GAO just dropped B-337994: the WISeR Model notice is a "rule" under the Congressional Review Act, and HHS should have submitted it before letting the model take effect in January.

A Rhode Island judge just handed DOJ its eighth straight loss in its HIPAA subpoena campaign targeting hospital records of minor patients.

Labcorp just became the 18th lab on Epic's Aura platform. The country's #2 lab joins Quest Diagnostics in betting its diagnostic future on Verona.

Red alert - we have the biggest information blocking court development since RTMS v. PCC: a preliminary injunction decision in Vyne v. Henry Schein!

Software ships at near-zero marginal cost. The maintenance tail does not. Every API is a liability the moment it ships, and a finite R&D budget can only service so much of yesterday's surface area before next quarter's earnings call wins the fight.

Particle Health v. Epic is back from hibernation and bringing the heat! Phase I closed with both sides filing dueling letters about what comes next.

OpenAI launched ChatGPT for Clinicians this week. It's a free AI copilot for verified U.S. physicians, NPs, PAs, and pharmacists: - Clinical search grounded in peer-reviewed literature - Reusable skills for common workflows - CME credits baked in.

Everyone has strong opinions about MyChart. I decided to stop speculating and take a look under the hood

Does anyone else feel like John Connor out here on LinkedIn and Substack, just trying to stay ahead of the evolution of AI prose? RIP to "genuinely" and anaphoric tricolon. Pour one out for "sharp" and "load-bearing". And God forbid you use antithesis anymore.

Salesforce just guillotined its own UI. "Headless 360" exposes every capability in the platform as an API, MCP tool, or CLI command so AI agents can run the whole system without ever opening a browser. The Great Beheading has begun!

A (perhaps final) post in the CMS-0062 series. This one is half an archaeologic dig through the layers of standards we accrue and half a story of a single organization (the CMS lands on two very different answers to seemingly the same question (how to convey clinical information) within just weeks

Health Gorilla just let a federal class action go unanswered. Plaintiff Ricky Lott filed for entry of default today in the Southern District of Florida after Health Gorilla blew past its response deadline. And it wasn't the only deadline they missed.

It's been five years since I last wrote about immunization information systems, and a lot has happened: some of it good, some of it stalled, and some of it potentially destructive.

Look, I'd be lying if I said this was the first (or second or fiftieth) MEDVi article. But this is about more than MEDVi or even all the spam, grey zone marketing, and Succession-level drama of business partners acquired by rivals.

New episode of The Information Exchange is live! What's O-PIMP? Why are we LLM image generating swaggy Thomas Keane pics? Find out by listening.

An Epic Anthropic Alliance: healthapiguy.substack.com/p/an-epic-an...

New to Bluesky. Let’s start with intros.

HTD Health will be hosting a session to run my HIMSS keynote (The State of Interoperability & HIE Today) back on Wednesday, March 26th, going through all the content and memes. Make sure to sign up if you weren't able to make it!

I kept raising and raising with different funds. Every day. 10 to 12 different VCs. Then I realized, I wanted to BE the VC. I wanted to be asking the dumb questions. I wanted to be saying "we're passing on this one" to me.

Everyone loves narratives of conspiracy with a bit of regulatory capture. I do think there's the potential for that in healthcare. It's just not Epic's history - it's potentially Oracle's future.

The new administration has begun and the executive orders don't stop coming. Similarly, the monthly recap of all the interoperability, regulatory, and litigation action continues. Check it out below, like, subscribe, share, comment, and tell a friend. open.substack.com/pub/healthap...

A lot is being made of Stargate, the ambitious new AI initiative announced by the Trump admin with the support of Larry Ellison of Oracle, Masayoshi Son of Softbank, and Sam Altman of OpenAI.

Just had @healthapiguy.bsky.social on the pod to unpack healthcare interoperability: why it’s still a struggle, the role of standards, and how #AI can help. Key takeaway? Leaders must act now to avoid payer data asymmetry and build a future of seamless data exchange. #MedSky

<To the tune of Billy Joel's "We Didn't Star the Fire"> Epic APIs, vendor fees Integration complexities Workshop partners, Toolbox rules Testing tools and sandbox pools App Orchard gone, changes made Documentation starts to fade FHIR and HL7 Standards fight for victory

While I've been focused on the information blocking cases by apps against EHRs/psuedo-EHRs (RTMS v. PointClickCare, Intus v. RTZ), there's actually another court case citing information blocking out there in the wild that's a very different story of a provider organization against their EHR.

What if I told you there was another antitrust case against a dominant healthcare system of record software vendor? There simply could not be another lawsuit between two payor software platforms, could there?

Yesterday was the deadline for Particle Health's response to Epic's motion to dismiss and they did not disappoint.

Looks like Epic rebranded their Health Grid offerings into "Save a Life" Grid Confused by this one

We end the first year of the Epic Alumni Slack Community with 626 participants across at least 41 states and 11 countries. It's been vibrant and fun discussions ranging across industry news, work-related help, hiring and opportunities, meetups, and more.

Much of the pain of digital health (and point solutions for enterprises in general) that is often blamed on EHRs is actually a manifestation of the principal agent problem - where one party (agent) makes decisions on behalf of another party (principal), but has different interests and incentives

The great technological tension of our time (which we will continue to see play out in health tech next year with escalation of antitrust and information blocking pushes) is how software vendors and their business customers control and access data.

We have descended into the Christmas season wormhole. And thus as we fast forward to early January, here's the monthly review of all the interoperability and regulatory happenings of the recent weeks. open.substack.com/pub/healthap...

I can guarantee you will not be able to guess in one million years what this post is in response to

My Sunday hot take for you all is that HIPAA is a terrible law on multiple fronts: 1. It's a terrible acronym that's constantly misspelled

They said it was impossible. They said it couldn't be done. But ladies and gentlemen, our scientists did it. @HIMSS is so back.

A common theme of ad-hoc discussion at the The Sequoia Project and Carequality Annual Meetings last week was around the role of state HIEs in a world with ubiquitous national networks.

Another HTI-2 mini-rule finalized Just the Protecting Care Access Exception (and not the "rest of the rule"), as predicted

History doesn't repeat itself, but it certainly rhymes. I'm eternally optimistic, so while we're slogging through "what is treatment", it's worth a look-ahead to the ubiquitous network that will come, based on parallels in other industries.

Thoughts on the Sequoia Project and Carequality annual meeting First up "What is Treatment"

Final rule for hti-2!!! www.federalregister.gov/public-inspe... Looks like they cut everything except clerical updates and the TEFCA updates Bummer

A brief discussion of rent-seeking, price controls, and second-order effects in healthcare information exchange. In this country, we (largely) agree that rent-seeking entities (those that act as middlemen and gain excess profits without contributing additional value to society) are bad.

Bluesky needs longer posts. Please upvote github.com/bluesky-soci...

People tend to think standards creation and implementation is a pleasant process filled with camaraderie and collaboration. It often is! But, like any cross-organizational engagement, things can go south

Migrating over my thread on my favorite hti-2 comments Originally here: x.com/healthapiguy...

In Part 2 of our conversation, @techguy.healthcareittoday.com of @healthcareittoday.com and I shifted from Epic discussion to more general healthcare interoperability. Teddy Roosevelt, Battlebots, and interoperability’s “messy shitshow” - we covered a lot of ground.

Sanderson fans, we did it. We broke Goodreads

Thrilled to see the @mickytripathi.bsky.social outline of where TEFCA needs to go 3 is not some "nice-to-have", feel-good goal. It's mission critical to delegating policing of fraud down to the patient, which enables the best kind of shared incentives and aligns with patient empowerment

@nikillinit posted this "Common healthcare questions I get" article yesterday, which included the common "Why do I need to fill out the same form each time I see the doctor?" outofpocket.health/p/common-healt… A few add-on thoughts:

Hammer meets nail. Excellent breakdown by Nikhil