see it as replacing God

Short takes: Garner Health’s $100M Series E; Veradigm files financial reports for ’23/’24, moved to net loss; Rovex debuts autonomous in-hospital transport robot

Post-holiday news roundup: Oracle Health acute care EHR market share crumbles to 20%–what that means; retail real estate downsizer marketing Walgreens leases; Oura files for US IPO, Swoop buys NimbleRx

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

 

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Selling Oracle Health’s EHR–what are the potential buyers, their odds, and price?

June 2, 2026 | by | 5 Comments

The speculation is now “official”, since it is by a London investment banking firm, but it confirms this Editor’s earlier view: Oracle, to become an “AI Infrastructure Landlord” (in their apt term), has to sell off what was Cerner and the EHR operation. 

That train is now approaching, though realistically, no one knows when it is due and at what station.

The need: Oracle must reduce the extent of its “liquidity and capital expenditure crisis” in order to stay in the AI Game. Layoffs of 30,000 staff, or 18% of their global employees, is not enough. A fresh financing of $16 billion from the PIMCO bond fund and others cannot relieve the financial stress created by a previous estimated $72 to $100 billion in previous debt load and payments, so significant that banks refused to lend to still-profitable Oracle. And the AI transformation itself is high risk. Oracle owes OpenAI alone $553 billion in remaining performance obligations, and it has obligations to Meta as well. Add to this the long “taffy pull”–the years-long process of building, chip expenditure, then making a data center operational and generating cash. [TTA 14 May, 7 May, and prior; also Ed Zitron’s article for a much longer take.] Take all of them together, and they are polite words for “rock and a hard place” or a Very Dark Corner.

The London investment banking firm Nelson Advisors has taken a deep yet remarkably easy-to-digest analysis on a potential sale. Highlights are below. The paper is one long web page, not a deck of 50 pages. It is well worth your reading time.

Background: Cerner was bought four years ago in the go-go days of June 2022 for $28 billion. Cerner had an aging EHR and a deteriorating market share. Recently it’s plummeted to a 27% market share versus Epic’s 48% in large health systems. Oracle’s interest was not only in health, but also the health data Cerner contained. The plans were to update the software based EHR to a cloud-native data platform as the linchpin of Healthcare Transformation (Ed. note), except that integration proved to be slow and far more expensive than estimated.

Oracle also inherited from Cerner two huge and impossible to escape Federal obligations: the Military Health System EHR and the Veterans Health Administration EHR Modernization, two separate but mandatorily interoperable systems. MHS was the first implemented and is now  completed, but remains an obligation. The VA EHRM, as TTA has chronicled, started rolling out in 2020 and by 2023 was halted after five implementations Due to Disaster. It resumed in April 2026. The VA and Congressional process for funding now has tight guardrails in place on continuance.  

Who will buy the Oracle/Cerner EHR operation is the question. For how much isn’t as clear. Selling Oracle Cerner “represents the most significant “lump sum” of liquidity available. In the Nelson analogy, Oracle took the Cerner cow, milked it of data to feed its data into its LLMs, and no longer wants knackered ol’ Bessie even rejuvenated by the cloud. (In this Editor’s view, Oracle knows it is fighting a losing battle against Epic, which does privately pretty much what it wants and plans to stay that way.)

The obvious group of potential buyers are ‘hyperscalers’ who view health data as the Next Frontier. They already have feet in this healthcare pond. They also meet approved FedRAMP High security requirements for the VA and MHS contracts. Equally, they all have drawbacks.

Microsoft seems the most logical. It already has a huge footprint and expertise within health systems, courtesy of ambient scribe Nuance/DAX Copilot and cloud computing platform Azure.

  • Conflict #1: Epic is a major Azure customer. Would Microsoft be willing to lose this business in a high-stakes move?
  • Conflict #2: FTC would likely challenge the acquisition based on this huge existing footprint.

Amazon is also engaged in healthcare, but not with health systems. It has Amazon Health Services comprising Pharmacy, One Medical, and DTC telehealth services. (Editor’s note: not mentioned by Nelson is that Amazon Health has a new leader, Dr. Roy Schoenberg, with experience in Federal contracts via Amwell for the Defense Health Agency and MHS. This broke late last week.)

  • Conflict: Amazon Web Services is an established vendor in other areas of health systems, and acquiring an EHR could be seen as too much under one roof.
  • Problem: no experience with EHRs (same as Oracle) nor highly regulated health systems. The scale of the MHS/VA implementation and academic hospitals would be a steep learning curve with little existing precedent or credibility in Amazon-World.

Google certainly has the size and resources, and could position the EHR to rival both Microsoft and Epic. 

  • Conflict #1: Cultural. Google moves fast and healthcare slowly.
  • Conflict #2: Lacks the enterprise sales and support needed to service health systems. It doesn’t have a service culture.
  • Editor’s note: Google has tried and failed to be a healthcare giant at least twice. It doesn’t seem to fit.

Nelson also looked at two outliers, UnitedHealth Group/Optum and the hospital groups HCA or CommonSpirit Health. Both would be vertical integrators. Hospital groups do not have the margin nor borrowing power to make the move. UHG and their Optum operation face cash crunches and ongoing Federal scrutiny. (Had this been a few years ago under a different management, this would have been on strategy for UHG.)

Another outlier from the international space is SAP. Their aim would be global expansion into the Middle East and Europe with another asset their enterprise resource planning (ERP) expertise. Their problem? Lack of experience in the highly regulated US environment. In the Nelson view, the US Government could be the make/break for any deal.

The final destination for this ‘hard to sell’ asset? Private equity. And more than one involved. Nelson looked at five PE players in the healthcare space: Thoma Bravo, Francisco Partners, Bain Capital, Blackstone, and New Mountain Capital. (All are familiar PEs to Readers.) Even with their considerable individual assets, it would likely take a consortium to buy Oracle Health in a $20 to $25 billion deal. Nelson rates this as the most likely scenario as long as a consortium could be formed and it can be seen as a turnaround. The drawbacks are a governance structure and the real lack of an exit strategy. (PEs always need exit strategies to keep the funders happy. They are not in it to buy and keep.) The lower price could be made palatable to Oracle if they retained the Oracle Cloud Infrastructure (OCI) network and the Oracle Autonomous Database revenue streams.

The other partner in this consortium scenario? The Federal Government. It’s a high priority to secure the EHR for both the MHS and VA. Congress is already concerned.

Place your bets!  Hat tip to a Reader who wishes to remain anonymous.

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

May 23, 2026 | by

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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Contact Editor Donna for more information.

Help Spread the News

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

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

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

May 22, 2026 | by | 2 Comments

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?

Chutes & Ladders: Vendor protest filed against VA-OIT, Teladoc stock touted as ‘best buy’, Treehub ‘founder residency’ launches, AcuityMD raises $80M to near-$1B valuation

April 23, 2026 | by

This one’s a puzzlement. This Editor was ‘tipped off’ to a bid protest filed against the Department of Veterans Affairs (VA), specifically against the Office of Information Technology (OIT) Industry Day that took place on 27 March. It was found on the Government Accountability Office (GAO) website, filed on 17 April by The Gilchrist Law Firm, PA on behalf of an undisclosed vendor, under the solicitation number for the OIT Industry Day. The update from the source, Orange Slices, a government contract (GovCon) news site, stated that “the vendor” (whoever enters the info into GAO) “made a mistake in their entry to GAO and it has nothing to do with the industry day…” It has still not been fixed on the GAO website on the bid protest page.

Run out and buy TDOC stock! That’s the advice from “Insider Monkey” publishing on Yahoo Finance. In fact the Monkey rates Teladoc “among the best medical AI stocks to buy now”. The article is an overview of the Pineal Capital Management call for $200 million in share buybacks, breaking up the Integrated Care and BetterHelp businesses, and other shareholder friendly cash-generating ‘reforms’ [TTA 3 April]. Teladoc’s 2026 revenue forecast under CEO Chuck DaVita is essentially flat–$2.47 to $2.59 billion versus 2025’s $2.53 billion. This Editor noted a small rise in the stock price in the past month of about 70 cents. There may be some drama around the Q1 earnings report which will be issued next Wednesday (29 April). 

The interestingly named Treehub launches out of Stanford University. It’s designed to bridge the gap between the extreme early stage of a developing healthcare idea or technology, usually out of an academic lab, to where the formed company is fundable. It seems to be a combination of a healthcare tech scout, a venture studio with hands-on support, and an incubator community, with the capital of a venture fund. The Los Altos-based residency program is funded via the AI Health Fund and has some heavyweight names attached to it: Mary Minno, herself a former venture-backed founder now at Google, a brace of Stanford professors, Derek Minno of Point Capital, and two Wojcickis: Anne Wojcicki, founder of 23andMe, as Operating Partner and her mother, Esther Wojcicki, as a Founding Advisor. One wonders how Anne Wojcicki is faring in rebuilding 23andMe’s business and the 23andMe Research Institute; certainly they haven’t been shy about new products such as add-ins of African genetic groups, reconstructing ancestors’ DNA, and genetic predictors for GLP-1 effectiveness (press release list). Treehub release, Mobihealthnews interview with Ms. Minno and Esther Wojcicki, ‘the godmother of Silicon Valley’.

Raises this week so far have been slim. Medical commercial intelligence platform AcuityMD announced a raise of $80 million in a Series C led by existing investor StepStone Group, with additional participation from Benchmark, Redpoint Ventures, ICONIQ, and Atreides Management. Previous investment was $76 million. The company’s valuation is nearing the $1 billion mark at $955 million. AcuityMD’s platform helps medtech companies towards commercial insights that are typically scattered across claims databases, FDA filings, government records, and market signals. The fresh funding will be used to accelerate platform capabilities via AI. The company claims as customers 16 of the top 20 medtech companies and helping to identify $34 billion in pipeline. Release, Mobihealthnews

VA’s Oracle EHR resumes go-lives at four Michigan systems–finally

April 15, 2026 | by

On schedule, the VA’s EHR Modernization resumes after a three-year-plus hiatus. The four VA Medical Centers (VAMCs) announcing their go-lives over this past weekend are all in Michigan’s VISN 10: Ann Arbor, Battle Creek, Detroit and Saginaw. Four more are planned for June, also in VISN 10 (a VISN is a VA region): Dayton Ohio, Chillicothe Ohio, Cincinnati, and Cincinnati-Fort Thomas Kentucky, then three more in August and two more in October. Based on the schedule, calendar 2026 will have a total of 13 system rollouts, all in VISN 10 except for the last in October, which will include VISN 20’s Anchorage, Alaska VA Health System. [TTA 8 Feb]

The only exception to the hiatus was a joint Military Health System/VA implementation at Lovell in Chicago, which has had its own bumps after its start in March 2024. VA previously had five disastrous implementations, VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022. After many actions to fix them, the VA halted implementations in April 2023. Even in 2025, in its agency report, the VA’s Office of Inspector General in their March 2025 report, and their January 2026 report on VA’s Management and Performance Challenges for FY 2025 found a distinct lack of VA staff confidence in the EHRM and its performance to date [TTA 8 Feb].

Strategically, confining the rollouts to one VISN and a small group at a time is smart because of the geographical adjacency and not scattering efforts all over the US. After these 13 however, there are 157 more. VA has pegged a full completion by 2031.

In its press release announcing the April go-lives, the VA identified four factors that got the EHRM off the dime. FTR: 

  • Fixing hundreds of problems related to the initial rollout of the EHR system at the six original VA sites. Some of these related to efforts by local VA facilities to customize the system, which only complicated the process.
  • Eliminating the bureaucracy that was holding the project back. VA replaced that unwieldy system with a single council that answers to top VA leaders, increasing accountability and making it easier to find and implement common sense decisions.
  • Getting local facilities more involved. As VA’s lead official on the EHR rollout, VA Deputy Secretary Paul Lawrence has visited all 13 deployment sites this year and has engaged directly with facility leaders at each location to answer questions and make sure these sites are ready to go.
  • Hiring more people to ensure the rollout goes smoothly. VA has already hired dozens of staff to help with the rollout in Michigan and other locations and is in the process of hiring a total of 400 people.

Last year, VA terminated contracts for at least six independent contractors supporting the EHRM as part of a mass cleanup of department contracts. FNN

Federal News Network, Healthcare Dive

There is nothing in the release, of course, about Oracle Health’s manpower cuts, rumored to be 30%, nor the persistent talk that the EHR unit will be sold or spun off. Or the effects that the recent indictment of a former EHRM head will have in Congress. In this Editor’s view, Oracle’s corporate redirection to and big bet on AI datacenters strongly suggests that Oracle will not be engaged with this deployment by the time 2031 rolls around.

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

April 3, 2026 | by

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.

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

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

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’. 

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]

News roundup 22 May: an inflight ‘save’ and AliveCor’s KardiaMobile, rolling out the VA/Oracle EHR in ‘waves’, Fuze Health formed from LetsGetChecked/Truepill, hacking and ransomware 92% of PHI data breaches

May 23, 2025 | by

Leading our news with a short, heartwarming story.

A passenger on a 29 April KLM flight from Uganda to Amsterdam experienced, three hours in, heart attack symptoms and extreme pain. The Dutch passenger’s luck was that a group of passengers were medical volunteers with Cura from the World, a Oklahoma-based group returning from a medical mission to Uganda. Dr. TJ Trad, the founder/CEO and an invasive cardiologist, created an aid station for the passenger where his legs could be raised and his vitals monitored with the assistance of a nurse. The lucky part was that the team had most of its equipment aboard, including a 12-lead ECG to confirm his cardiac status, plus five medications used for emergency treatment. He was stabilized, but the interesting part was that Dr. Trad used his personal AliveCor KardiaMobile to monitor the patient for arrhythmia, the later and high emergency stage. Dr. Trad was carrying it because a year earlier, he had experienced his own heart attack that canceled out his last medical mission trip and used it to monitor himself. With the patient under monitoring and medications, the KLM flight did not have to divert to Tunisia and it landed at Amsterdam Schiphol three hours later. At the hospital, the Dutch patient was examined over 12 hours and eventually discharged, as he was not diagnosed with a heart attack, stroke or pulmonary embolism, according to the passenger’s wife speaking with CNN. Dr. Trad was able to catch his connecting flight home. From an aviation perspective, it underscores the need for medical training and an emergency kit for monitoring this type of incident. Hat tip to Dave Albert, MD, founder and chief medical officer of AliveCor.

VA now dubbing the rollout of the Oracle Cerner EHR as a ‘wave’ strategy. Dr. Neil Evans, the acting executive program director of VA’s Electronic Health Record Modernization Integration (EHRM) Office elaborated on the ‘wave’ in an interview with GovCIO Media & Research. Each rollout will be clustered in sites that routinely work together and where patients flow for care from one location to another. For instance, the planned 2026 rollout previously announced in December 2024 will be in four Michigan locations: VA Battle Creek Medical Center, VA Detroit Healthcare System, VA Ann Arbor Healthcare System, and VA Saginaw Healthcare System. The nine additional sites in 2026, except for Alaska standing alone, are similarly clustered [TTA 4 April]. The new news? FTA:

  • The White House’s proposed discretionary budget for FY 2026 calls for an increase of nearly $2.2 billion in funding for the EHR program as a “top priority effort.”
  • The proposed budget also plans to streamline much of the agency’s over 1000 IT systems, which it claims are “decades old” and “duplicative.”
  • It pauses procurement of new systems and directs the U.S. Department of Government Efficiency Service (DOGE) to conduct a full review of the agency’s IT systems alongside the VA.
  • Other government agencies are going through the same process: National Oceanic and Atmospheric Administration (NOAA), Defense Department (MHS), and the Coast Guard also are modernizing their EHRs. VA is learning from them as well as the private sector, according to Dr. Evans.

The ‘wave’ needs to work. Veterans Affairs Secretary Doug Collins outlined VA plans at two House appropriations hearings last week on the 2026 and 2027 VA budgets. The total for the EHRM is $3.5 billion in FY 2026 (Federal budgets start in October; the total budget has been dubbed the ‘Big Beautiful Budget’) and is needed for additional rollouts in FY 2027. But given the failures at the six existing implementations and the continuing fixes and patches, in a process that seems like it started in 1900 (actually 2018), one can understand the consternation of Veterans Affairs committee member Rep. Greg Murphy (R-NC): “I’m still dumbfounded at the billions and billions and billions of dollars that have been poured into an EHR that should have never been done in the first place. It’s not a system that should be used for the largest healthcare system in the country.” Healthcare Dive

Fuze Health launches–phase 2 of a merged LetsGetChecked and Truepill ‘arranged marriage’. The merger of the two last October with digital/mail order pharmacy Truepill operating as a subsidiary of at-home diagnostics via testing kits LetsGetChecked was a $525 million deal that we classified as a ‘smush’ when it was announced last August. Both were heavily invested in by Optum and torching  through cash. While $525 million was the purchase value in the headline, only $25 million was in cash and the rest of the financing didn’t add up to the total. The Phase 2 of this entity, Fuze Health, now has a third partner, prescription deliverer Alto, and a new name, Fuze Health. No acquisition amount is mentioned for Alto, which has a total funding of $62.4 million through a June 2021 Series B plus equity crowdfunding (March 2024!) and no financing from Optum (Crunchbase). The only Fuze management mentioned in the release are Alicia Boler Davis, Alto’s CEO, and Paul Greenall, Fuze chief development officer. Their website links back to the four individual companies.

In 2022, LetsGetChecked acquired Veritas Genetics, now prominently featured as part of Fuze. Also in 2022, Truepill fell under DEA scrutiny with a ‘show cause’ action after being a fulfillment pharmacy for Cerebral and Done Health in their Schedule II controlled substance violations. This was settled in November 2023 with multiple requirements including continuing heightened compliance (DEA release). Fuze Health promotes itself as “a technology-powered home health screening, genomics and pharmacy services provider committed to transforming patient experiences and enabling its healthcare partners – including care providers, health plans, employers and life sciences companies – to excel in an outcomes-focused system.” No mention of investors or backing, as is typical in these announcements.  Now go forth and make money. Hat tip to HIStalk 5/23/25 

Hacking and ransomware now constitute 92% of healthcare data breaches. Once upon a time, when this Editor reported on what were then unusual data breaches, the more common causes were insider theft, unauthorized access/disclosure, and improper disposal or loss. They have nearly vanished as the ‘business of breaches’ has settled down and internal security has approved. A cross-sectional study published as a research letter in JAMA Network surveyed breaches from 2009 to 2024 using HHS’s Office of Civil Rights (HHS-OCR) reporting. Of 566 incidents in 2024, 457 were “IT incidents” and 61 were tagged as ransomware, totaling 92%. Despite the massive Change Healthcare breach, ransomware breaches fell to 11%.  Considering patient records, there were 170 million breached in 2024 and hacking/IT incidents accounted for 91% of the total. Of 732 million records affected from 2010 to 2024, hacking or IT incidents and ransomware (considered as a subset) accounted for 88% (643 million) and 39% (285 million) of incidents. Since 2020, ransomware has affected more than half of all patients annually, reaching 69% in 2024–again, the effect of Change Healthcare. Also Healthcare Dive

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

April 8, 2025 | by

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

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

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

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

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

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

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

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

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

April 4, 2025 | by

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

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

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

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

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

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

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

March 21, 2025 | by

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

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

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

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

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

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

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

March 19, 2025 | by

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

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

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

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

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

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

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

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

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

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

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