Leveraging Real-World Data for Proactive Protocol Design
Ashley Daigneau, Head of Clinical Trials at Verana Health
Clinical trials have grown more complex than ever before. Protocols are becoming more specialized, endpoints more refined, and eligibility criteria narrower and more precise. At the same time, development programs are expected to move faster and operate with greater efficiency. Despite this dual pressure, feasibility projections often rely on high-level estimates or investigator recall rather ... Read More
<img width="869" height="726" src="https://hitconsultant.net/wp-content/uploads/2026/06/ashley-daigneau-headshot-2024-1.jpg" alt="Leveraging Real-World Data for Proactive Protocol Design" class="wp-image-96560" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/ashley-daigneau-headshot-2024-1.jpg 869w, https://hitconsultant.net/wp-content/uploads/2026/06/ashley-daigneau-headshot-2024-1-300x251.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/ashley-daigneau-headshot-2024-1-290x242.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/06/ashley-daigneau-headshot-2024-1-768x642.jpg 768w" sizes="(max-width: 869px) 100vw, 869px" /> Ashley Daigneau, Head of Clinical Trials at Verana Health Clinical trials have grown more complex than ever before. Protocols are becoming more specialized, endpoints more refined, and eligibility criteria narrower and more precise. At the same time, development programs are expected to move faster and operate with greater efficiency. Despite this dual pressure, feasibility projections often rely on high-level estimates or investigator recall rather than validated assessments of patients who truly meet protocol criteria in a real-world clinical setting. When projected patient populations fail to emerge or sites underperform, the consequences extend beyond delayed timelines. Protocol amendments, operational strain, stressed site relationships, and escalating costs follow. As protocol complexity increases, the risk of designing studies without a clear understanding of real-world care patterns becomes harder to ignore. Real-world data (RWD) offers a meaningful opportunity to close this gap, but only when it is integrated thoughtfully and early in the development process. Moving from Retrospective Insight to Proactive Design For years, RWD has played an important role in post-marketing research and evidence generation. Increasingly, its greatest impact is realized earlier in development, where it can inform protocol design, feasibility planning, and evidence strategy before studies begin. Real-world analyses are often introduced once new signals emerge during study execution, whether related to enrollment velocity, shifting standard of care, unexpected interim trends, competitive trial dynamics or the need for contextual evidence. At that point, the ability to influence study design is limited, and adjustments become tactical rather than strategic. A more effective approach is to embed real-world insights before protocol finalization and use it to stress-test assumptions around eligibility criteria, endpoint definitions, and projected enrollment rates under real-world conditions. Longitudinal clinical data, particularly when electronic health records are combined with complementary data sources such as claims, can reveal insights that prevalence estimates alone may miss. Prior lines of therapy, laboratory trends, disease severity markers, referral pathways, and comorbidities all influence whether a patient is realistically eligible and likely to enroll. Viewing the full treatment journey allows teams to assess whether inclusion and exclusion criteria align with how disease is diagnosed and managed during routine clinical practice. When applied early, these insights help reduce the risk of overestimating the truly eligible populations and help prevent downstream feasibility gaps during study execution. Precision in Site and Patient Strategy While historical enrollment performance remains a valuable indicator, past success does not guarantee that a site currently treats patients who meet highly specific eligibility requirements. Real-world insight allows sponsors to evaluate feasibility at the patient-level. Rather than solely relying on aggregate performance metrics, teams can assess whether a site actively manages patients who match the study criteria. This distinction is crucial as competition for eligible participants intensifies. Advanced modeling approaches allow teams to simulate enrollment scenarios before a study begins. By examining patient funnels, referral dynamics, and treatment pathways, sponsors can better anticipate how many patients are likely not only to qualify, but to enroll and remain on study. This represents a shift from directional forecasting to data-informed feasibility planning grounded in how care is delivered in practice. “By scaling the site insights derived from real-world data, we’re better able to select sites that enroll patients aligned with our trial criteria,” Emily Carter, AbbVie Data Quality, Infrastructure, and Global Realities The promise of RWD is significant, but its value depends on the integrity of the underlying data. Incomplete documentation, inconsistent coding, limited linkage across datasets, and gaps in longitudinal continuity can restrict the reliability of insights. Advanced analytics and machine learning can enhance harmonization and help scale the curation of unstructured clinical information, but no methodology can overcome fundamentally poor data quality. “Real world data is an essential part of our development lifecycle when it comes to generating evidence. One of the main challenges is data quality. You can have as much data as you want, but if quality is poor, you can apply your AI and everything to be garbage in, garbage out,” Alex Asiimwe, PhD, Gilead Sciences Beyond quality considerations, infrastructure fragmentation remains a challenge. Many organizations operate across functional silos, license datasets independently, and lack standardized frameworks for sharing and integrating insights across teams. Global development further complicates the landscape. Robust data sources may be available in certain regions, while others lack comparable depth or accessibility. Matching feasibility modeling with geographic strategy requires careful coordination and a realistic assessment of data availability. Speed is another critical factor. Insight generation must align with development timelines. If analyses take months to complete, their ability to shape protocol decisions diminishes. Scalable infrastructure, clear governance, and embedded workflows are essential to ensure that real-world insights inform decisions when they matter most. Fit-for-Purpose Integration and Cross-Functional Alignment Ultimately, the question is not whether to use real-world data, but when and how to apply it appropriately. While regulatory openness has grown, RWD should be integrated for clear, fit-for-purpose reasons and guided by scientific rationale, not momentum. That requires cross-functional integration across clinical, epidemiology, regulatory, and operations to weigh trade-offs, ethics, and feasibility. RWD is not a replacement for randomized trials, but it can strengthen development by reducing uncertainty and supporting study design with clinical reality. As the industry evolves, designing trials for the real world is increasingly essential to generating evidence that is both rigorous and operationally achievable. About Ashley Daigneau Ashley Daigneau is head of clinical trials at Verana Health, where she oversees the strategy and execution of innovative clinical research solutions leveraging real-world data. Ashley has more than 15 years of experience supporting the development of real-world evidence strategies and overseeing clinical study execution.
Alternative Funding Programs vs. In-Benefit Optimization: Designing a Sustainable Specialty Drug Strategy
Ryan Czado, PharmD, MBA, Chief Pharmacy Officer at RazorMetrics
Specialty medications are expanding what is clinically possible, but not without a price. The affordability gap on these therapies continues to widen, placing sustained pressure on health plan budgets. U.S. prescription drug spending reached approximately $467 billion in 2024, with projections exceeding $556 billion by the end of 2026. As costs rise, employers and pharmacy ... Read More
<img loading="lazy" src="https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-1500x2249.png" alt="Alternative Funding Programs vs. In-Benefit Optimization: Designing a Sustainable Specialty Drug Strategy" class="wp-image-96563" width="571" height="857" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-1500x2249.png 1500w, https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-200x300.png 200w, https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-193x290.png 193w, https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-768x1151.png 768w, https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-1025x1536.png 1025w, https://hitconsultant.net/wp-content/uploads/2026/06/Ryan-Czado-CPO-1366x2048.png 1366w" sizes="(max-width: 571px) 100vw, 571px" /> Ryan Czado, PharmD, MBA, Chief Pharmacy Officer at RazorMetrics Specialty medications are expanding what is clinically possible, but not without a price. The affordability gap on these therapies continues to widen, placing sustained pressure on health plan budgets. U.S. prescription drug spending reached approximately $467 billion in 2024, with projections exceeding $556 billion by the end of 2026. As costs rise, employers and pharmacy benefit managers (PBMs) face increasing pressure to ensure that high-cost therapies remain both clinically appropriate and financially sustainable. To address pharmaceutical affordability, employers are increasingly turning to technology-enabled savings strategies. Two commonly considered approaches are alternative funding programs (AFPs) and in-benefit optimization. AFPs are designed to address high-cost specialty therapies through alternative sourcing pathways, often unlocking meaningful savings in concentrated areas of spend. In-benefit optimization focuses on reducing waste within existing pharmacy benefit structures, enabling more consistent, system-wide cost control. To determine which platforms best promote financial optimization, employers should first understand the operational steps to reduce pharmaceutical spending and identify how different analytics-powered systems address them. The Operational Blueprint for Cost Reduction To operationalize meaningful savings, PBMs should consider the following steps, many of which are incorporated into algorithm-driven optimization strategies: Recognize specialty spend concentrations: Identify which limited quantities of drugs or therapies are driving disproportionate expenses and validate whether each case is appropriate and necessary. Evaluate structure for inefficiencies: Use analytics to identify duplication, overlapping treatment, regimen complexity, and oversupply to determine avoidable refill occurrence. Stress-test disruptions: Assess time-to-therapy, interfacing burden, and risk of discontinuity when implementing spending reduction pathways. Prioritize prescriber operations: Implement scalable margin protections that benefit clinical workflows and support clinician operations. Ensure regulatory adherence: Certify financial pathways are defensible to auditors, members, regulators, and clinicians. Look beyond financial outcomes: Track adherence, continuity, complaints, and escalations to support patient well-being within savings pathways. Implementing the included steps will help PBMs to establish secure, defensible savings. Yet pre-established spending reduction technologies and pathways can make these steps feel more achievable. For this reason, plan sponsors often consider structured cost-reduction platforms designed to address high-cost specialty spending, such as AFPs. Understanding the Role of AFPs AFPs are one way to address disproportionate drug spend across pharmaceutical markets. By leveraging alternative sourcing pathways, these programs can reduce costs for select therapies, particularly where traditional benefit structures offer limited flexibility. In many cases, AFPs coordinate access through manufacturer patient assistance programs (PAPs) or other external mechanisms to improve affordability for members. This option reduces patient out-of-pocket costs while enabling recipients to afford medications for life-saving or chronic conditions. Implementing AFPs requires thoughtful coordination across stakeholders, including pharmacies, manufacturers, and support programs. These models often introduce additional documentation, communication, and process considerations that plan sponsors should evaluate alongside potential savings. When applied with clear guardrails, AFPs can serve as an effective component within a broader cost management strategy, particularly for high-cost, high-impact therapies. In-benefit optimization focuses on identifying and resolving inefficiencies within existing pharmacy workflows. Technology-Enabled Savings Within the Benefit In-benefit optimization allows PBMs to prioritize savings within their existing workflows. This approach leverages a unified platform to address common sources of excess spend to eliminate waste and inefficiencies. Most drug and waste inefficiencies occur in a few areas within pharmaceutical channels. Duplicative or overlapping therapies are common sources, often aggravated by oversupply, early refills, and unused medications. There are also many opportunities for lower-cost medications through in-network channels that are often missed. Prescription adherence can also prove detrimental for employer margins. If a patient’s regimen is overly complex, they are unlikely to follow their medication routine. By identifying where certain drug outcomes overlap with algorithm-guided recommendations, PBMs can eliminate unnecessary therapy use and achieve cost reductions without deviating from normal pharmacy pathways or extending services to multiple points of contact. Automated drug-spend intelligence platforms that integrate in-benefit optimization directly into prescriber workflows eliminate redundant administrative tasks that exacerbate workloads. This approach allows plan sponsors to automatically optimize pricing in context of availability, policy changes, and updated drug costs. Both AFPs and in-benefit optimization offer viable ways to establish savings. When PBMs apply clear guardrails, they can leverage both approaches concurrently to help operationalize each outlined step for margin protection. Layering both approaches using drug-spend intelligence platforms allows PBMs to address small specialty spend concentrations and achieve long-term, sustainable cost management. Guardrails for Sustainable Drug Cost Strategies Whether employers rely on in-benefit optimization, AFPs, or a hybrid model, they should ensure their chosen method meets several non-negotiable sustainable savings requirements to preserve defensibility. The non-negotiables: Preserves continuity of therapy and regimen. Eases prescriber administrative workload. Operates within outlined compliance boundaries. Creates clear, documented savings. When employers use available technology to achieve sustainable spending reductions that meet these requirements, benefit sponsors can confidently remain compliant while defending their margins. Designing the Right Savings Strategy With the affordability crisis squeezing margins across all stakeholders, plan sponsors must implement cost-saving strategies. In-benefit optimization addresses each cost-management step by implementing digital tools that work within pharmaceutical workflows to reduce costs. AFPs provide targeted solutions for high-cost therapies, while in-benefit optimization delivers broader, system-level efficiency by addressing waste within existing workflows. Both options have the potential to create measurable savings when plan sponsors apply them with clear guardrails. When plan sponsors layer data-driven optimization strategies with clear guardrails, they can achieve sustainable cost control, improve member experience, and support long-term benefit stability. About Ryan Czado, PharmD, MBA, Ryan Czado, PharmD, MBA, is a pharmacy benefits expert with a background spanning PBMs, health plan consulting, and employer benefits strategy. With leadership roles at Express Scripts, Minuteman Health, Deloitte, and Lockton, Ryan has helped organizations streamline pharmacy programs and reduce costs. As Chief Pharmacy Officer at RazorMetrics, he focuses on simplifying prescription decisions to optimize healthcare spending.
Health Catalyst to Divest Vitalware Unit for $147M to Med-Metrix
What You Should Know Healthcare intelligence leader Health Catalyst has signed a definitive agreement to divest its mid-revenue cycle business unit, Vitalware, LLC, to Med-Metrix for $147M in cash. The transaction allows Health Catalyst to shed a non-core financial software asset and sharpen its corporate focus on driving cost, clinical, and consumer performance improvements. The ... Read More
<img loading="lazy" width="1440" height="522" src="https://hitconsultant.net/wp-content/uploads/2026/06/Vitalware.jpg" alt="Health Catalyst to Divest Vitalware Unit for $147M to Med-Metrix" class="wp-image-96554" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Vitalware.jpg 1440w, https://hitconsultant.net/wp-content/uploads/2026/06/Vitalware-300x109.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/Vitalware-290x105.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/06/Vitalware-768x278.jpg 768w" sizes="(max-width: 1440px) 100vw, 1440px" /> What You Should Know Healthcare intelligence leader Health Catalyst has signed a definitive agreement to divest its mid-revenue cycle business unit, Vitalware, LLC, to Med-Metrix for $147M in cash. The transaction allows Health Catalyst to shed a non-core financial software asset and sharpen its corporate focus on driving cost, clinical, and consumer performance improvements. The $147M cash injection, combined with existing capital, will be deployed to fully repay and terminate Health Catalyst’s $160 million senior secured term loan facility. Vitalware is a recognized mid-revenue cycle leader that generated approximately $37 million in revenue during fiscal year 2025. The corporate separation frees up long-term financial flexibility, allowing Health Catalyst to accelerate its core technology and healthcare AI roadmap. Focus Over Fragmentation: Why Health Catalyst Is Divesting Vitalware for $147M The healthcare technology and enterprise software landscape is working through an intensive phase of structural realignment. Over the past decade, many digital health vendors sought to build expansive, multi-categorical platforms by acquiring adjacent software business units across clinical, operational, and financial silos. However, running a highly fragmented portfolio often dilutes an organization’s core engineering focus and ties up valuable capital in distinct software categories that require separate research and development pipelines. In a macroeconomic market that increasingly penalizes operational complexity, healthcare leaders are realizing that enterprise success requires deep domain conviction rather than broad, disconnected offerings. For technology provider organizations, long-term sustainability means shedding non-core business segments to maximize capital flexibility, clear outstanding debt, and aggressively fund specialized artificial intelligence frameworks that return immediate, measurable value to customers. To streamline its operational profile and fully back its long-term corporate roadmap, healthcare intelligence pioneer Health Catalyst, Inc. has announced a definitive agreement to divest Vitalware, LLC and its associated mid-revenue cycle business unit. The business will be acquired by technology-enabled revenue cycle specialist Med-Metrix for a total consideration of $147M in cash. Expected to close in 2026 pending standard regulatory waiting periods, the transaction represents a calculated corporate pivot designed to accelerate Health Catalyst’s core clinical transformation. Deleveraging the Balance Sheet to Accelerate the Core AI Roadmap Vitalware by Health Catalyst has long operated as a highly respected suite of mid-revenue cycle solutions, providing hospitals with specialized data models and applied AI to manage coding compliance, chargemaster tasks, charge capture, and federal price transparency rules. The business unit achieved best-in-KLAS status and captured approximately $37 million in revenue during fiscal year 2025. Yet, financial operations represent an administrative category entirely distinct from the data-driven clinical and operational improvement initiatives that form the historical identity of Health Catalyst’s platform. By divesting this segment to Med-Metrix—a company explicitly structured to invest deeply in dedicated revenue cycle management—Health Catalyst immediately strengthens its financial flexibility. The company plans to merge the $147 million in net cash proceeds with existing cash on hand to fully repay and terminate its outstanding senior secured term loan facility. This financial maneuver wipes out approximately $160 million in outstanding principal debt as of March 31, 2026, alongside associated interest obligations and prepayment costs, structurally cleaning the corporate balance sheet. Ben Albert, CEO of Health Catalyst, highlighted the strategic necessity of the transaction, calling it a significant step forward for the enterprise. Albert noted that by concentrating the business precisely around the clinical environments where they maintain the deepest conviction, the company can deploy a lean capital structure optimized to sustain its long-term growth priorities. Monetizing a Moat of $2.8 Billion in Documented Outcomes Once free of its legacy debt obligations, Health Catalyst’s core strategy will focus heavily on scaling its proprietary healthcare improvement data engine. Built on 18 years of historical tracking and backed by $2.8 billion in validated, documented outcomes, this core platform allows health systems to move seamlessly from raw data silos to confident, prioritized actions. The freed-up capital will directly fund an aggressive, clinical AI roadmap designed to enable hospital networks to autonomously turn their localized data lakes into clear operational improvements across cost, clinical care, and consumer engagement performance. To complete the transaction, Raymond James acted as the exclusive financial advisor to Health Catalyst, with Latham & Watkins LLP providing outside legal counsel. Additional statutory disclosures surrounding the cash divestiture have been filed via a Form 8-K with the Securities and Exchange Commission.
Philips and WellSpan Health Launch 7-Year Strategic AI and Imaging Partnership
What You Should Know Philips and WellSpan Health have announced a seven-year strategic alliance establishing a comprehensive research, co-development, and advanced imaging platform across Central Pennsylvania and Northern Maryland. Moving past standard vendor transactions, the agreement marks the first joint innovation and research strategy between Philips and a U.S. community health system. The research framework ... Read More
<img loading="lazy" width="640" height="400" src="https://hitconsultant.net/wp-content/uploads/2026/06/Wellspan_Health_logo-1.jpg" alt="Philips and WellSpan Health Launch 7-Year Strategic AI and Imaging Partnership" class="wp-image-96551" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Wellspan_Health_logo-1.jpg 640w, https://hitconsultant.net/wp-content/uploads/2026/06/Wellspan_Health_logo-1-300x188.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/Wellspan_Health_logo-1-290x181.jpg 290w" sizes="(max-width: 640px) 100vw, 640px" /> What You Should Know Philips and WellSpan Health have announced a seven-year strategic alliance establishing a comprehensive research, co-development, and advanced imaging platform across Central Pennsylvania and Northern Maryland. Moving past standard vendor transactions, the agreement marks the first joint innovation and research strategy between Philips and a U.S. community health system. The research framework focuses on validating AI and digital tools to optimize hospital throughput, cost, and workflow efficiency, directly supporting WellSpan’s goal to reclaim over 500,000 hours of workforce time annually. The enterprise commercial agreement establishes Philips as the preferred vendor across all major imaging modalities (CT, MR, digital X-ray, ultrasound, and image-guided therapy) spanning all 12 WellSpan hospitals, diagnostic centers, and ambulatory surgery sites. A core feature of the partnership is a unified technology lifecycle management blueprint that coordinates equipment, specialized training, and software upgrades under a single framework to eliminate regional patient access gaps. Shifting the Innovation Axis: Why Philips Partnered with WellSpan Health on a 7-Year EHR-Neutral Alliance The operational environment for regional healthcare delivery systems is working through an intensive structural transformation. Historically, cutting-edge clinical research, advanced artificial intelligence validation, and medical device co-development have been heavily concentrated within a handful of massive, highly funded urban academic medical centers. Yet, this centralized innovation blueprint introduces an acute mismatch with the realities of American medicine: community health networks are where the overwhelming majority of the population actually goes to receive care. Today, these regional networks face severe administrative headwinds, characterized by compressed operating margins, an escalating chronic care burden, and profound clinician burnout. When community systems are forced to act as passive buyers—purchasing disconnected tech stack solutions that require constant custom integrations—data fragmentation worsens, and valuable staffing hours are lost to administrative tasks. To ensure long-term viability, progressive community provider networks must shift from being passive software adopters to active co-creators of enterprise-grade technology. To dismantle this legacy procurement model and place regional care networks at the center of medical technology evolution, Philips and regional clinical powerhouse WellSpan Health have announced a landmark seven-year strategic alliance. Encompassing all 12 WellSpan hospitals, alongside its complete footprint of diagnostic imaging and ambulatory surgery centers, the alliance establishes a scalable, AI-driven, platform-based framework designed to drive measurable improvements across patient care quality, workflow efficiency, and technology lifecycle management. Eliminating the Efficiency Drain: Reclaiming 500,000 Workforce Hours The definitive cornerstone of the Philips-WellSpan alliance is a deeply integrated research agreement and joint innovation strategy—marking the first partnership of its kind between Philips and a U.S. community healthcare provider. Rather than deploying uncalibrated, off-the-shelf generative applications, WellSpan will actively pull from Philips’ global R&D pipeline to design, validate, and build next-generation medical intelligence products. The primary metric guiding this collaborative research is the aggressive removal of workforce friction. The joint teams will systematically analyze how embedded AI and digital orchestration software impact imaging throughput, case-mix costs, and point-of-care charting times. This structural optimization is engineered to fulfill WellSpan’s explicit enterprise goal: reclaiming more than 500,000 hours of workforce time every single year. Roxanna Gapstur, Ph.D., R.N., President and CEO of WellSpan Health, emphasized that as the system’s clinical capabilities have scaled, leadership has assumed a responsibility to be highly intentional regarding technology lifecycle support. Gapstur noted that this alliance builds a coordinated infrastructure that advances digital, AI-enabled care while demonstrating that community health networks belong at the very center of healthcare innovation. Unifying Lifecycle Management to Eradicate Regional Access Gaps On a commercial scale, the agreement designates Philips as WellSpan’s preferred enterprise vendor across all core diagnostic imaging and image-guided therapy modalities, including CT, MR, digital X-ray, and ultrasound. This comprehensive standard ensures a smooth, uniform experience for clinicians and patients across the entirety of Central Pennsylvania and Northern Maryland. Importantly, the relationship moves beyond traditional purchasing to focus heavily on a coordinated approach to technology lifecycle management. WellSpan and Philips will manage all hardware acquisitions, enterprise service agreements, clinical training modules, and software upgrade paths under a single unified framework. By synchronizing these updates, the health system can guarantee consistent imaging availability across all regional facilities, eliminate historical gaps in patient access, and build a stable database foundation for subsequent algorithmic tools. Roy Jakobs, CEO of Royal Philips, stated that combining Philips’ health technology leadership with WellSpan’s deep clinical expertise creates an ideal mechanism to deliver measurable operational gains. The platform-based approach supports frontline clinicians in their daily tasks while actively shaping the future of global care delivery.
Vida Health Partners with Instacart to Launch Category-Specific Grocery Stipends for Cardiometabolic Care
What You Should Know Virtual cardiometabolic provider Vida Health has finalized a nationwide partnership with grocery technology leader Instacart to integrate category-specific grocery stipends into virtual chronic care delivery. The collaboration utilizes Instacart Health Fresh Funds to provide members with direct financial stipends dedicated exclusively to purchasing dietitian-approved, nutritious groceries. The initiative directly targets the ... Read More
<img loading="lazy" width="1500" height="731" src="https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-1500x731.jpg" alt="" class="wp-image-96557" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-1500x731.jpg 1500w, https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-300x146.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-290x141.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-768x374.jpg 768w, https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-1536x748.jpg 1536w, https://hitconsultant.net/wp-content/uploads/2026/06/Instacare-Fresh-funds-2048x998.jpg 2048w" sizes="(max-width: 1500px) 100vw, 1500px" /> What You Should Know Virtual cardiometabolic provider Vida Health has finalized a nationwide partnership with grocery technology leader Instacart to integrate category-specific grocery stipends into virtual chronic care delivery. The collaboration utilizes Instacart Health Fresh Funds to provide members with direct financial stipends dedicated exclusively to purchasing dietitian-approved, nutritious groceries. The initiative directly targets the social determinants of health (SDOH), leveraging Instacart’s logistics network which reaches 98% of U.S. households—including 95% of low-income, low-access food deserts. Guided by a multidisciplinary team of obesity medicine-certified physicians and registered dietitians, the program delivers culturally sensitive meal plans accounting for budget constraints across more than 25 distinct backgrounds. Future infrastructure phases plan to make Vida’s clinical meal plans directly shoppable via the Instacart Marketplace while establishing direct employer subsidization channels within enterprise benefit packages. Prescribing the Pantry: Why Vida Health and Instacart Are Unifying Food Stipends and EHR Nutrition Loops The clinical management of chronic cardiometabolic diseases across the United States has arrived at a critical operational crossroads. For decades, the traditional healthcare apparatus has treated metabolic instability, obesity, type 2 diabetes, and severe hypertension through highly isolated, clinical interventions. Frontline physicians and registered dietitians frequently deliver expert nutritional advice during brief patient encounters, advising vulnerable individuals to radically alter their dietary choices. However, once a patient leaves the virtual or brick-and-mortar clinic, this advice routinely collides with harsh socioeconomic realities. In underserved areas, rural communities, and urban food deserts, accessing fresh, nutritious food is a significant structural barrier. When clinical guidance is completely disconnected from real-world food access, patient compliance drops. Individuals are forced to default back to affordable, processed, ultra-palatables that worsen their metabolic conditions. For self-insured employers, commercial health plans, and risk-bearing provider organizations, this fragmentation leads to an unmanaged cost spiral—driving up avoidable emergency department visits, accelerating chronic disease progression, and eroding the return on digital health investments. To close this gap between clinical intent and daily nutrition, value-based virtual provider Vida Health has announced a comprehensive nationwide partnership with Instacart. By integrating Instacart Health Fresh Funds directly into its virtual cardiometabolic workflows, Vida is transforming passive medical advice into a highly accessible, financially incentivized system of action. Activating Fresh Funds to Bypass the Food Desert Barrier The core operational mechanism driving the Vida-Instacart partnership is the deployment of Instacart Health Fresh Funds. These are category-specific grocery stipends provided to Vida members, allowing them to instantly purchase the exact dietary recommendations outlined by their care teams. Rather than forcing low-income or food-insecure individuals to absorb the high out-of-pocket costs of specialized diets, this stipend architecture lowers the financial barriers that historically derail nutritional adherence. This logistical workflow is supported by Instacart’s extensive North American delivery network, which connects with more than 2,200 retail banners representing nearly 100,000 local stores. Instacart’s infrastructure reaches more than 98% of all U.S. households, crucially including 95% of areas formally designated as low-income and low-access food deserts. By pairing same-day home delivery with flexible, destination-restricted funds, the collaboration removes the geographic and transportation barriers that commonly impede rural and underserved patient populations. Amy Mushlin, Chief Clinical and Member Service Officer at Vida Health, emphasized that building healthy lifestyle habits demands far more than raw clinical information. It requires empathetic, culturally relevant guidance combined with immediate, physical access to nutritious options. By syncing with Instacart, the specific adjustments suggested by dietitians and health coaches become instantly actionable at the point of purchase, allowing members to safely execute impactful lifestyle modifications. Culturally Grounded Navigation and the Value-Based Continuum Vida’s virtual cardiometabolic platform functions on a whole-person, multidisciplinary care model delivered in both English and Spanish across all 50 states and Washington, D.C.. Its clinical network—comprising obesity medicine-certified physicians, registered dietitians, licensed therapists, and expert coaches—is engineered to manage patients across the complete acuity spectrum. To ensure long-term engagement, Vida’s dietitians design culturally sensitive nutritional pathways that incorporate flavor profiles and culinary traditions spanning more than 25 distinct cultural and ethnic backgrounds while adjusting for localized store availability and household budget realities. The integration with Instacart is systematically designed to scale across multiple strategic phases. The initial rollout focuses heavily on immediate member activation and engagement, linking Vida’s clinical protocols directly to Instacart’s online ordering network. Subsequent deployment phases will allow dietitian-developed, disease-specific meal plans to be directly shoppable with a single click inside the app. Furthermore, the organizations are actively exploring employer-subsidized food access models to integrate these programs directly into commercial enterprise benefit structures. This maps out a future where personalized nutrition support and grocery logistics function as unified components of enterprise cardiometabolic care.
Don’t Let Legacy Data Derail Your Health System’s Growth
Dave Lamar, Chief Growth Officer of MediQuant
As health systems continue expanding through acquisitions and partnerships, many find themselves racing to bring new practices onto shared EHR platforms. The motivation is clear: unify care, streamline operations, and unlock value across the enterprise. But beneath that strategic vision lies a messy operational reality – one that too often gets overlooked until it’s too ... Read More
<img loading="lazy" src="https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-1500x2255.webp" alt=" Don’t Let Legacy Data Derail Your Health System’s Growth" class="wp-image-96548" width="655" height="985" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-1500x2255.webp 1500w, https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-200x300.webp 200w, https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-193x290.webp 193w, https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-768x1154.webp 768w, https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-1022x1536.webp 1022w, https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant-1362x2048.webp 1362w, https://hitconsultant.net/wp-content/uploads/2026/06/Dave-Lamar_MediQuant.webp 1703w" sizes="(max-width: 655px) 100vw, 655px" /> Dave Lamar, Chief Growth Officer of MediQuant As health systems continue expanding through acquisitions and partnerships, many find themselves racing to bring new practices onto shared EHR platforms. The motivation is clear: unify care, streamline operations, and unlock value across the enterprise. But beneath that strategic vision lies a messy operational reality – one that too often gets overlooked until it’s too late. At the center of this challenge is legacy data. For every practice or partner brought into the fold, there’s a trail of applications, contracts, and patient data that needs to be rationalized and retained. Done right, this process supports compliance, reduces risk, and keeps the onboarding timeline on track. Done haphazardly, it leads to costly delays, redundant systems, and compliance vulnerabilities that can unravel even the best-laid integration plans. Many health systems underestimate the complexity of legacy data management during onboarding. And that misstep can cost more than just money. It can erode trust, stall growth, and expose organizations to serious regulatory risk. The overlooked first step: contract review When a new practice is acquired, attention typically goes straight to clinical integration. But before a single data extract is ordered or archive strategy is discussed, the first priority should be reviewing contracts tied to legacy applications. Too often, organizations skip this step and unknowingly target systems that can’t be sunset for years due to termination clauses or data release restrictions. Worse, some vendors use this confusion to their advantage. Ordering the wrong type of data extract, or missing critical deadlines, can trigger auto-renewals that lock systems in place far longer than planned. Application inventory management is a smart investment To prevent these costly missteps, leading organizations are investing in application inventory management tools. These platforms track everything from contract terms to data ownership to rationalization decisions. Having this centralized visibility not only supports strategic planning, it also saves time and resources during transitions by preventing unnecessary projects or duplicate efforts. Even avoiding a single contract renewal that didn’t need to happen can pay for the system. A missed opportunity for compliance and cost control Surprisingly, many health systems still lack comprehensive data retention policies. And even when they exist, enforcement is often inconsistent across departments or application types. This results in over-retention of unnecessary data, under-retention of key records, and a lot of gray area when it comes time to archive. Done well, data retention policies guide smarter, more cost-effective archiving decisions. Not every legacy system needs a full clinical archive. In some cases, a small subset of documents or a limited dataset is all that’s required to meet regulatory requirements. But you can’t make that call without a clear policy in place. A mature retention strategy also supports compliance with evolving regulations, including the Cures Act. With growing pressure to provide patients with access to all their health data, no matter where it originated, organizations must define and enforce retention standards that align with both internal policy and external expectations. It’s about the patient, too While compliance and cost control might be top priorities, the patient experience must also be considered. More patients expect access to historical records than ever before. In some cases, health systems are choosing to retain certain data beyond required timeframes simply because it helps patients tell a more complete health story. That may feel counterintuitive after talking about cost control, but the balance is possible. It starts with defining what’s most important to the organization and choosing a data management strategy that supports those goals. Standardization: The path to scale As health systems grow, they need onboarding processes that don’t reinvent the wheel every time. That means building a repeatable playbook for how to handle legacy data from contract review to archive execution. The more standardized the approach, the faster and more affordable the onboarding. This is especially critical for systems leveraging Community Connect, where consistency across sites matters for both operations and compliance. Standard workflows, clear decision points, and trusted data partners can dramatically reduce the lift required from internal teams. Choose experience Finally, while onboarding might seem like a job for internal teams, legacy data management is not the place to experiment. The stakes are too high. Organizations should work with partners who understand the nuances of clinical, financial, and operational data and who have done it before, at scale. It’s not just about flipping the switch on a new EHR. It’s about protecting your organization from hidden costs, regulatory exposure, and the operational drag that comes from ignoring the data left behind. Growth is good. But scalable, compliant growth requires a plan. And that plan needs to start with legacy data. About Dave Lamar Dave Lamar is Chief Growth Officer of MediQuant, a leading provider of enterprise data archive technology for the healthcare industry. Since joining the company in 2017, Dave has redefined projects and services for increased revenue, helped to integrate and reframe the services provided by new acquisitions for a comprehensive offering, and guided the opportunity for the firm to win the largest assignment in MediQuant history with the Department of Defense
Ilant Health Secures $15M to Expand Value-Based Precision Obesity Management
What You Should Know Value-based obesity management leader Ilant Health has closed a $15M Series A funding round led by Cornucopian Capital, elevating its total funding footprint past $22 million. The financing round features strategic participation from naturalX, Peakbridge, Semcap AI, Evidenced, Operator Partners, and existing investors Celtic, LifeX, and AlphaLab. Founded by former McKinsey ... Read More
<img loading="lazy" width="1500" height="663" src="https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-1500x663.jpg" alt="" class="wp-image-96545" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-1500x663.jpg 1500w, https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-300x133.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-290x128.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-768x340.jpg 768w, https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-1536x679.jpg 1536w, https://hitconsultant.net/wp-content/uploads/2026/06/Ilant-Health-2048x906.jpg 2048w" sizes="(max-width: 1500px) 100vw, 1500px" /> What You Should Know Value-based obesity management leader Ilant Health has closed a $15M Series A funding round led by Cornucopian Capital, elevating its total funding footprint past $22 million. The financing round features strategic participation from naturalX, Peakbridge, Semcap AI, Evidenced, Operator Partners, and existing investors Celtic, LifeX, and AlphaLab. Founded by former McKinsey and Molina Healthcare executive Elina Onitskansky, the company bypasses fragmented weight-loss apps to deliver an integrated, value-based cardiometabolic care platform. Early clinical deployments document that Ilant members achieve a 15% average weight loss—outperforming the 5.8% benchmark typically recorded in uncalibrated, real-world settings. To bring structural transparency to corporate pharmacy spend, Ilant leverages direct contracting and transparent pricing frameworks through integrations with pharmaceutical leaders Eli Lilly and Novo Nordisk. Defeating the GLP-1 Cost Spiral: Why Ilant Health Raised $15M to Scale Outcomes-as-a-Service The commercial healthcare benefit ecosystem is currently confronting an unsustainable economic dilemma. The rapid rise and explosive consumer demand for GLP-1 receptor agonist weight-loss therapies have left self-insured employers and health plans trapped in a severe fiscal squeeze. Corporate benefits directors face a difficult choice: they must either expand open-ended access to these premium specialty medications and watch their pharmaceutical spend spike dramatically, or heavily restrict coverage and face compounding long-term chronic disease liabilities and structural health plan attrition. The underlying issue stems from a persistent focus on transaction-oriented point solutions that treat obesity in isolation from broader cardiometabolic health. Traditional weight-loss programs frequently operate under a one-size-fits-all model centered entirely on drug access, failing to integrate baseline clinical, behavioral, and personal data inputs. Without continuous, data-driven optimization or multi-modal lifestyle support, real-world GLP-1 adherence rates drop, leading to an average real-world weight reduction of just 5.8%. For enterprise organizations, this fragmented approach represents a broken system—one where employers pay premium prices for uncoordinated care while chronic disease markers continue to slide. To eliminate this data fragmentation and introduce a precise, outcomes-driven framework for metabolic care, value-based obesity treatment pioneer Ilant Health has finalized a $15M Series A financing round. Led by Cornucopian Capital, with prominent participation from naturalX, Peakbridge, Semcap AI, Evidenced, Operator Partners, and existing backers Celtic, LifeX, and AlphaLab, the round brings Ilant’s total capitalization to more than $22 million. The capital injection will be used to fuel rapid market expansion, scale its precision analytics engine, and deliver integrated obesity care across a growing network of employer and health plan partners. Precision Matching and the “Outcomes-as-a-Service” Mandate Founded by Elina Onitskansky, an alumnus of McKinsey and former executive at Molina Healthcare, Ilant Health functions as a comprehensive, technology-enabled entry point for individuals navigating complex metabolic conditions. Moving past generic digital weight-loss programs, Ilant delivers a precision-matched care model that evaluates every patient across clinical, behavioral, and personal variables. The platform automatically builds an individualized treatment roadmap that combines intensive behavioral therapy, metabolic medications (spanning both GLP-1 and non-GLP-1 options), and bariatric surgical pathways to simultaneously optimize nutrition, physical movement, and stress management. By deploying data analytics to match members with the specific clinical interventions most likely to trigger a personal response, Ilant systematically avoids ineffective care. The performance data surrounding this model shows significant improvements over standard care: members enrolled in Ilant achieve an average weight loss of 15%. This clinical success is accompanied by major improvements in holistic patient metrics, including an average of two additional self-reported mentally healthy days per month. Aryeh Ganz, Founder and Managing Partner of Cornucopian Capital, highlighted the strategic shift underwritten by this model, stating that the next generation of category-defining digital health enterprises must deliver “outcomes as a service” rather than just standalone tools or medication access. Ganz noted that the future of cardiometabolic care will be won by platforms capable of aligning clinical rigor with verified economic value, matching the right treatment option to the right patient at the optimal point of intervention. Bending the Pharmacy Cost Curve via Direct Contracting The primary commercial moat for enterprise clients adopting Ilant sits within the platform’s direct, transparent integration with major pharmaceutical manufacturing networks. In November 2025, Ilant established direct contracting and transparent pricing solutions for obesity medications through Eli Lilly’s Employer Connect program, alongside active operational collaborations with Novo Nordisk. These manufacturer alignments give enterprise benefit managers clear visibility and control over their pharmacy budgets, offering predictable, transparent medication pricing paired with flexible benefit design options. Kenneth L. Gardner, Director of Growth, Benefit Operations, emphasized that Ilant’s precision-based, data-driven approach immediately distinguished it from medication-only models. By running advanced population health analyses, Ilant isolates exactly which corporate members are positioned to derive the highest clinical and financial benefit from specific therapies. This targeted tracking gives benefits teams deep confidence in both patient experience and immediate return on investment (ROI), ensuring that chronic care delivery bends the employer’s long-term spend curve.
4 Critical Guardrails for Community Hospital Tech Procurement
Healthcare is moving toward models that reward outcomes, continuity, and population health management, yet disparities in access to specialized care continue to persist. And while community hospitals are central to closing this gap, they are being inundated with technologies that promise to transform care yet are structurally difficult to translate from large academic medical centers ... Read More
<img loading="lazy" src="https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-1500x1500.jpg" alt="" class="wp-image-96542" width="838" height="838" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-1500x1500.jpg 1500w, https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-300x300.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-290x290.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-768x768.jpg 768w, https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-1536x1536.jpg 1536w, https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-2048x2048.jpg 2048w, https://hitconsultant.net/wp-content/uploads/2026/06/headshot-image-Jian-100x100.jpg 100w" sizes="(max-width: 838px) 100vw, 838px" /> Jian Zhang, founder & CEO of Noah Medical Healthcare is moving toward models that reward outcomes, continuity, and population health management, yet disparities in access to specialized care continue to persist. And while community hospitals are central to closing this gap, they are being inundated with technologies that promise to transform care yet are structurally difficult to translate from large academic medical centers to smaller ones. Rural hospitals operate with lower patient volumes and thinner margins, practical realities that force patients to travel long distances for specialty diagnostics and procedures, particularly in oncology, pulmonary medicine, and cardiovascular care. It is not a failure of commitment. It is a question of feasibility. A platform that works well in a high-volume referral center can falter locally if it requires specialized staffing, unpredictable scheduling, or capital risk that smaller systems cannot absorb. Hospital leaders, therefore, need a practical way to determine which advanced technologies truly belong in their environment. Four questions can help distinguish innovations that look compelling in demonstrations from those that can succeed in daily practice. 1. Can We Deliver This Consistently, Not Occasionally? Advanced diagnostics only improve outcomes if patients can reliably access them. Programs that rely on visiting specialists, limited scheduling blocks, or fragile staffing models rarely achieve sustained utilization. When availability is uncertain, referring physicians continue to send patients elsewhere. A strong indicator of success is the ability to offer the procedure on a predictable schedule using local staff. Programs that must be canceled frequently or require complex coordination often fail to gain momentum. Leaders should also evaluate turnaround times. If patients wait significantly longer locally than at regional centers, referral leakage will persist. Consistency builds confidence among clinicians and patients alike. 2. Does It Fit Our Workforce Reality? Many advanced technologies were developed for large institutions with subspecialized teams. Community hospitals must assess whether existing clinicians can safely and efficiently adopt the technology. Programs are far more viable when they can be staffed by current physicians and care teams following structured training, rather than requiring recruitment of scarce specialists. Dependence on a small number of highly specialized individuals introduces significant continuity risk. Successful implementations typically allow clinicians to reach proficiency within months and maintain competence through routine use. Technologies that require frequent practice to remain safe can be difficult to sustain in lower-volume settings. The key question is whether expertise can be maintained, not just acquired. 3. Will Patient Volume Support Long-Term Viability? Without the referral base of major academic centers, community hospitals must realistically assess local demand. One useful benchmark is outbound referrals. If a hospital regularly transfers patients elsewhere for a specific diagnostic or procedure, recapturing a portion of that volume may support a local program. Low volumes create cascading challenges. Per-procedure costs rise, clinicians struggle to maintain proficiency, equipment sits idle, and scheduling becomes inefficient. Over time, an underutilized program can strain finances and erode confidence. Technologies addressing common conditions with clear local prevalence tend to be more sustainable than highly specialized services. 4. Does It Strengthen Local Care or Fragment It? Not every advanced capability should be decentralized. Some complex interventions are best concentrated at tertiary centers. However, technologies that anchor care locally can strengthen continuity and patient retention. Early diagnostics are especially valuable because they often determine where subsequent treatment will occur. A positive indicator is the ability for patients to move from diagnosis to treatment within the same regional network or through coordinated partnerships. If most patients still require immediate transfer elsewhere, the local benefit may be limited. Programs that reinforce relationships with primary care physicians and local specialists tend to generate durable referral patterns. A Practical Definition of Innovation For community hospitals, innovation is not about acquiring the most advanced tool available anywhere. It is about expanding what can be delivered safely, reliably, and sustainably for the population they serve. When the right technologies are implemented thoughtfully: Patients avoid long travel for critical diagnostics Diseases are detected earlier Care fragmentation decreases Hospitals retain patients who might otherwise leave the system Financial sustainability improves In these cases, access and economics reinforce one another. Why This Matters Now Scalable innovations that spread to the broader healthcare landscape improve access and benefit communities. Community hospitals do not need every new technology. They need the right ones, those aligned with their workforce, patient base, and operational realities. When advanced capabilities become feasible at the community scale, the impact extends well beyond individual procedures. Hospitals strengthen their role as regional anchors of care, patients receive services closer to home, and innovation fulfills its most important promise: improving outcomes for more people, not just those living near major medical centers. About Jian Zhang Jian Zhang is the founder and CEO of Noah Medical. Prior to founding Noah Medical in 2018, he co-founded two other startups, was employee #2 at Auris Health (which was acquired by Johnson & Johnson for $5.7 billion), and previously worked at Intuitive Surgical.
Rural Hospitals Are Collapsing Under Administrative Burden That AI Alone Cannot Solve
More than 180 rural hospitals in the United States have closed since 2005, according to the Chartis Center for Rural Health, while providers spend over $25 billion annually on claims adjudication, with nearly $18 billion of that tied to claims that are ultimately paid, according to Premier Inc. That’s not a demand problem. It’s an ... Read More
<img loading="lazy" src="https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-1500x1072.jpg" alt="Rural Hospitals are Collapsing Under Administrative Burden that AI Alone Cannot Solve" class="wp-image-96537" width="842" height="601" srcset="https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-1500x1072.jpg 1500w, https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-300x214.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-290x207.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-768x549.jpg 768w, https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-1536x1097.jpg 1536w, https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld-113x81.jpg 113w, https://hitconsultant.net/wp-content/uploads/2026/06/Matt-Seefeld.jpg 2048w" sizes="(max-width: 842px) 100vw, 842px" /> Matt Seefeld, CEO of MedEvolve, More than 180 rural hospitals in the United States have closed since 2005, according to the Chartis Center for Rural Health, while providers spend over $25 billion annually on claims adjudication, with nearly $18 billion of that tied to claims that are ultimately paid, according to Premier Inc. That’s not a demand problem. It’s an administrative one. And increasingly, it’s a technology infrastructure problem tied to how work is managed, measured, and automated. And for rural hospitals operating with limited staff and thin margins, that level of inefficiency isn’t just costly; it’s unsustainable. The Work Behind Getting Paid In most healthcare organizations, a claim isn’t processed once and paid; it’s worked over and over again. It gets handed off, corrected, resubmitted, and appealed. Each of those touch points requires human time, and each one introduces delay and cost. According to the Council for Affordable Quality Healthcare (CAQH), administrative transactions in healthcare still cost the system tens of billions annually, with a sizable portion being driven by manual processes. Even more concerning, a large share of denied claims that ultimately get paid requires intervention, meaning that much of the work happening inside financial operations is rework, not value creation, as highlighted in the Premier analysis. That’s where a lot of margins disappear. Why Rural Hospitals Feel It First and Hardest Large health systems can absorb inefficiency. Rural hospitals can’t. Nearly half of rural hospitals are operating at a financial loss, and many are at risk of closure due to sustained margin pressure, according to the Chartis Center report. When you have smaller teams, fewer specialists, and less redundancy, every extra touch matters. Administrative staff aren’t just processing claims; they’re juggling eligibility issues, documentation gaps, payer requirements, and follow-up. There’s no buffer. In larger systems, inefficiency is expensive. In rural hospitals, it’s existential. Complexity Is Growing Faster Than Capacity Payers are continuing to increase requirements, which means more edits, more prior authorizations, and more documentation specificity. A 2024 American Medical Association survey found that physicians complete an average of 43 prior authorizations per week with many reporting delays that directly impact care delivery. At the same time, systems remain fragmented, and workflows are rarely aligned across the financial lifecycle. The result is simply more work per claim. Not more reimbursement. Not better outcomes. Just more effort required to get paid. Where AI Fits and Where It Doesn’t There’s a lot of discussion right now about AI solving administrative burden in healthcare. But in practice, AI is not a replacement for the people doing this work, especially in rural hospitals. The reality is that a substantial percentage of the issues that require human intervention are tied to nuance. Documentation context, payer-specific rules, and incomplete information aren’t problems you can fully automate. Beyond automating repetitive tasks, AI is increasingly being used to improve visibility—helping organizations analyze claims data, identify patterns, and enhance payment accuracy across workflows, as outlined by McKinsey & Company But resolution still requires human judgment. In rural hospitals, the goal isn’t to replace people. That’s not realistic, and it’s not the right objective. The goal is to reduce the amount of unnecessary work those people are being asked to do so they can focus on more high-value work. AI works best as a force multiplier, helping teams focus on what actually requires expertise instead of chasing preventable problems. The Real Opportunity: Reducing the Work, Not Just Automating It Too often, the focus is on how to process work faster. The better question is, why does the work exist in the first place? If a claim is touched multiple times before it’s paid, speeding up those touches doesn’t solve the problem. It just accelerates inefficiency. The opportunity is to reduce the number of touches altogether. That starts with understanding where work is being created, where breakdowns are happening, where rework is being introduced, and where effort is being duplicated. From there, organizations can begin to redesign workflows to prevent issues instead of reacting to them. That’s where both operational discipline and technology need to come together. What’s at Stake Rural hospitals aren’t just healthcare providers; they’re access points for entire communities. When they close, patients don’t just lose convenience, they lose access. The Chartis Center for Rural Health continues to warn that rural hospital closures create care deserts, forcing patients to travel significantly farther for essential services. We’re investing heavily in clinical innovation and AI across healthcare. But if the administrative side of the system continues to erode financial stability, those investments won’t matter for the organizations that can’t afford to stay open. Administrative complexity is not a secondary issue. It’s a structural one. Until we address it by reducing unnecessary work, improving visibility, and supporting the people doing the work, rural hospitals will continue to operate at a disadvantage they can’t overcome. About Matt Seefeld Matt Seefeld, CEO of MedEvolve, is a healthcare executive with more than 25 years of experience in the assessment, design, and implementation of process improvement programs and technology development for the healthcare revenue cycle. He focuses on reducing administrative complexity and improving operational performance across healthcare organizations.
Bridging the Diagnostics Gap: Deloitte Research Exposes Core Mismatch Between Manufacturers and Providers
What You Should Know A new survey by the Deloitte Center for Health Solutions reveals that 62% of diagnostics manufacturer executives believe future growth depends entirely on adopting a business-to-business-to-consumer (B2B2C) operational model. The research highlights an immediate strategic disconnect: while providers rank test ordering as their single greatest clinical friction point, manufacturers mistakenly over-index ... Read More
<img loading="lazy" width="1500" height="1280" src="https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-1500x1280.png" alt="Bridging the Diagnostics Gap: Deloitte Research Exposes Core Mismatch Between Manufacturers and Providers" class="wp-image-96526" srcset="https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-1500x1280.png 1500w, https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-300x256.png 300w, https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-290x247.png 290w, https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-768x655.png 768w, https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-1536x1310.png 1536w, https://hitconsultant.net/wp-content/uploads/2026/05/US189118_Figure-1-2048x1747.png 2048w" sizes="(max-width: 1500px) 100vw, 1500px" /> What You Should Know A new survey by the Deloitte Center for Health Solutions reveals that 62% of diagnostics manufacturer executives believe future growth depends entirely on adopting a business-to-business-to-consumer (B2B2C) operational model. The research highlights an immediate strategic disconnect: while providers rank test ordering as their single greatest clinical friction point, manufacturers mistakenly over-index on results interpretation as the primary challenge. Rising consumerization is reshaping the market landscape, with 76% of provider respondents stating that consumer- and patient-initiated testing demands will fundamentally alter diagnostics over the next three years. Interoperability remains an acute infrastructure hurdle; 74% of healthcare providers admit that their current database systems are completely disconnected and un-integrated across the end-to-end diagnostic journey. To survive the expansion of home diagnostics and wearables, manufacturers must embed AI natively within EHR workflows, automate prior authorizations, and deliver highly personalized, visual data context directly to consumers. The B2B2C Migration: Why Diagnostics Manufacturers Must Shift from Product Vendors to Workflow Partners The global diagnostics manufacturing sector is currently navigating an aggressive, multi-directional market disruption. On the consumer front, patients are rapidly adopting sophisticated, distributed health tools—utilizing virtual healthcare portals, direct-to-consumer (DTC) self-ordered testing, digital health applications, and advanced wearable sensors to independently track, interpret, and manage their baseline biological data. Concurrently, traditional healthcare providers—encompassing independent commercial laboratories, hospital systems, and imaging facilities—are under intense operational pressure to deliver faster, highly streamlined, and deeply personalized clinical experiences or risk permanently losing market share to agile, consumer-focused tech entrants. While these shifts point directly toward a data-driven, consumer-centric, and personalized ecosystem, legacy clinical models will not vanish overnight. Traditional healthcare providers still generate the dominant share of core revenue for diagnostics manufacturers. The pressing strategic question for corporate boards is no longer how to bypass the traditional system, but how manufacturers can actively equip their core provider customers to survive and compete in a consumer-driven marketplace. To assess industry readiness for this transition, the Deloitte Center for Health Solutions conducted parallel surveys of 50 diagnostics manufacturer executives and 50 healthcare provider executives, supplemented by 20 in-depth interviews with industry leaders. The findings reveal a stark reality: 62% of manufacturers recognize that future growth hinges on a next-generation B2B2C blueprint. However, deep structural disconnects in stakeholder engagement, workflow integration, and consumer personalization threaten to stall this critical evolution. Dissecting the Three Core Provider Disconnects Before manufacturers can capture the emerging B2B2C opportunity, they must re-engineer how they interact with their primary healthcare provider customers. Deloitte’s research exposes three critical disconnects where manufacturer strategies are misaligned with localized provider realities: The Problem-Solving Disconnect: In the study, providers explicitly identified test ordering as the single heaviest friction point in their daily clinical pipeline. Manufacturers, conversely, focused their innovation efforts on result interpretation. To bridge this gap, forward-looking manufacturers must look past physical diagnostic kits to expand their offerings into automated software and workflow services. The Stakeholder Disconnect: Surveyed manufacturers stated that their primary account contacts remain hospital procurement offices and channel partners—the traditional buyers who execute contracts. Providers, however, counter that the individuals who actually command clinical adoption and long-term utilization are ordering clinicians, lab directors, and service-line leaders. Manufacturers are over-investing in procurement relationships while under-investing in the clinical stakeholders who dictate actual product adoption. The Engagement Disconnect: Providers heavily prioritized peer-to-peer clinical education, medical conferences, and intuitive, digital self-service web portals to research technology independently. Manufacturers, by contrast, continue to deploy high-frequency field sales teams, an outreach method that several provider interviewees described as overly frequent and lacking clinical value. Harnessing Platform-Based AI and Interoperable Moats The urgency to fix these engagement gaps is accelerating. 76% of provider respondents state that consumer-initiated testing demands will radically transform the diagnostics footprint over the next three years. Furthermore, 92% of providers are already actively offering or exploring patient-initiated testing pathways, compared to just 70% of manufacturers—proving that frontline clinics are absorbing the brunt of changing consumer behaviors. As testing decentralizes into the home and retail environments, providers are becoming nodes in a distributed care network. Consumers expect visual, contextually clear results that move past raw numbers to outline actionable next steps. To help providers scale this level of personalization, manufacturers must prioritize comprehensive data and workflow integration. Currently, the tech stack is highly fragmented: 74% of providers report that their backend systems are entirely un-integrated across the end-to-end diagnostic journey. This data isolation creates a significant entry point for platform-integrated Artificial Intelligence. Rather than deploying isolated, standalone algorithms, the competitive advantage belongs to integrated platforms that connect data across revenue cycles, automated prior authorizations, and native EHR workflows. 66% of provider executives state that personalized workflow integration will be exceptionally important over the next three to five years. Manufacturers that embed their testing infrastructure within these automated loops can capture a continuous, longitudinal view of patient health extending far beyond the clinical encounter. Those that resist this integration risk being relegated to interchangeable commodity test vendors with zero visibility into consumer behavior and no influence over future diagnostic decisions.
Shifting the Interoperability Axis: Why Layered Extensions Fail Modern Hospital Core EHRs
Sandra Johnson, SVP Client Services, CliniComp
Every year, there are roughly 33.5 million hospital admissions, 155 million emergency department visits, and hundreds of millions of outpatient encounters across the United States. At the same time, healthcare spending has reached $4.9 trillion annually. When patient data, especially for such a large number of healthcare consumers, is fragmented across multiple applications, vendors, and ... Read More
<img loading="lazy" src="https://hitconsultant.net/wp-content/uploads/2026/05/Sandra_Updated-Head-Shot-1.jpg" alt="Shifting the Interoperability Axis: Why Layered Extensions Fail Modern Hospital Core EHRs" class="wp-image-96509" width="812" height="541" srcset="https://hitconsultant.net/wp-content/uploads/2026/05/Sandra_Updated-Head-Shot-1.jpg 1200w, https://hitconsultant.net/wp-content/uploads/2026/05/Sandra_Updated-Head-Shot-1-300x200.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/05/Sandra_Updated-Head-Shot-1-290x193.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/05/Sandra_Updated-Head-Shot-1-768x512.jpg 768w" sizes="(max-width: 812px) 100vw, 812px" /> Sandra Johnson, SVP Client Services, CliniComp Every year, there are roughly 33.5 million hospital admissions, 155 million emergency department visits, and hundreds of millions of outpatient encounters across the United States. At the same time, healthcare spending has reached $4.9 trillion annually. When patient data, especially for such a large number of healthcare consumers, is fragmented across multiple applications, vendors, and systems, the effect is exponential. It is multiplied across every encounter, every workflow, and every decision, impacting not only quality of care and the patient experience, but also hospital performance and the bottom line. As a result, EHR interoperability is becoming central to how healthcare organizations think about sustainability, efficiency, and care delivery at scale. While industry conversations have traditionally focused on interoperability as only a regulatory requirement or technical milestone, the shift is becoming more apparent. This shift is also reflected in how healthcare leaders are approaching their technology environments. In a 2026 CHIME survey, nearly 90% of healthcare CIOs reported that vendor consolidation is a priority within their interoperability strategy. There is broad alignment around the need to simplify environments and reduce fragmentation. At the same time, interoperability is still often being approached as something layered onto existing systems rather than a capability built into their EHR core. Shifting Interoperability from Project to Infrastructure Interoperability isn’t a new need or a new concept; for years, health system IT departments have advanced compatibility through interfaces, integrations, and incremental improvements. This approach wasn’t wrong; in fact, it has enabled meaningful progress for more than a decade, and has expanded the ability for healthcare organizations to exchange data across systems. But, each additional connection requires implementation, ongoing maintenance, governance, and costs. Over time, these connections and improvements have also introduced significant complexity to systems that can and should be simple. That complexity has caused many health IT leaders to shift how they think about interoperability to the point that it is no longer viewed solely as a series of projects that somehow connect together. Instead, it is increasingly viewed as a continuous capability that must both be sustained and scaled. Despite this new focus on interoperability, only 16% of CHIME respondents reported that interoperability is capable through the core of their EHR system, highlighting the gap between strategic intent and architectural reality. Data Says That the Roadblocks are Resulting in Dollar Signs This dynamic isn’t about knowledge, skill, institutional support, or desire; instead, data points to cost. Healthcare leaders report that the financial burden of integration and ongoing maintenance remains a primary barrier to achieving interoperability at scale, and more than 47% of CHIME respondents cited cost as their biggest obstacle. Even as organizations invest in new technologies and standards, the underlying model can make it difficult to achieve progress without adding complexity. Foundational Challenges are Keeping Interoperability at Bay Cost may be the primary barrier slowing down interoperability for most health IT leaders, but it is not the only one. The foundational challenges of interoperability have remained consistent and it shows in the data. Vendor unwillingness and delays impact more than 42% of CHIME respondents working towards interoperability, lack of standardization stands in the way for 26% and IT staffing and internal resource constraints block the path for another 37%. In addition to these challenges, 47% of CHIME respondents ranked data silos and system fragmentation as a top concern when it comes to achieving interoperability. These are not new issues, nor are they the result of a lack of effort. Instead, they reflect the way healthcare technology has evolved over time, typically in response to immediate needs rather than long-term architectural alignment with the hospital’s needs and goals. The impact of these challenges becomes clearer when viewed at scale. Across millions of patient encounters each year, fragmented data can contribute to repeated testing, delays in information access, and increased administrative burden. These all contribute to increased financial pressure over time, a pressure made worse by the mounting cost of uncompensated care. Since 2000, hospitals have provided nearly $745 billion in uncompensated care. While many factors contribute to this, inefficiencies tied to disconnected systems remain monumental to the broader equation. Interoperability as an Enabler of Outcomes Looking past these challenges, the direction forward is increasingly clear, Interoperability is about connecting systems to enable positive outcomes. In the CHIME survey, 58% of CIOs cited improved care coordination as the most important potential result of interoperability, while 37% pointed to patient safety improvements and cost reduction. When interoperability functions as intended, it becomes part of the background, a silent partner that seamlessly supports the end goal for all clinicians and patients; the right data in the right hands at the right time. Clinicians need access to complete and timely information. Organizations can reduce duplication and streamline workflows. Patients experience more coordinated care across settings. In this way, interoperability facilitates essential infrastructure of all clinical decisions and outcomes. The industry has already made significant progress: standards continue to evolve, technologies are advancing, and strategic alignment is stronger than it has been in the past. The next phase of interoperability builds on this progress by establishing these advancements as the foundational core of the EHR and supporting clinical delivery at the point of care. As healthcare continues to evolve, the alignment between strategy and architecture will play an increasingly important role. Interoperability is required to be embedded, supported, and sustained as part of the core system. That is where the full value can be realized across the entire care continuum. About Sandra Johnson As Senior Vice President of Client Services, Sandra Johnson is responsible for delivering healthcare IT solutions and managing the customer experience to ensure CliniComp’s technology is continuously evolving to meet the changing needs within the healthcare community. Sandra oversees all aspects of the customer lifecycle including account & project management, application support, clinical services, cybersecurity, and learning & development for our global customer base.
ŌURA Launches Oura Ring 5: Embedding Live Blood Pressure Signals and GLP-1 Tracking Into Wearable Tech
What You Should Know Wearable technology leader ŌURA has officially launched Oura Ring 5, re-engineering its mechanical and electrical architecture to create a device that is 40% smaller than its predecessor. Moving past passive metrics, the latest software update introduces Health Radar, a clinical expansion featuring background tracking of blood pressure signals, nighttime blood pressure ... Read More
<img loading="lazy" width="1144" height="656" src="https://hitconsultant.net/wp-content/uploads/2026/05/Oura-Ring-5.jpg" alt="ŌURA Launches Oura Ring 5: Embedding Live Blood Pressure Signals and GLP-1 Tracking Into Wearable Tech" class="wp-image-96513" srcset="https://hitconsultant.net/wp-content/uploads/2026/05/Oura-Ring-5.jpg 1144w, https://hitconsultant.net/wp-content/uploads/2026/05/Oura-Ring-5-300x172.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/05/Oura-Ring-5-290x166.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/05/Oura-Ring-5-768x440.jpg 768w" sizes="(max-width: 1144px) 100vw, 1144px" /> What You Should Know Wearable technology leader ŌURA has officially launched Oura Ring 5, re-engineering its mechanical and electrical architecture to create a device that is 40% smaller than its predecessor. Moving past passive metrics, the latest software update introduces Health Radar, a clinical expansion featuring background tracking of blood pressure signals, nighttime blood pressure drops, and 30-day rolling respiratory data. For individuals managing anti-obesity medications, the application debuts GLP-1 Insights, unifying dosing schedules, subjective side-effect metrics, and weight profiles with continuous sleep and biometric tracking. The company is building out a connected care infrastructure by integrating an on-demand, AI-enabled clinical triage layer via Counsel Health, allowing users in 43 U.S. states to text licensed physicians directly inside the app. Oura Ring 5 is constructed from non-allergenic titanium with an extra-strong physical vapor deposition scratch coating, retails starting at $399, and begins shipping globally on June 4, 2026. Beyond Awareness to Action: Oura Ring 5 Unveils Proactive Health Radar and Connected Care Pathways The global consumer wearable sector has reached a critical structural turning point. For the past decade, the market has been dominated by wrist-worn smartwatches that primarily functioned as descriptive biometric scorecards—tracking raw daily step counts, capturing broad heart rate zones, and archiving basic sleep metrics. However, as consumers grapple with complex chronic conditions, rising healthcare costs, and expanding insurance navigation hurdles, the demand for technology has fundamentally shifted. Modern users are no longer satisfied with passive digital tracking that simply tells them they slept poorly or exercised frequently. They demand proactive, predictive intelligence capable of converting raw biometric noise into structured, clinical systems of action. Furthermore, as behavioral medicine increasingly merges with medical weight management therapies, the hardware housing these insights must evolve past bulky screens to deliver highly discreet, continuous, and lifestyle-integrated forms. To dismantle the traditional boundaries separating consumer electronics from proactive health optimization, smart ring pioneer ŌURA has announced the global launch of Oura Ring 5. Built on twelve years of categorical engineering, the device combines a massive architectural miniaturization with a comprehensive ecosystem of clinical health records, real-time activity tracking, and on-demand physician integration. Miniaturizing the Pulse: The Re-Engineered Architecture The core engineering triumph of Oura Ring 5 centers on a comprehensive overhaul of its underlying hardware parameters, achieving a 40% reduction in total size compared to Oura Ring 4 to establish itself as the world’s smallest smart ring. To construct this thinned, lightweight, non-allergenic titanium silhouette without sacrificing structural data accuracy, ŌURA re-engineered its mechanical, electrical, optical, and battery geometries from the ground up. The ring’s upgraded biometric signal layer integrates low-profile sensor domes for optimal skin contact, high-efficiency LEDs, and twelve dedicated signal pathways. This advanced hardware baseline guarantees a clean, continuous optical reading across diverse finger structures and skin tones. Crucially, the finger remains the optimal location for consumer biometric sensing. The local digital arteries deliver a clear pulse signal that is up to 100 times stronger than signals captured at the wrist, enabling Oura Ring 5 to track real-world cardiovascular indicators with a level of precision that legacy smartwatches cannot replicate. Pricing & Availability Crafted to withstand uninterrupted daily wear, the device features an extra-strong physical vapor deposition (PVD) coating for advanced scratch resistance, along with a dust- and waterproof rating up to 100 meters. Pre-orders open immediately, starting at $399 for base finishes (Silver and Black) and $499 for premium finishes (including modern Gold and Deep Rose), with global shipping scheduled to commence on June 4, 2026. Activating the Health Radar: Blood Pressure Signals and Sleep Regularity Alongside the miniaturized hardware, ŌURA has rolled out a sophisticated suite of preventative clinical software applications. Leading this transformation is Health Radar, a proactive monitoring matrix engineered in collaboration with more than 40 in-house medical doctors and Ph.D. scientists. Health Radar continuously analyzes background biometric signals to surface anomalous physiological patterns long before they escalate into acute medical issues. The primary clinical focus of the radar is the trackable measurement of Blood Pressure Signals. Cardiovascular strain is notoriously invisible during daily activity, obscured by stress, movement, and caffeine consumption. Oura Ring 5 solves this tracking dilemma by monitoring blood pressure patterns during sleep, a critical resting state when the human cardiovascular system outlines its truest condition. The app monitors nighttime dipping trends—alerting users when their biometrics point to a persistent lack of nocturnal blood pressure reduction, which serves as a vital early indicator of long-term cardiovascular risk. Users can also log manual cuff measurements directly into the interface to align real-world diagnostic numbers with their ongoing physiological data streams. To further expand its sleep and respiratory diagnostics, the platform integrates a 30-day rolling analysis of Nighttime Breathing disturbances. To transition these insights into direct medical care, ŌURA has partnered with home-health respiratory giant ResMed. Members documenting elevated respiratory interruptions can instantly access trusted diagnostic education, complete validated sleep assessments, and connect directly with independent medical professionals to evaluate potential home care pathways. Hardwiring Care Delivery and GLP-1 Adherence Tools Oura Ring 5 is positioning itself to serve as a primary, interoperable data link for connected care. Through its newly deployed Health Records module, the platform merges clinical data with daily wearable signals into a single, privacy-first longitudinal record. In the United States, members can securely sync eligible provider portals to import verified diagnoses, active medications, lab metrics, and allergen profiles. This function delivers a direct preview of ŌURA’s commitment under the Centers for Medicare & Medicaid Services (CMS) Health Technology Ecosystem pledge to seamlessly link interoperable clinical infrastructure with everyday biological signals. To bridge the gap between algorithmic insight and direct medical intervention, the app has embedded an on-demand, AI-enabled clinical triage layer in partnership with Counsel Health. The integration combines specialized medical language models with a dedicated network of licensed physicians. Members can ask complex health questions and receive clinical guidance from certified providers within minutes natively inside the app, a capability launching across 43 U.S. states. Concurrently, the platform has launched GLP-1 Insights to address the rapid rise of metabolic medication self-management. Instead of forcing patients to manage their therapy across disconnected apps, Oura integrates dosing records, user side-effect logs, and weight tracking directly with core biometric signals like sleep, readiness, activity, and metabolic stress. Through subsequent Lab Uploads, members can import blood biomarker results straight into the app, positioning hard lab data alongside continuous wearable trends for an exhaustive view of metabolic health.
Garner Health Secures $100M at $2.74B Valuation to Scale Clinical Quality Infrastructure
What You Should Know Healthcare data navigation and quality platform Garner Health has finalized a $100M Series E funding round, valuing the company at $2.74B. Led by Index Ventures, the round features significant continuation backing from blue-chip institutional investors including Kleiner Perkins, Redpoint, Thrive, Sequoia, Founders Fund, and Kaiser Permanente Ventures. Garner’s underlying financial infrastructure ... Read More
<img loading="lazy" width="1500" height="431" src="https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-1500x431.jpg" alt="Garner Health Secures $100M at $2.74B Valuation to Scale Clinical Quality Infrastructure" class="wp-image-96514" srcset="https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-1500x431.jpg 1500w, https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-300x86.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-290x83.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-768x221.jpg 768w, https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-1536x441.jpg 1536w, https://hitconsultant.net/wp-content/uploads/2026/05/Garner-Health-Logo-2048x589.jpg 2048w" sizes="(max-width: 1500px) 100vw, 1500px" /> What You Should Know Healthcare data navigation and quality platform Garner Health has finalized a $100M Series E funding round, valuing the company at $2.74B. Led by Index Ventures, the round features significant continuation backing from blue-chip institutional investors including Kleiner Perkins, Redpoint, Thrive, Sequoia, Founders Fund, and Kaiser Permanente Ventures. Garner’s underlying financial infrastructure generates approximately $200M in gross annual recurring revenue (ARR), doubling year-over-year for five consecutive periods. The platform addresses systemic waste by parsing an absolute data moat of 60 billion medical records across 320 million patients, evaluating providers using 550 proprietary clinical metrics. By routing nearly 2.5 million members to high-performing providers, the platform eliminates out-of-pocket friction for employees while delivering an average 12% reduction in total healthcare spend for enterprise employers in the first year alone. Reversing Out-of-Pocket Insurance Inflation: How Garner Health’s AI Agent Drives a 12% Cost Reduction The commercial health insurance landscape is operating under a punitive structural misalignment. For decades, the foundational economic model of American medicine has rewarded volume over absolute value—paying clinical providers for the sheer quantity of procedures they perform rather than the objective safety and durability of their patient outcomes. To protect margins against this systemic inflation, enterprise employers and commercial health plans have steadily shifted financial liability directly onto the consumer. This ongoing cost-shifting has triggered an out-of-pocket spending crisis. Patients face narrower network restrictions and compounding deductibles, left entirely in the dark regarding which physicians consistently practice evidence-based care. The economic fallout of this information deficit is severe. The single most critical choice in any medical journey is which doctor the patient engages. When individuals lack clear data, they routinely default to unverified referrals or low-performing clinicians. These providers are statistically more likely to drop modern medical guidelines, execute redundant diagnostic testing, and trigger avoidable complications. For self-insured corporations managing massive employee populations, this data fragmentation results in an unmanaged cost spiral that drains corporate capital and strains employee well-being. To reshape this broken marketplace and transition network design into an auditable system of action, healthcare transparency leader Garner Health has closed a landmark $100 million Series E financing round. Led by Index Ventures, with major participation from premier existing backers including Kaiser Permanente Ventures, Redpoint, Thrive, Sequoia, Founders Fund, and Kleiner Perkins, the injection pushes Garner’s market valuation to $2.74 billion. The fresh capital will be deployed to expand its provider intelligence platform, accelerate AI-native product deployment, and scale its benefits coverage across millions of new enterprise members. Parsing 60 Billion Records to Eradicate “Ghost Quality” Garner Health bypasses superficial doctor-rating models by constructing an elite commercial intelligence layer grounded in deep clinical reality. Rather than depending on subjective user reviews, Garner ‘s architecture analyzes a massive claims database encompassing over 60 billion medical records from 320 million longitudinal patient profiles. This infrastructure screens the performance of every clinician in the country across more than 550 proprietary clinical metrics. To maintain this dataset at scale, Garner has deployed a powerful dual-front AI strategy. Behind the scenes operates the Garner Research Agent, an advanced AI engine built to automatically ingest the latest peer-reviewed medical literature and instantly translate new guidelines into sophisticated data-parsing algorithms. By continuously matching live clinical records against cutting-edge research, the Research Agent verifies that Garner’s physician metrics remain uniquely rigorous and up to date. On the consumer side, the recently launched Garner Assistant serves as an intelligent front door for members. Operating inside corporate benefits portals, this conversational agent guides individuals through tedious care tasks: locating high-performing doctors, cross-referencing live appointment availability to book visits, and translating complex health plan documentation to check active claims, payments, and reimbursement statuses. Redefining the Economics of Consumer Behavior Change The true structural moat of the Garner ecosystem lies in its ability to combine clinical quality measurement with precise consumer financial incentives. Nick Reber, CEO and Co-Founder of Garner Health, noted that meaningful systemic change cannot occur through minor, incremental tweaks. It requires arming individuals with the definitive metrics and clear economic incentives needed to make optimal choices about their care. Under Garner’s model, when an employee utilizes the platform to select a top-performing provider, their employer steps in to cover the vast majority or entirety of their out-of-pocket costs. This transparent strategy drives immediate results: members pay on average 80% less out-of-pocket to access top-tier physicians. This clear value proposition eliminates care barriers, driving an unprecedented 46% of eligible members to actively utilize the system. This behavioral shift delivers a dual victory across the value chain. Top-performing doctors help patients recover faster while systematically avoiding unnecessary surgeries and uncalibrated prescription loops. For enterprise customers—which now include nearly 800 large-scale clients like USA Today, Paylocity, the University of Oklahoma, and global agricultural giant Archer-Daniels-Midland (ADM)—the clinical efficiency translates to a 12% reduction in total corporate healthcare spend in the first year alone. This immediate financial optimization has unlocked rapid commercial scaling. Garner’s gross annual recurring revenue (ARR) has reached approximately $200M, more than doubling for five consecutive years. Concurrently, provider networks like Mercy, Atlantic Health, Teladoc, and Marathon Health are directly embedding Garner’s data engines into their platforms to guide high-quality specialist referrals and audit internal practice patterns.
Ambience Healthcare Launches Chart-Aware Inpatient AI Suite to Resolve 91% of Documentation Gaps
What You Should Know Clinical AI leader Ambience Healthcare has announced a major expansion of its chart-aware intelligence across its enterprise inpatient platform, embedding deep chart reasoning into every phase of a hospital stay. Inpatient documentation relies heavily on non-conversational metrics; Ambience’s internal data shows that 70% of clinically important inpatient diagnoses have no signal ... Read More
<img loading="lazy" width="900" height="450" src="https://hitconsultant.net/wp-content/uploads/2025/11/image-2.png" alt="Ambience Healthcare Launches AI Conditions Advisor to Capture Full Patient Complexity" class="wp-image-92241" srcset="https://hitconsultant.net/wp-content/uploads/2025/11/image-2.png 900w, https://hitconsultant.net/wp-content/uploads/2025/11/image-2-300x150.png 300w, https://hitconsultant.net/wp-content/uploads/2025/11/image-2-290x145.png 290w, https://hitconsultant.net/wp-content/uploads/2025/11/image-2-768x384.png 768w" sizes="(max-width: 900px) 100vw, 900px" /> What You Should Know Clinical AI leader Ambience Healthcare has announced a major expansion of its chart-aware intelligence across its enterprise inpatient platform, embedding deep chart reasoning into every phase of a hospital stay. Inpatient documentation relies heavily on non-conversational metrics; Ambience’s internal data shows that 70% of clinically important inpatient diagnoses have no signal in a traditional audio transcript. The platform addresses severe provider cognitive load by automatically parsing longitudinal histories, daily labs, imaging updates, medications, and vitals to construct source-backed Progress Notes, H&P Notes, and Handoff Summaries. In multi-center evaluations across four health systems, Ambience’s chart-aware discharge summaries resolved 91% of information gaps that traditional, standard documentation pipelines had missed. Deployed at organizations like Saint Luke’s Health System, the solution has driven an active utilization rate exceeding 70% across core inpatient charting workflows while elevating provider Net Promoter Scores (NPS) by 31 points. Beyond the Transcript: Ambience Healthcare Unveils Inpatient AI That Reasons Outside the Bedside Recording The modern inpatient hospital ward operates under an immense, structural data squeeze. Unlike outpatient clinics—where patient interactions are typically episodic, isolated, and highly conversational—inpatient medicine is inherently continuous, fluid, and profoundly complex. Hospitalists routinely manage 15 to 20 highly acute patients simultaneously. Each individual’s clinical trajectory is dictated by a massive, fluctuating stream of day-over-day changes: shifting laboratory values, real-time vital tracking, new diagnostic imaging results, complex medication updates, and continuous clinical orders. The cognitive load required to manually process and synthesize this unceasing data burden is staggering. Faced with severe time constraints and fragmented shift handoffs, clinical teams frequently default to the dangerous practice of “carrying yesterday’s note forward.” This manual duplication saves immediate time but strips away critical medical context as a patient moves between departments and care teams. When documentation is incomplete or decoupled from the real-world trajectory of the patient, critical care gaps emerge. Most critically for the hospital enterprise, this data fragmentation means diagnoses are under-captured, preventing health systems from translating complex care into accurate billable codes and severely limiting revenue integrity. To eliminate this documentation crisis and transition hospital medicine into an automated system of action, clinical AI pioneer Ambience Healthcare has announced a major expansion of its chart-aware intelligence across its inpatient platform. By moving past standard ambient technologies that rely strictly on audio recordings, Ambience embeds deep chart reasoning into the entire inpatient arc—ensuring that documentation accurately reflects patient complexity and health systems capture the exact revenue they have earned. Eradicating the Outpatient Bias in Acute Care Environments The fundamental limitation of first-generation ambient medical AI is that it was engineered almost exclusively for outpatient care models. In a typical clinic setting, the software operates under a simple framework: a provider enters an exam room, records a conversation with a patient, and an algorithm translates that transcript into a standard clinical summary. In acute inpatient medicine, this model breaks down completely. In roughly half of all inpatient encounters, there is no active conversation to record. Even when a bedside dialogue does occur, the critical clinical variables that actually drive documentation and treatment—such as an overnight drop in hemoglobin or a targeted change in an IV medication dose—are executed entirely outside the speech transcript. Ambience’s analysis confirms the severe shortfall of audio-only approaches, revealing that 70% of clinically important inpatient diagnoses have no signal in the spoken transcript. For high-stakes conditions that dictate corporate coding and financial reimbursement, that blind spot is even wider. Ambience solves this structural limitation by engineering its AI to read, reason, and continuously monitor the patient’s complete electronic health record (EHR). Dr. Michael Han, Chief Medical Officer at Ambience Healthcare, noted that hospitalists have historically lacked tools built for their true day-to-day workflows. Because the overwhelming majority of what drives inpatient charting never enters an audible conversation, bringing chart-aware intelligence across the entire hospital stay ensures clinicians possess a holistic view of their patients—whether or not an audio recording is ever captured. The platform embeds this comprehensive chart awareness across five core technical pillars: Patient Summary: Instantly compiles a patient’s longitudinal medical history, allowing hospitalists to rapidly orient themselves before stepping into a room. History and Physical (H&P) Notes: Dynamically synthesizes bedside interactions with months of background chart data to build compliant, comprehensive intake documentation. Real-Time Triage & Diagnoses: Surfaces missed clinical conditions and provides precise ICD-10 coding recommendations backed by objective, verifiable chart evidence. Progress Notes: Replaces the legacy copy-forward trap by automatically building each day’s note from the previous day’s record combined with real-time laboratory, medication, and vital updates. Handoff & Discharge Summaries: Maintains a continuous synthesis of the hospital stay to enable clean clinical transitions, generating a complete, auditable discharge summary with a single click. Validated Performance and Widespread Clinician Trust The operational metrics surrounding Ambience’s inpatient deployment demonstrate a massive leap in data fidelity and provider satisfaction. In evaluations conducted across 66 distinct encounters at four major health systems, the platform’s chart-aware discharge summaries successfully resolved 91% of information gaps that standard documentation workflows had completely missed. This high level of accuracy has driven rapid enterprise adoption. At Saint Luke’s Health System, provider utilization across H&P notes, daily progress notes, and discharge summaries has soared past 70%, while the organization’s Net Promoter Score (NPS) surged by 31 points. To maintain this clinical trust, nearly 20% of Ambience’s internal workforce is composed of active or trained medical clinicians who are directly embedded within model training, product development, and validation pipelines. This continuous co-design ensures the software functions as a safe, intuitive asset that clinicians trust and rely on daily.
Teal Health and WashU School of Medicine Partner to Launch Cervical Cancer Screening Pilot
What You Should Know Virtual women’s health pioneer Teal Health has announced a strategic research collaboration with the Washington University School of Medicine in St. Louis to expand cervical cancer screening access. Orchestrated through the SCORE Initiative at Siteman Cancer Center, the pilot study targets women who have fallen out of touch with the traditional ... Read More
<img loading="lazy" width="1500" height="290" src="https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo-1500x290.jpg" alt="Teal Health and WashU School of Medicine Partner to Launch Cervical Cancer Screening Pilot" class="wp-image-96522" srcset="https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo-1500x290.jpg 1500w, https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo-300x58.jpg 300w, https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo-290x56.jpg 290w, https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo-768x148.jpg 768w, https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo-1536x297.jpg 1536w, https://hitconsultant.net/wp-content/uploads/2026/05/Teal_Health_Logo.jpg 1801w" sizes="(max-width: 1500px) 100vw, 1500px" /> What You Should Know Virtual women’s health pioneer Teal Health has announced a strategic research collaboration with the Washington University School of Medicine in St. Louis to expand cervical cancer screening access. Orchestrated through the SCORE Initiative at Siteman Cancer Center, the pilot study targets women who have fallen out of touch with the traditional healthcare system and routine preventative care. The community-based distribution model deploys Teal Health’s FDA-authorized at-home HPV (human papillomavirus) self-collection kits across trusted spaces like health fairs, food banks, and wellness initiatives in Illinois and Missouri. The study evaluates two distinct participant onboarding workflows: a self-directed digital track where women enroll independently using a QR code, and a guided track featuring on-site navigators for real-time enrollment and education. Researchers will closely monitor metrics crucial to enterprise clinical validation, including kit return rates, telehealth completion, follow-up care engagement for abnormal results, and overall patient experience. Moving Outside the Clinic: Why Teal Health and WashU Medicine Are Distributing At-Home HPV Kits via Food Banks The preventative oncology sector is confronting an acute equity and access crisis within its clinical trial and screening pipelines. Despite decades of evidence proving that routine cervical cancer screenings significantly lower mortality rates, millions of women across the United States remain dangerously overdue for care. The legacy screening model relies heavily on traditional, in-office pelvic exams—a system that introduces severe structural friction for underserved populations. Obstacles like lack of transportation, child care constraints, clinic hours that conflict with hourly work shifts, and past medical mistrust frequently push vulnerable patients out of touch with routine preventative loops. When women fall through these healthcare cracks, the clinical fallout is devastating. Cervical cancer is highly preventable when caught early, yet data fragmentation and rigid access models mean that diagnoses in underserved communities are often caught at advanced stages. For healthcare systems, academic medical centers, and Medicaid programs, resolving this gap requires moving past traditional campus-based medicine. Innovation must shift toward patient-centered, decentralized infrastructure that can safely meet individuals outside the clinic walls. To bridge this data wall and build a community-directed system of action, virtual women’s health company Teal Health has finalized a strategic research collaboration with the Washington University School of Medicine in St. Louis. Led by the SCORE Initiative—a dedicated project to increase the uptake of recommended cancer screenings at Siteman Cancer Center based at Barnes-Jewish Hospital and WashU Medicine—the collaboration launches a new pilot study to evaluate a decentralized, community-based distribution framework for cervical cancer prevention. Activating the Self-Collection Layer via Trusted Spaces The operational differentiator of the Teal Health-WashU Medicine integration is its focus on utilizing established community trust to drive clinical engagement. Rather than waiting for high-risk patients to navigate complex hospital scheduling lines, the pilot study directly routes Teal Health’s FDA-authorized at-home HPV self-collection kits into local community spaces across Illinois and Missouri. Kits will be distributed at highly accessible, routine touchpoints, including local wellness initiatives, regional health fairs, and area food banks. To optimize data collection and understand consumer behavior, the Institutional Review Board (IRB)-approved study is actively testing two distinct operational pathways: The Self-Directed Digital Track: Women independently enroll in the screening program and activate their profile on-site by scanning a localized QR code with their mobile device. The Guided Navigation Track: Specialized on-site medical navigators assist participants with real-time digital enrollment and deliver immediate clinical education during the community event. By offering a private, comfortable alternative to traditional clinic exams, the platform removes the primary physical and psychological barriers to proactive screening. Researchers will comprehensively track and evaluate multiple backend workflow milestones to measure success: kit return rates, telehealth consultation completion, overall participant satisfaction, and follow-up care engagement timelines for patients returning abnormal results. Kara Egan, CEO and co-founder of Teal Health, emphasized that for too long, cervical cancer screening has lacked the operational flexibility to easily fit into the realities of many women’s lives. The collaboration solves this friction by bringing advanced diagnostic capabilities into trusted community environments. This model provides a blueprint for a future where life-saving preventative care is genuinely accessible to everyone, everywhere. Scaling Interoperable Prevention Across Medicaid Networks For health plan administrators, academic networks, and community health organizations, the pilot delivers vital, real-world data on how to scale home-based diagnostic operations for historically hard-to-reach demographics. Nicole Miller, BSN, RN, an oncology nurse navigator from Siteman Cancer Network member Phelps Health in Rolla, Missouri, noted that integrating at-home self-collection directly enhances the standard of localized care. It provides a highly secure option for individuals who prefer privacy, serving as an important step toward ensuring cancer prevention is universally accessible. Michelle Silver, PhD, ScM, an epidemiologist and health services research member at Siteman and associate professor at WashU Medicine, highlighted the broader implications of the study. Silver noted that the collaboration provides an invaluable, real-world lens into the precise mechanics required to engage women who have fallen through the traditional screening infrastructure. The data generated from this pilot could fundamentally reshape regional and national approaches to cervical cancer prevention.