Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.

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Healthcare Tech

Nicole Ortiz

Healthcare Brew delivers the latest news and trends in healthcare.

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) giant Epic Systems has largely become a mainstay to many hospital providers, with last year being its biggest year yet as it added 176 multispecialty hospitals and more than 29,000 beds to its market, Fierce Healthcare 

 in May. That jump in growth brought the company to control 42.3% of the acute care EHR market.

So it only makes sense that there would be hospital employees whose entire job is to navigate Epic.

That’s where Sacramento, California-based UC Davis Health’s Kevin Fox, certified Epic systems telehealth analyst, comes in. He works to help coordinate virtual care for the 653-bed facility, and previously did similar work as an Epic analyst with Fresno, California-based Community Medical Centers and Newton, Massachusetts-based Atrium Health.

Healthcare Brew spoke with Fox about how his role works and the areas he’s most excited about in the industry.

This interview has been lightly edited for length and clarity.

How would you describe your specific job to someone who doesn’t work in healthcare?

I build telemedicine tools that integrate deeply into the hospital’s [EHR]. I specifically work on tools and workflows that link lower-populated areas to highly specialized physicians at UC Davis and other 

 that provide care and valuable research to advancement of the field.

What’s the best change you’ve made or seen at a place you’ve worked?

I’m implementing an integrated remote family visitation workflow for NICU babies and their parents. It’s simplifying the efforts for nurses and parents while creating clean data for research, which one researcher is already planning to use after the go-live. (Go-live is on Oct. 29.)

Of completed work, I was one of the first to lead a project in 

I’ve additionally created a novel method of 

. It involves countless interfaces and notification streams

What’s the most fulfilling aspect of your job?

, increasing patient access, and bridging the equity gap without adding costs to anybody while eliminating expenditures.

What healthcare trend are you most optimistic about?

Cancer research. It’s not related to what I do. We all just have a story, and I’m living through one with somebody. Seeing the progress the world has made with treatment is comforting.

What healthcare trend are you least optimistic about?

 continued existence due to their degradation of care incentives, constant cost increases, and government-accepted trait of doing as they want.

Tell us about one new or old health tech product or platform that’s made your life easier.

My whole livelihood has been predicated on 

. I’ve been building in it for 11 years across six modules. The expanse it has created is incredible, and though it has some rightful critics, physicians and nurses joining an Epic-running organization [after using other options] are always relieved to do so.

A look into a UC Health Davis telehealth analyst’s Epic role

Kevin Fox has spent his entire career in the electronic health record system.

illustrated headshot of caroline catherman, healthcare brew reporter

Caroline Catherman

Cassie McGrath

UnitedHealth Group, Cigna, and Humana all have something in common—besides being major health plans, that is.

They’re all currently facing lawsuits from patients alleging AI programs led to denied care. These suits claim (pun not intended) the insurance companies used AI-based algorithms to deny care without human oversight.

 of healthcare by leaders across the industry. AI scribes have 

 to give clinicians more face time with patients and better work-life balance, while also saving hospitals money. 

, able to carry out complex tasks autonomously, have turbocharged the tech’s potential.

 these tools are being adopted faster than safeguards, despite concerns about 

. Now, with all the emerging lawsuits, the outlook of AI in healthcare is looking even more complicated.

Fawad Butt, former chief data officer of Kaiser Permanente, UnitedHealthcare, and Optum, told Healthcare Brew there’s been a lack of oversight regarding “whether algorithms are behaving as good actors or bad actors.”

UnitedHealth spokesperson Eric Hausman told us it isn’t used for “adverse coverage decisions,” Cigna spokesperson Justine Sessions told Healthcare Brew AI isn’t being used to deny claims, and Humana didn’t respond to a request for comment.

But providers say the opposite—that plans 

 using AI for denials. While bigger health systems have more resources to appeal denials, some experts say independent rural hospitals

could be hit harder. A 2023 Stat investigation 

 UnitedHealth was using predictive algorithms to decide when some patients should be cut off from care.

Alexa McKinley Abel, director of government affairs and policy at the National Rural Health Association, said the research and advocacy organization is hearing rural hospitals are increasingly burdened by responding to prior authorization and claims denials because they have 

“If plans’ use of AI means even more prior authorization denials, then we would have concerns about the increasing paperwork and time associated with rectifying the denials for hospital staff as well as delays for rural patients that need to receive care,” she said.

The Centers for Medicare and Medicaid Services doesn’t require insurance companies to share how prior authorization decisions are made or how predictive technology is used in the process, so most of the evidence comes from providers, patients, or insurers that choose to self-report.

 from the National Association of Insurance Commissioners found 84% of 93 insurers used AI, with 50% saying they use it or are exploring its use to detect fraudulent claims, 68% for prior authorization approvals, 61% for disease management programs, and 45% for sales and marketing.

Only 9 of the 93 (12%) said they used or were considering using it to deny prior authorization requests.

Infinitus is an agentic communication platform that currently works with providers such as Medicare Advantage company Zing Health and Gramercy Surgery Center. The voice agent software can do things like conduct health risk assessments and handle specialty pharmacy prior authorization approvals for plans.

“The direction of travel for the industry is to introduce things that we fundamentally couldn’t do today because of a lack of human capital,” Infinitus CEO and founder Ankit Jain said.

On the other hand, healthcare providers and patients are using AI, too, for tasks like appealing denials. Startups 

 are an example of this, creating tools that collect patient and coverage information, then format and send a letter to the plan.

But insurers say some providers are taking AI too far.

Elevance CEO Gail Boudreaux alleged in a July earnings call “isolated pockets” of hospitals are using AI to “increase documented acuity,” driving up unit costs for the insurer. And Centene CEO Sarah London said in her company’s July earnings call that the insurer uses AI in response to that trend.

“As [hospitals] integrate AI into the revenue cycle, we’re integrating AI into payment integrity to make sure that we are sort of keeping pace with all of that,” London said.

Marc Douek, managing partner and co-owner at physiotherapy chain Renew Wellness, told us the chain cuts hours of work down to minutes by using a tool called Spry to automate prior authorization requests and appeals.

A 2024 American Medical Association survey found physicians and their staff spend an average of 13 hours a week completing prior authorization requests. It’s also an expensive process, as the healthcare industry 

 on prior authorization in 2023, according to the 2024 CAQH Index Report.

“Without using Spry in the automation…we wouldn’t be able to expand. We wouldn’t be able to treat our patients. We’d have to just turn people away,” Douek said.

Based on his conversations with insurers, Butt said providers have adopted AI faster—and insurers, which “haven’t adopted agentic [AI] as quickly,” now feel the tech has them “under the gun.”

“They’re left with old technology and humans responding to this deluge of appeals that are coming in from providers who just bought a software or an agent that essentially keeps appealing everything,” he said.

Butt is also co-founder of startup Penguin Ai, a platform intended to be a one-stop shop where both payers and providers can create AI agents. He believes both will need them in the future.

“What I predict is that it’s going to be agent wars galore,” he said.

Virtual Digital hand of Artificial Intelligence (AI). Healthcare technology and innovation concept. Hologram. 3d rendering

The AI arms race between insurers, providers has begun

Health plans have already been accused of using AI to deny patients. 

Back in 2008, Claire Guest started training dogs to detect the odor of bladder cancer… from her dining room.

As an animal behaviorist, she had read about the science and heard enough stories to believe dogs’ snouts, which have hundreds of millions of olfactory receptors (humans typically have just a few million), could 

. So she took samples from volunteers and people she knew to run tests.

“Even though it was a small-scale study, it was obvious the dogs could do it very reliably,” Gemma Butlin, head of communications and people engagement at Guest’s UK-based research organization and charity Medical Detection Dogs, told Healthcare Brew.

 in 2010, and has since been built out under the organization to study how dogs can detect bowel cancer, bacterial infections, Covid-19, pseudomonas, urinary tract infections, Parkinson’s disease, malaria, and prostate cancer. It collects samples from organizations like Hull University Teaching Hospital National Health Service Trust and Milton Keynes University Hospital in the UK and Johns Hopkins in the US.

With prostate cancer, for example, the novel detection method was 71% sensitive and 70%–76% specific at identifying high-grade Gleason 9 prostate cancer in the samples, according to 

“The science is very legitimate,” Bruce Trock, professor in the departments of urology, epidemiology, and oncology and director of the division of epidemiology in the Brady Urological Institute at Johns Hopkins, told us.

Their long-term goal is to build an e-nose that can do all the sniffing itself and “inform technology,” Butlin added. That’s because the charity is “never going to be able” to have enough dogs to send one into “every waiting room and tell everybody who thinks they might have cancer” that they should get tested, she said.

Dogs ideally begin training with Medical Detection Dogs at eight weeks old, Butlin said, with one year of socialization with volunteers. Then they kick off their “scent work.”

To start, dogs may be asked to find a tennis ball and are rewarded when finding it. Then training scales up to more difficult hiding places and smaller balls before there’s just a residue and they learn to search for the odor of the ball, Butlin said. Afterward, the dogs learn the scent of a disease the organization is studying.

At this stage, Butlin said, dogs are not meant to replace more traditional testing but instead be a first line of screening to help patients realize they may need to see a doctor.

“All of our work is geared toward early diagnosis,” Butlin said. “The earlier you can get checked out for these things, the better your survival rate is.”

With breast cancer, for example, the five-year survival rate is 99% when the disease is detected early in the localized stage, according to the 

. Butlin told us Guest’s own dog, Daisy, helped her detect her own breast cancer.

Dogs are ultimately sensing a difference between noncancerous cells and cancer cells, which use oxygen differently and consume more energy and nutrients while also emitting “different signals to other cells in their environment,” Trock said.

 In some cases, dogs will be sent into settings to sniff patients passively, but over the long term, researchers plan on developing the e-nose.

The charity has worked with tech company RealNose.ai for 10 years to develop technology that can do it without the snout.

“In the same way that your phone can scan you and tell you whether your blood pressure is high or you’ve had enough sleep…it might be able to tell a gentleman that his [prostate-specific antigen] levels are high and he’s at risk of prostate cancer,” Butlin said.

While Butlin doesn’t have an exact timeline for finishing the technology, she said she hopes it’s ready within 10 years.

“It’s fair to say [dogs] are the best biosensors on the planet at the moment. They are ahead of technology,” she said.

Back in the US, researchers are also working on understanding how dogs can detect disease.

 and the California-based nonprofit InSitu Foundation are all developing research and tools on the subject.

at the nonprofit American Kennel Club Canine Health Foundation, said the group is working in collaboration with researchers at the Penn Vet Working Dog Center to see if dogs can detect cancer in other dogs as well.

“Even though our mission is to advance the health of all dogs, a lot of times there’s benefit to humans,” she said.

, “have the potential to help in disease detection,” Trock said, as they remove potential human error from the testing process and are noninvasive. Though, he added, there’s still the potential for nonmorbid positives and requires a controlled environment.

“It’s likely that, just as with many other biomarkers currently in use or being investigated, e-noses will initially be used in conjunction with current standard of care methods, rather than as a replacement,” he said.

Cutout of a dog partially breaking out of the frame of a shape, with diamond-shaped icons on each side.

This UK charity is building an e-nose based on dogs that can smell cancer 

It started with one researcher in her dining room. Now the dogs are detecting several cancers and diseases. 

Maia Anderson

Although the psychedelic medicine industry faced a significant setback in late 2024 when the FDA 

 a front-running MDMA-based treatment, healthcare 

In fact, AbbVie, one of the largest pharmaceutical companies in the US, 

 in August plans to drop more than $1 billion to acquire a psychedelic drug in development from Gilgamesh Pharmaceuticals.

With states continuing to introduce and pass legislation to 

 psychedelics, Healthcare Brew asked leaders from across the industry their thoughts on psychedelic medicines, how they’re being integrated into the healthcare system, and what work still needs to be done.

Rachel Yehuda, endowed professor of psychiatry and neuroscience of trauma at Mount Sinai in New York, told us the healthcare industry is “in a transitional moment with psychedelic medicine.”

“We’re seeing growing interest from traditional institutions, including academic medical centers, government agencies like the Department of Veterans Affairs and National Institutes of Health, and pharma,” Yehuda said.

However, it’s still early days, as it’s hard to conduct clinical trials for psychedelic medicines and there are still “too few,” she added.

Mount Sinai in 2021 opened a psychedelic research center, renamed the Parsons Research Center for Psychedelic Healing in 2024, because the hospital believes it’s “essential to bring scientific rigor, clinical safety, and ethical clarity to this emerging field,” Yehuda said.

In order to safely integrate psychedelics into healthcare, key priorities should be making sure clinicians are trained properly, ensuring historically underserved communities 

 to the treatments, and conducting ongoing research, she added.

Jerry Rosenbaum, psychiatrist-in-chief emeritus as well as founder and director of Mass General Brigham’s Center for the Neuroscience of Psychedelics in Boston, told Healthcare Brew that while there’s uncertainty around the logistics of how psychedelic medicines may be delivered and reimbursed, he thinks it’s very likely several will eventually work their way through FDA approval.

That’s because some research suggests psychedelics are effective in treating or reversing many psychiatric conditions without the need for daily medication and are also often effective for patients who haven’t responded to existing treatments, according to Rosenbaum.

Psychedelics are most poised to treat psychiatric conditions such as treatment-resistant depression, generalized anxiety disorder, PTSD, obsessive-compulsive disorder, and substance use disorders, he said.

 on MDMA as a treatment for PTSD, for example, found 71% of 104 patients no longer had symptoms meeting PTSD criteria after treatment. And a 

 from psychedelic medicine company Usona Institute found psilocybin treatment was associated with a “significant sustained reduction” in depression symptoms.

Mass General Brigham founded the Center for the Neuroscience of Psychedelics in 2021 to “understand how psychedelic molecules act to change the brain in hopes of deepening our understanding of psychiatric conditions and to facilitate the discovery of novel therapies,” Rosenbaum added.

Andrew Whitman, a clinical pharmacist in hematology and oncology at UVA Health in Charlottesville, Virginia, told Healthcare Brew psychedelics have the potential to be particularly impactful for cancer patients.

“A lot of patients are dealing with the distress from cancer diagnosis and existing depression [or] anxiety. There’s a trauma response associated with the cancer diagnosis,” he said.

In his experience, providers in the oncology space are generally open to exploring psychedelic medicines since they work with such a vulnerable patient population, Whitman said.

 from Johns Hopkins found psilocybin therapy helped combat depression and end-of-life anxiety in cancer patients.

A potential benefit psychedelics could have is to allow providers to deprescribe other medications and be more minimalistic when it comes to prescribing, Whitman said. That way, patients don’t have to take medication every day.

“You’re really putting the work into working through the underlying cause…so it shifts that focus from daily use to a more holistic approach to making sure patients are being taken care of,” Whitman said.

However, psychedelics don’t work for everybody. There’s concern for people with conditions such as bipolar disorder or schizophrenia because psychedelics may potentially exacerbate their condition, Whitman added.

Leonardo Vando, medical director for Mindbloom, a telehealth company that provides ketamine therapy, told Healthcare Brew that while stigma around psychedelics still exists, he’s starting to see the healthcare system embrace the treatments.

“Academic medical centers are leading clinical trials, and health systems are increasingly exploring what it could look like to integrate psychedelic care responsibly. Even insurers are 

 closer attention,” he said. “We’re still in the early stages, but momentum is building.”

The three areas of focus to bring psychedelics more into the mainstream are research, access, and education, Vando said.

The industry needs to continue conducting rigorous research on psychedelics, as well as make sure the medicines are “affordable, scalable, and available to people from all walks of life, not just those with privilege or proximity to major research institutions,” he said.

And education is needed to combat misconceptions that psychedelic medicines are experimental or risky, Vando added.

“If we can deliver these treatments with compassion, structure, and integrity, they won’t just join the mainstream; they’ll help reshape it,” he said.

Healthcare execs on the state of psychedelic medicine 

While there’s still a long way to go, the industry is starting to embrace psychedelics. 

 that it had opened two new national security investigations, also known as Section 232 investigations, into personal protective equipment (PPE) and medical items as well as robotics and industrial machinery imports.

These investigations are a signal of possible tariffs on these products, as they ask companies to report how devices and their parts can, among other things, “meet domestic demand.” The probe began on Sept. 2 but wasn’t reported publicly until last week.

 in a Truth Social post 100% tariffs would be coming for certain imported drugs unless parent companies have started building a facility on US soil by Oct. 1. That’s 

 around whether pharmaceutical tariffs were coming and what they would look like. (In August, President Donald Trump 

As of publication, there are no specific tariffs on medtech or pharmaceuticals, though there 

 on goods from China and 20.8% for the rest of the world. Professional supply chain organization the Association for Health Care Resource and Materials Management reported these tariffs could increase hospital expenses “by at least 15%.”

“At the end of the day, tariffs are essentially a tax on fragility. Without smart exemptions and faster investment in domestic capacity, we risk raising today’s prices without actually protecting tomorrow’s supply,” Pankit Bhalodia, partner at consultancy West Monroe, told us in an emailed statement.

Mergers and acquisitions (M&A) in the medtech industry have been down so far this year, 

, which found there were 104 transactions in Q2 2025, compared to 128 in Q2 the year prior.

Managing director at PMCF Bryan Hughes told Healthcare Brew this can be connected to tariff-related market “uncertainty.”

“The tariffs have obviously been all over the place, and what we’ve seen is it’s really paused a lot of discussions around potential M&A activity, as well as other investments,” he said.

While Hughes said he’s watching to see how the Section 232 affects the market, he thinks activity will still remain slow amid the uncertainty. Otherwise, he’s keeping an eye on products like gloves, masks, and gauze, which are 

“I don’t think anyone knows what’s going to happen with tariffs,” he said, but there’s “much less room to absorb some of that cost pressure” from PPE used every day compared to medical devices.

These incoming pharmaceutical tariffs could impact $229 billion in drug imports to the US, the 

Big biotech companies like Johnson & Johnson, Eli Lilly, and GSK are dealing with tariffs by announcing new investments in US manufacturing facilities. Pfizer also 

 with the Trump administration on Sept. 30 to offer discounted drugs in exchange for waived tariffs for three years, so long as the pharma company continues to manufacture in the US.

But Bhalodia said reshoring a facility is a long process. Getting FDA validation for a new drug facility can be “multiyear efforts,” and the benefits “won’t be immediate,” he said.

Bhalodia expects prices for branded medicines will be impacted by tariffs but not as much as generic drugs, which he said will be hit harder. He predicts more market consolidation and M&A as a result.

“Any incremental tariff [for generics] could have a very immediate effect. There’s not enough margin to absorb that kind of shock,” he said.

Otherwise, Bhalodia said he thinks tariffs will drive technology adoption due to the “labor premium” from onshoring.

But, he added, pharmaceuticals “cannot afford to sit back.”

“They should be mapping where tariffs will hit, pressing suppliers to share in the cost burden, building 60 to 90 days of safety stock, and filing for exemptions where possible,” he said.

Cargo container hitting large-scale medical cross symbol.

Medtech, pharma tariffs loom over healthcare industry 

The healthcare industry should start preparing for tariffs, expert says.

It seems like there’s an app for everything these days. You don’t have to leave your house for food, work, or social interaction (though we hope you still do on that last one).Now, we’re getting closer to testing drugs digitally, too.

 in npj Digital Medicine in May that used data from 59,000 Mayo Clinic patients’ 

 (EHRs), combined with computer modeling, to predict whether 17 existing drugs could help treat symptoms of heart failure.

The researchers checked their predictions against existing clinical trial results. They found their digital clinical trials predicted whether or not the drugs could improve several heart failure prognostic markers with about 89% accuracy, according to Nansu Zong, a biomedical informatician at Mayo Clinic and lead author of the study.

Because it uses existing data on real-world outcomes of drugs, an approach like this can’t predict outcomes of drug candidates that haven’t gone to market. But it could one day be a screening tool that helps researchers decide whether to repurpose an existing drug to potentially treat a new disease.

“I don’t think our intention will be to replace the actual clinical trial but to provide some signals so that it will be more effective and more efficient,” Cui Tao, the Nancy Peretsman and Robert Scully chair of the AI and informatics department and VP of Mayo Clinic Platform Informatics, told Healthcare Brew.

The researchers plan to test this model on other health conditions, too, and the “ultimate goal” is to predict how well

drugs will work on a disease, not just whether or not they’ll work, Nansu Zong, a biomedical informatician at Mayo Clinic and lead author of the study, told us. This can help them decide whether a clinical trial will be worth it.

“If you are low risk, low probability to achieve your expectation, maybe you’re going to change your drugs or you’re going to change your trials,” Zong said.

 of studies using observational data to simulate randomized trials, a process called emulation. Randomized clinical trials are considered the most rigorous way to determine a cause-and-effect relationship, but they’re expensive to conduct.

Doing a virtual trial run like this can help save money. The R&D for bringing a new drug to market can cost $1.5 billion to $2.5 billion over an average of 10+ years. R&D for repurposing an existing drug is around $300 million and takes an average of three years, according to a 2024 

 by Duke University research institute the Duke-Margolis Institute for Health Policy.

Emulation also allows researchers to track real-world drug outcomes after they’re approved and get data from patients typically 

 in clinical trials, like older people, minorities, or people with comorbidities, Tao said.

 According to the study, this research went beyond other clinical trial emulations by incorporating drug-target prediction, an analysis that predicts the probabilities a drug will affect specific genes.

In this case, the researchers predicted the probability each drug would work on genes associated with heart failure.

The researchers found this was a more accurate method than EHR-based emulation alone, which had about 70% predictive accuracy in this study according to Zong. The paper notes, however, “drawing definitive conclusions about the method’s effectiveness at this stage would be premature.”

 The research “offers a great direction for helping to design more targeted trials,” Jimeng Sun, professor at University of Illinois Urbana-Champaign’s school of computing and data science and co-founder of Keiji AI—a generative AI platform for clinical research—told us.

“I think similar approaches can be expanded to other conditions like 

 if sufficient EHR data can be obtained,” Sun, who was not involved in this study, said.

One limitation, he added, is that outcome measures have to be data EHRs regularly include.

“Diseases with slow progression and without very clear outcome endpoints, like Alzheimer’s, will be difficult to adopt with these approaches,” he said.

The study’s researchers said they want to explore whether advanced simulation methods like AI can allow them to evaluate new, untested drugs as well.

“We are currently investigating the use of advanced simulation technologies to generate synthetic data, which may extend the framework to evaluating new drug candidates,” Zong said.

How Mayo Clinic researchers are using algorithms to predict drug efficacy

The tool may aid the selection of drug candidates in the not-too-distant future.

Congress is once again closing in on a deadline to extend Medicare coverage of home 

 services. And, again, the decision has been left until the last minute.

Telehealth has had new flexibilities since the 

 public health emergency began, including expanded Medicare reimbursement. Originally scheduled to sunset alongside the emergency’s declared end, these flexibilities have been 

 over and over again, often just weeks before planned expirations hit.

Congress has seen several bipartisan bills ranging from another 

 to even making some Medicare flexibilities for telehealth permanent. The House 

 an extension in a stopgap bill that aimed to avoid a looming government shutdown, but the Senate 

If nothing is passed, on Oct. 1, many Medicare members won’t be able to access telemedicine from their homes anymore.

Even if an extension is passed, this uncertainty still impacts providers’ businesses, leaving them struggling to plan for a potential future where they might lose a chunk of their patients, experts told us.

“For us in the industry, it creates operational and administrative burdens to ensure we are compliant. For patients, the uncertainty creates a lack of trust,” Taya Gordon, CEO of Atlas and Perpetua Healthcare Consulting and government affairs committee member for the professional organization Medical Group Management Association (MGMA), said.

 If the flexibilities go away, most Medicare patients will have to take telehealth appointments from a provider’s office, hospital, or skilled nursing facility. They won’t be able to take calls from home unless they’re getting treatment for mental health or a substance use disorder, or a few other narrow exceptions.

Other restrictions will also come back into play. Telehealth will once again be limited to patients in a rural health professional shortage area, within a federal telehealth demonstration project, or in a county that isn’t in a metropolitan statistical area.

Each time these flexibilities get close to expiring, medical groups must plan how to transition telehealth appointments to in-person appointments and budget for the cost of losing some patients, Anders Gilberg, SVP of government affairs for MGMA, told Healthcare Brew over email.

Amid this repeated “headache,” some providers are “seriously thinking about eliminating” telehealth and remote patient monitoring, Tom Leary, SVP and head of government relations of the Healthcare Information and Management Systems Society, told us.