The Prior Authorization Reset: What AHIP’s Latest Move Signals for the Industry

The healthcare industry has reached a breaking point on prior authorization.

Long criticized for delaying care, increasing administrative burden, and frustrating both providers and patients, prior authorization is now undergoing one of the most coordinated reform efforts in recent history.

The latest announcement from America’s Health Insurance Plans marks a meaningful escalation in that effort.

What Just Happened

In its latest update, AHIP outlined the next phase of industry-wide commitments to streamline and simplify prior authorization across commercial, Medicare Advantage, and Medicaid managed care populations.

At its core, the initiative focuses on five structural changes:

• Standardizing electronic prior authorization workflows

• Reducing the number of services requiring prior authorization

• Ensuring continuity of care during plan transitions

• Improving transparency and communication on decisions

• Expanding real-time approvals

The intent is clear: move prior authorization from a fragmented, manual process to a standardized, digital, near real-time system.

The Numbers Behind the Momentum

This is not just a policy announcement. Early execution is already underway.

• Health plans have eliminated approximately 11% of prior authorization requirements, equating to millions fewer approvals required annually

• The initiative impacts coverage affecting over 250 million Americans

• The industry is targeting 80% real-time electronic approvals by 2027

At the same time, major payers are beginning to standardize submission requirements and digitize workflows at scale.

Why This Matters More Than It Looks

This is not incremental improvement. It is structural realignment.

Historically, prior authorization has been:

• Manual

• Inconsistent across payers

• Highly administrative

• Reactive rather than predictive

The AHIP initiative signals a transition toward:

• Interoperability-first workflows (FHIR-based APIs)

• Automation and real-time decisioning

• Standardized clinical and administrative requirements

• Reduced reliance on manual review processes

This is effectively the digitization of utilization management at scale.

The Strategic Implication: Control Is Shifting

The deeper implication is not operational. It is competitive.

For years, payers controlled friction through prior authorization. That friction acted as a gatekeeping mechanism for cost, utilization, and risk.

Now:

• Standardization reduces payer differentiation in process

• Automation reduces administrative leverage

• Transparency increases accountability

The battleground is shifting away from control of approvals toward:

• Clinical value

• provider experience

• workflow integration

• speed of decision-making

In short: prior authorization is moving from a control tool to a service layer.

The Reality Check

Despite progress, skepticism remains.

Physicians still report high administrative burden, averaging dozens of prior authorization requests weekly.

And key gaps remain:

• Prescription drug prior authorization is not fully addressed

• Provider adoption of new digital workflows is uneven

• Interoperability execution is still early-stage

This means the industry is in transition, not resolution.

What Healthcare Leaders Should Be Watching

This shift creates immediate implications across the ecosystem.

Health Plans

• Must modernize UM infrastructure rapidly

• Need to operationalize FHIR-based workflows

• Risk falling behind if execution lags commitments

Providers

• Will benefit from reduced friction

• But must invest in digital integration to realize gains

Health Tech & Services Companies (Safeguard positioning)

• Massive opportunity in:

  • workflow optimization

  • API integration

  • prior auth automation

  • data standardization

The Bottom Line

AHIP’s latest move is not just about simplifying prior authorization.

It is about redefining how care access decisions are made, processed, and experienced.

The winners in this next phase will not be those who reduce prior authorization the fastest.

They will be the ones who rebuild the system around speed, transparency, and seamless workflow integration.

Rural Hospitals Have a Narrow Window to Use the New $50 Billion Federal Fund Wisely

Rural hospitals are under pressure from every direction: tighter margins, workforce shortages, administrative burden, and rising costs. The urgency is not theoretical. The UNC Sheps Center reports 195 rural hospital closures or conversions since January 2005, including 152 since 2010. Separately, the American Hospital Association cited Sheps data showing that proposed federal cuts in 2025 could place more than 300 rural hospitals at risk of closure, conversion, or service reductions. The AHA’s 2026 cost report also found that hospital expenses grew 7.5% in 2025, with workforce costs up 5.6%, supplies up 9.9%, and drug costs up 13.6%.

That is the backdrop for the federal Rural Health Transformation Program, the new $50 billion rural health fund administered by CMS. The program makes $10 billion available each year from fiscal 2026 through fiscal 2030. CMS states that 50% of each year’s funding is distributed equally among approved states, while the other 50% is allocated based on factors such as rural population, rural facilities, and hospital conditions in the state. CMS announced first-year awards to all 50 states on December 29, 2025, with 2026 awards averaging about $200 million per state.

This matters, but the structure of the fund matters even more. KFF notes that the money is temporary, while many of the underlying financial pressures are not. The law provides funding only through 2030, funds must generally be spent by the end of the following fiscal year, and all funds must be spent before October 1, 2032. KFF also notes that the fund was created against a backdrop of much larger projected Medicaid reductions, meaning the rural fund can help stabilize and modernize systems, but it is not a permanent operating backstop.

The practical implication is simple. Rural organizations should not treat this as bailout money. CMS explicitly frames the program around sustainable transformation. The program allows states to fund training and technical assistance for technology-enabled solutions, software and hardware for major IT advances, cybersecurity capability development, technology-driven chronic disease tools, and coordination models that let rural facilities share operations, technology, primary care, specialty care, and emergency services. CMS also says states should prioritize long-term improvements rather than perpetual operating expenses.

That is where EHR strategy becomes central. CMS specifically says upgrades, enhancements, added modules, interfaces, and new functionality for existing EMR or EHR systems are allowable uses of funds and are not subject to the program’s 5% limitation. The 5% limit applies to replacing an existing certified EMR with a completely new one. CMS also says those upgrades should align with CMS and ASTP/ONC interoperability criteria. In other words, rural hospitals do not have to choose between doing nothing and ripping everything out. They can use the fund to strengthen what they already have, connect it better, or selectively move toward a more scalable model.

That makes shared and managed EHR models highly relevant. Epic says health systems have used Community Connect since 2007 to extend their Epic instances to nearby medical groups, allowing them to gain access to Epic without hiring internal support teams or purchasing infrastructure. Epic also says more than 1,000 hospitals and 22,000 clinics using Epic are now live on TEFCA through Epic Nexus, underscoring the growing importance of networked interoperability. Outside Epic, Oracle positions CommunityWorks as a fully managed model for community, rural, and critical access hospitals, and MEDITECH positions MaaS as a cloud-based model that gives smaller organizations enterprise-level tools without major capital investment or on-premise infrastructure.

The case for these models is not just vendor marketing. ASTP’s 2023 hospital interoperability brief found that only 36% of rural hospitals were routinely interoperable, compared with 47% of urban hospitals. It also found that only 22% of independent hospitals were routinely interoperable, versus 53% of system-affiliated hospitals. More broadly, 71% of hospitals said necessary outside clinical information was routinely available at the point of care, but only 42% said clinicians routinely used it when treating patients. That gap is exactly where better implementation, cleaner interfaces, stronger governance, and smarter workflow design matter.

The fund’s rules also make clear what disciplined execution looks like. Broadband infrastructure is not an allowable use of funds. New construction is not allowed. Minor alterations and renovations are capped at 20% of the total award in the childcare example CMS gives. Provider payments are capped at 15% of a state’s award for that category and must tie to specific transformation initiatives and outcomes. CMS has already appropriated the full $50 billion, but it expects states to avoid duplication, avoid supplanting existing funding, and build plans that survive after the federal money ends.

So the real opportunity is not “buy software.” It is to build a rural health operating model that can last after the grant period. For some organizations, that will mean Epic Community Connect. For others, it will mean optimizing an existing platform, adding interoperability layers, tightening cybersecurity, improving referral and transfer workflows, enabling telehealth or remote monitoring, or moving to a managed platform better suited to a rural cost structure. The wrong move is chasing a large technology purchase without a sustainable operating model behind it. The right move is using this funding window to reduce fragmentation, strengthen local access, and create an implementation plan that a rural organization can actually support five years from now.

That is the opening for experienced execution support. Rural hospitals and health systems do not just need strategy decks. They need help evaluating whether to stay, optimize, connect, or migrate. They need program governance, vendor selection discipline, interface planning, legacy data strategy, implementation management, workflow redesign, and change management that fits the realities of rural operations. This is the kind of work Safeguard Consulting Group can support: practical, execution-focused help for rural health initiatives involving Epic Community Connect, interoperability modernization, and right-sized EHR strategies for smaller systems.

The $50 billion rural health fund is real. The window is finite. Rural organizations that turn it into durable operational and clinical improvement will be in a far stronger position than those that treat it like temporary relief

The Coding Game Is Over. Most Payers Haven’t Realized It Yet.

For years, payers found a reliable way to grow.

Document more.
Code better.
Capture more risk.

It worked so well that entire operating models were built around it. Vendors scaled. Teams expanded. Technology followed.

Revenue didn’t just come from managing health.
It came from how well you described it.

That model is now breaking.

And most organizations are still playing by the old rules.

What’s changed isn’t subtle.

Oversight on risk adjustment is tightening.
Payment pressure is increasing.
Medical costs are accelerating faster than premium growth.

The result is simple.

You can’t code your way to growth anymore.

This is where the disconnect starts.

Most payer organizations are still optimized for documentation, not outcomes.

They are built around:

• Retrospective chart reviews

• Coding audits and vendor programs

• Documentation capture strategies

All of it designed to make sure nothing is missed.

But nothing about that model actually improves the health of a member.

It just improves how the condition is recorded.

That distinction didn’t matter as much before.

Now it does.

Because growth is shifting.

Not from how well you capture risk.
But from how well you manage it.

And that’s a completely different capability.

It requires identifying risk earlier.
Intervening in real time.
Closing care gaps before they turn into cost.

That’s not a coding function.

That’s operational execution.

Here’s the problem.

You can’t take a system designed to look backward
and expect it to perform looking forward.

The workflows don’t match.
The incentives don’t align.
The infrastructure isn’t there.

And yet, many plans are still trying to stretch documentation engines into clinical ones.

At the same time, the economics are shifting underneath them.

The return on coding optimization is shrinking.
The cost of poor outcomes is rising.

Avoidable admissions.
Chronic disease mismanagement.
Member churn tied to experience.

These aren’t side issues anymore.

They are margin drivers.

This is the part most organizations are underestimating.

Coding is no longer the strategy.

It’s the baseline.

Everyone is expected to get it right.
No one is going to win because of it.

The winners will be the plans that move first.

The ones that shift from retrospective capture
to proactive intervention.

The ones that stop asking, “Did we document it?”
and start asking, “Did we change it?”

Most payer organizations won’t make this shift quickly.

Not because they don’t understand it.
But because their entire operating model is built for something else.

And that’s where the opportunity sits.

The coding game isn’t evolving.

It’s ending.

The only question is how long it takes before your organization realizes it.

Why Healthcare Providers Are Spending Billions Just to Get Paid

Getting paid in healthcare should be simple.

It isn’t.

Providers are now spending over $25 billion a year just working through claims. Not because the claims are wrong, but because the process is.

About 15% of claims get denied upfront. That sounds reasonable until you realize most of them are eventually approved and paid anyway.

That means the system is not catching bad claims. It is slowing down good ones.

Every denial triggers the same loop. Review. Resubmit. Wait. Repeat. Weeks turn into months. Multiply that across thousands of claims and the cost explodes.

This is not a technology issue. It is a workflow problem built into the system itself.

Then there is prior authorization. Providers ask for approval before care. They get it. Then the claim can still be denied later.

So now they ask for permission, receive permission, and still have to fight to get paid.

That is not control. That is duplication.

The impact is immediate. Hospitals are operating with tighter margins than they have in years. Cash is delayed. Staff is tied up in administrative work. Investment in care gets pushed out.

At the same time, these inefficiencies drive up costs across the system, contributing to higher premiums.

Nothing about this is accidental. The system is doing exactly what it was built to do.

The problem is what it was built to do no longer makes sense.

Most denied claims end up getting paid. Billions are spent proving what was already true.

Until payer rules are standardized, unnecessary approvals are reduced, and claims are validated before submission, this does not change.

Providers will keep funding a process that works against them.

Hospitals in a Doom Loop: Why Healthcare Is Slowing Down as Spending Rises

Hospitals are doing more than ever and getting less done.

Spending is up. Staffing levels have increased. Technology investment has never been higher. Yet patients are waiting longer, outcomes are slipping, and frontline staff feel like they are moving slower, not faster.

A recent analysis from The Economist puts a name to what many operators already know: hospitals are stuck in a self-reinforcing loop that is degrading performance instead of improving it.

The Shift No One Reversed

The healthcare system did not recover from the pandemic. It adapted to dysfunction.

During COVID, hospitals were forced into reactive mode. Elective procedures stopped. Throughput collapsed. Backlogs built. Staff stretched beyond sustainable limits.

That was expected.

What wasn’t expected is that the system never returned to baseline. The temporary state became permanent.

Patients came back sicker. Staffing came back less experienced. Processes came back slower.

And the system locked into a new equilibrium.

A worse one.

The Loop That Is Breaking Hospitals

The problem is not isolated. It compounds.

Patients wait longer to be seen.
Longer waits mean more advanced illness.
More advanced illness requires longer, more complex care.
Longer care blocks beds and staff.
Blocked capacity increases wait times again.

This is not congestion. It is a feedback loop.

Hospitals are no longer dealing with volume spikes. They are operating inside a system that continuously manufactures delay.

Why More Money Made It Worse

The instinctive response has been to add resources.

More staff. More funding. More capacity.

But output has not followed.

Because healthcare is no longer constrained by inputs. It is constrained by flow.

Adding staff into a slowed system does not increase throughput. It often reduces it. Newer clinicians require more coordination. Decision-making slows. Variability increases.

At the same time, every patient now consumes more time.

Deferred care during the pandemic created a wave of higher-acuity cases. Chronic illness is rising. Aging populations are increasing demand intensity, not just demand volume.

So even as staffing numbers rise, effective capacity falls.

More people. Less movement.

The Flow Problem No One Owns

Hospitals are not failing on the inside. They are failing at the edges.

A patient who cannot access primary care shows up in the emergency department.
A patient who cannot be discharged stays in a hospital bed.
A patient who needs post-acute care waits because no placement exists.

Every breakdown outside the hospital becomes a bottleneck inside it.

Beds turn into holding areas. Emergency departments turn into queues. Clinicians spend time managing movement instead of delivering care.

What looks like a hospital problem is actually a system problem.

But no one owns the system.

Technology Didn’t Solve It

The industry invested billions into platforms like Epic and Cerner.

Data is everywhere.

But movement is not.

Most systems were built to document care, not accelerate it. They capture information but do not coordinate action in real time. They add visibility without removing friction.

The result is a paradox.

More data. Slower decisions. Lower throughput.

What This Actually Means

Healthcare is not collapsing from lack of investment.

It is stalling from lack of coordination.

Until systems are redesigned around flow, nothing else scales. Not staffing. Not funding. Not technology.

The organizations that break this loop will not be the ones that spend more.

They will be the ones that move faster.

Because in the current environment, speed is capacity.

And right now, capacity is the one thing healthcare no longer controls.

AI in Payer Operations: Efficiency Tool or Legal Liability?

The payer industry is moving fast on AI.

Claims are being automated. Prior authorizations are being streamlined. Risk adjustment is being augmented. Call centers are being replaced with conversational models.

The story everyone is telling is simple.
AI drives efficiency. Efficiency drives margin.

That story is incomplete.

What’s actually happening is this:
AI is moving faster than the controls required to manage it.

And that gap is where the real risk sits.

AI is no longer a support tool. It’s embedded directly into decision-making.

It determines whether a claim is paid.
It influences whether a prior authorization is approved.
It flags what gets reviewed and what gets ignored.

That shift matters.

Because once AI starts making decisions, you’re no longer optimizing workflows.
You’re automating judgment.

And most organizations are not set up to govern that.

There’s a problem building under the surface that few teams are willing to say out loud.

First, accountability starts to break down.

When a decision is driven by an algorithm, ownership becomes unclear.
Was it the plan? The vendor? The model?

In a manual process, responsibility is obvious.
In an automated one, it fragments.

Second, explainability becomes a real issue.

It’s easy to say a model flagged something.
It’s much harder to explain why in a way that stands up to audit, appeal, or legal review.

If you can’t clearly defend a decision, the efficiency you gained becomes irrelevant.

Third, and most important, mistakes scale.

A human makes errors one at a time.
AI makes them thousands at a time.

If the logic is flawed, the impact isn’t contained. It compounds quickly and quietly.

By the time it’s discovered, the exposure is already material.

This is where the industry is headed.

AI-driven decisions are starting to attract scrutiny.
Litigation is emerging.
Regulators are behind, but not indefinitely.

The imbalance is obvious.
Decision velocity is increasing. Oversight is not.

That doesn’t hold for long.

The mistake most payers are making is treating AI like a technology upgrade.

It gets handed to IT.
It gets implemented through a vendor.
It gets measured in terms of cost reduction.

That framing misses the point entirely.

AI in payer operations is not just a technology layer.
It is a decision layer.

And decision layers require control, accountability, and governance.

Right now, many organizations don’t have that foundation in place.

What needs to change is straightforward, but not easy.

Every automated decision needs to be traceable.
Every outcome needs to be explainable.
Every workflow needs to be defensible.

Not in theory. In practice.

Human oversight isn’t going away in high-risk areas.
It just needs to be redesigned around the system, not bolted on after the fact.

AI will continue to expand across payer operations. That’s not the question.

The real divide will be between organizations that deploy it
and organizations that can defend it.

Because the next wave of pressure won’t come from innovation.

It will come from scrutiny.

The question is no longer whether to use AI.

It’s whether your organization can stand behind the decisions it makes when AI is involved.

The White House Built a “News App.” It Looks a Lot Like Surveillance

The White House recently launched a mobile app described as a direct, unfiltered news feed. On the surface, that sounds like a simple modernization of communication—cut out the middleman, deliver information straight to the public, and control the narrative without distortion.

But that framing breaks down the moment you examine how the app actually behaves.

This is not just a content platform. It is a government-operated application with system-level access to personal devices, and that changes the conversation entirely.

A typical news app has a narrow purpose. It delivers articles, videos, and notifications. It does not need to know where you are, who you are beyond a login, or what else exists on your device. It certainly does not require biometric identifiers or the ability to control how your device operates in the background.

This app does.

The permissions tell the real story. Ignore the branding and look at what the application actually requests: precise location access, full network connection visibility, biometric and fingerprint authentication, the ability to prevent the device from sleeping, and permission to modify or delete contents in shared storage.

A standard news app does not need this level of access.

Each of these permissions can be explained away in isolation. Together, they form something very different. They enable continuous location awareness, persistent background activity, identity-level linkage, and access to user-stored data. That combination is not about improving a user experience. It is about establishing infrastructure-level control.

The more important issue is not just what the app can access, but what happens after that access is granted. There is limited transparency around how data is collected, how frequently it is transmitted, whether it is shared with third parties, and how long it is retained. In any other context—particularly one involving sensitive systems—this lack of clarity would immediately trigger scrutiny.

That’s where the healthcare IT lens becomes useful.

In healthcare, systems are built around strict principles of data minimization, explicit consent, and traceability. Under HIPAA, organizations are required to justify every piece of data they collect, define exactly how it is used, and maintain auditable controls over access and retention. An application requesting this level of access without clear disclosure would not pass a compliance review. It would be flagged as a risk.

Outside of healthcare, those standards are not consistently applied. Consumer applications—and increasingly, government-facing platforms—operate in a gray area where capability often outpaces governance. That gap is where concern should live.

Because when you combine a direct government communication channel with deep device-level permissions and unclear data practices, the result is not just a better way to distribute information. It is the foundation for something much broader: the ability to link identity, behavior, and environment in a continuous and largely invisible way.

This is why comparisons to Big Brother continue to surface. Not because of rhetoric, but because of structure. A centralized authority controlling its own messaging, operating through devices people carry at all times, with the technical capability to observe and collect data at scale.

The difference is that this model is not imposed. It is adopted. Users download the app, grant permissions, and carry it with them voluntarily. That makes it more efficient, more scalable, and far less visible than anything imagined in Nineteen Eighty-Four.

If this were just a news app, it would behave like one.

It doesn’t.

At a certain point, the distinction between communication and surveillance stops being theoretical. It becomes architectural.

And once that shift happens, the warning is no longer metaphor.

Big Brother is watching.

Infosys Acquires Optimum Healthcare IT: Healthcare Transformation Is Being Consolidated

The acquisition of Optimum Healthcare IT by Infosys is not just another services deal. It is a clear signal that healthcare transformation is no longer driven by niche expertise. It is being consolidated by global platforms.

If you are a healthcare executive, this directly impacts how you choose partners, how your systems evolve, and how much control you retain over your transformation.

Scale Is Replacing Specialization

For years, firms like Optimum Healthcare IT built their reputation on deep provider-focused expertise, especially in EHR implementation, optimization, and large-scale system transformation.

That model is now being absorbed.

Infosys is not acquiring Optimum to preserve a boutique consulting approach. It is acquiring it to industrialize that expertise and plug it into a global delivery engine powered by AI, automation, and offshore scale.

This changes the value proposition.

Healthcare organizations are no longer buying expertise alone. They are being sold platforms, delivery models, and long-term dependency on a single ecosystem.

This Is About Control, Not Capability

On the surface, this looks like a win for healthcare providers:

• Broader capabilities

• End-to-end transformation services

• Access to global innovation and AI

But the dynamic shifts underneath.

When transformation is owned by large integrated firms:

• Control moves away from the provider

• Flexibility decreases

• Standardization increases, whether it fits your organization or not

As consolidation increases, the number of truly independent advisors shrinks.

The End of Fragmented Vendors

Healthcare organizations used to assemble their own ecosystem:

• One firm for advisory

• Another for implementation

• Another for optimization

That model is disappearing.

Large firms like Infosys are building closed-loop service models:

Strategy to implementation to managed services to optimization, then repeat.

Once you enter that loop, exiting becomes difficult. This is intentional.

AI Is the Justification, Not the Strategy

Every acquisition today is framed around AI, cloud, and automation.

Those drivers are real, but they are not the core strategy.

The strategy is consolidation.

AI makes consolidation easier to justify and easier to sell.

By combining Optimum’s provider expertise with its own AI and cloud platforms, Infosys strengthens its position as a single-source partner. The real question for healthcare organizations is whether they are adopting AI to improve operations or to fit into a vendor-controlled platform.

What Healthcare Leaders Should Be Asking

Most organizations will evaluate this type of acquisition at a surface level. That is a mistake.

The real questions are:

• Who owns your transformation roadmap, your team or your vendor

• How easily can you switch partners once you are embedded in a global delivery model

• Are you buying outcomes or committing to long-term dependency

This shift creates dependency at scale.

The Market Is Moving Toward Fewer, Larger Players

This deal is part of a broader pattern. The healthcare IT services market is consolidating around a small number of global firms that offer:

• Deep vertical expertise

• Scalable delivery models

• Integrated technology platforms

This combination is powerful, but it reduces choice.

As consolidation accelerates, healthcare organizations will face fewer alternatives, less negotiating leverage, and increased exposure to vendor-driven strategies.

Where This Leaves You

If you are leading digital transformation in a healthcare organization, the takeaway is direct.

Stop evaluating vendors based only on capability. Start evaluating them based on control.

Capability is now expected.

The real differentiators are:

• Who owns the data

• Who controls the roadmap

• Who dictates the pace of change

Infosys acquiring Optimum Healthcare IT is not just another transaction. It marks a shift.

Healthcare transformation is being centralized, standardized, and scaled.

If you are not actively managing that shift, you are being absorbed by it.

Epic, Microsoft collaboration will bring AI technology to healthcare

Thanks to a collaboration between Epic Systems and Microsoft, healthcare providers can now receive a time-saving hand from generative AI technology that drafts responses to patient messages and inquiries.

For years, Microsoft has allowed Epic to use the cloud hosting platform Azure as part of their longstanding collaboration, Garrett Adams, product lead for Epic’s Ambulatory Research and Development Division and member of the Cognitive Computing Platform team, said. 

The recent expansion involves the use of Azure OpenAI, which Adams described as a large language model that is “very good at predicting the next word.” This specific technology has been trained over a large collection of information to draft responses to patient messages for providers.  

“It is really a master of language,” Adams said. 

Utilizing OpenAI will save an incremental amount of time for the provider to respond to patients, Adams said. This became especially relevant after the pandemic, which saw a large rise in telehealth services and patient messaging. 

The asynchronous messaging model happened to prove itself so useful during the pandemic that it stuck around, Adams said. The goal now is to reduce the workload associated with responding to such messages. 

“This overall has incredible potential in our industry to reduce the administrative burden, to automate mundane tasks and to give providers as much as that face-to-face time with patients as possible,” he said.  

By using the Azure OpenAI service, Epic can leverage patient data and information securely because it is HIPAA compliant, Adams said. 

Adams emphasized the AI technology provides draft messages, meaning the messages are not automatically sent. Healthcare providers can review the AI generated message, modify and then send it – or opt to draft a blank message as they would’ve before. 

An example of the technology is when patients reach out to providers for information about medication refills. The AI brings in additional information from the chart in a secure, private way and combines that data with the patient request – along with some additional cues for sentence structure and tone to avoid sounding robotic, Adams said. 

Generative AI is also being used in Epic’s reporting tool SlicerDicer to enhance conversational support, Adams said. Through SlicerDicer, providers can customize searches and find data on patient populations.  

Prior to this technology, providers had to filter through information and hunt through directories but can now have a time-saving conversation with the software for information via chat or voice, Adams said.

“I think that as much as we can do to improve the happiness and reduce the burden on users – that’s just gonna pay dividends on the care that they’re able to provide for patients,” he said.  

Three organizations are currently live with the Azure OpenAI message drafting software: UC San Diego Health, UW Health and Stanford Health Care. These organizations are experimenting with a subset of users that Epic has helped set up for success, Adams said. 

“We’re taking a very thoughtful and incremental approach to how we roll this out,” he said.

CMS Taking Steps to Modernize Approach to Digital Technologies

May 03, 2019 - CMS is working with other federal agencies and lawmakers in Congress to modernize its approach to coverage for data-driven medical devices and other innovative technologies.

As digital tools, companion apps, and analytics technologies become more commonplace across the industry, CMS hopes to speed up the process of determining payment rates for breakthrough advances in patient care, CMS Administrator Seema Verma said in a speech at the Medical Device Manufacturers Association Annual Meeting this week.

“Our vision is ambitious yet achievable: to protect and secure Medicare and ensure beneficiaries have access to the latest medical technologies,” said Verma.

“The advent of novel medical technologies requires CMS to remove barriers to ensure safe and effective treatments are readily accessible to beneficiaries without delaying patient care.  In essence, keeping new technologies and treatments moving from bench to bedside—and into the hands of those who need them most.”

CMS is anticipating the continued development of medical devices and other products that incorporate advanced analytics, data interoperability, and machine learning to offer actionable insights for patients and providers at the point of care.

Integrating new products and services into the Medicare fee schedule can be a lengthy and complex process, however, said Verma. 

CMS and its Medicare Administrative Contractors (MACs) must first make coverage decisions on a national or local level.  Then the agency must determine if the new technology can be coded for payment with existing codes or if new codes are needed.

Lastly, the agency makes a payment determination, taking into account the site and purpose of use in addition to other criteria.

Medicare can take years to make these decisions.  Oftentimes, coverage for a “new” technology or device can lag behind commercial coverage by as much as a decade.

As the pace of innovation accelerates as the healthcare industry enters the age of artificial intelligence, this snail’s pace is simply no longer acceptable, said Verma, especially as other agencies such as the FDA take proactive steps to modernize their processes.

“With the remarkable number of transformative technologies coming to market — many with unprecedented price tags — Medicare must develop new frameworks that will support tomorrow’s innovations and endure the test of time,” she said.

“Simply put, our goal is to get new innovations to our beneficiaries concurrent with FDA approval by removing government barriers to innovation and harmonizing CMS coverage, coding, and payment processes.”

CMS has proposed several changes to payment policies for medical devices that receive “breakthrough device” designations from the FDA.

“This includes waiving the requirement for ‘substantial clinical improvement,’ which is one of the criteria that must be met for CMS to make additional payments,” said Verma.  “For devices granted Breakthrough-designated FDA approval, real-world data regarding outcomes in different patient populations is often limited at the time of approval, making it hard for innovators to meet this requirement.” 

“Waiving this requirement would provide additional Medicare payment for the technologies for a period of time while real-world evidence is emerging, so Medicare beneficiaries don’t have to wait for access to the latest innovations.”

Medical devices on the market for two years would still have to demonstrate substantial clinical improvement to qualify for a third year of payment, but putting products into the market more quickly will allow patients to benefit from innovations immediately, she added.

By collaborating more closely with the FDA, CMS is repositioning Medicare as an innovation leader instead of a barrier to bringing new devices and technologies to some of the nation’s neediest patients.

“We are also working with Congress on a raft of legislative changes to address the challenges we face in adapting the Medicare program to modern technology,” Verma continued. “For example, the President’s Budget proposes expanding coverage of disposable devices, such as innovative glucose monitors and insulin pumps that substitute for a durable device, for use in the management and treatment of diabetes.”

“If we implement all of these changes, we will ensure beneficiaries have access to the latest technologies in a timely manner; improve the innovator experience with Medicare; create predictable coverage pathways; enhance opportunities for coverage for transformative technologies; reduce wait times for permanent codes; and modernize payment for innovative services.”

These efforts align with Verma’s signature Patients Over Paperwork initiative, which aims to reduce unnecessary complexity for beneficiaries and providers.

“Patients over Paperwork is an agency-wide effort to solicit input from stakeholders on policies that are outdated, redundant, or overly burdensome, and to make updates in response,” she explained.

“We believe these changes clarify and simplify the process, helping to ensure that manufacturers get appropriate therapies and medical devices to patients more efficiently. These improvements respond to stakeholders’ suggestions for more transparency, including multiple opportunities for engagement with CMS and our MACs.”

Making widespread changes to such a large and influential government entity isn’t easy, Verma acknowledged, but collaborating with industry stakeholders and other agencies will help to advance the adoption of cutting-edge analytics and innovative medical devices in a safe and effective manner, she concluded.

“A modernized CMS, with stronger inter-agency collaborations with FDA and NIH, will unleash innovation for years to come, and be a catalyst for improving quality, enhancing access, increasing efficiency, and lowering costs.”

Faulkner Guides Epic Systems from EHR to Comprehensive Health Record

Epic Systems founder and CEO Judy Faulkner has a reputation for big ideas.

And with some of the top health systems in the country among her customers and around two-thirds of patients owning a current Epic record, the company and its leader tend to have their sites set at scale.

Faulkner has dedicated decades to growing her company into a market mover that features prominently in any discussion of the health IT space, and her yearly presence at the annual HIMSS Conference and Exhibition punctuates how serious she is about bringing her big ideas not just to her own clients, but to the healthcare system at large.

Judy Faulkner, Founder and CEO of Epic Systems

Source: Epic Systems

Moving from paper charts to electronic health records has been a difficult enough leap for many, but Faulkner believes that her community of customers is ready for the next big shift in thinking: stepping up from the EHR to the CHR.

The “E” has become irrelevant, she asserted, reinforcing an idea that is guiding Epic towards increased interoperability, simplified workflows, and more open communication between disparate organizations. 

It’s time to stop dwelling on the difference between paper and processing power and start reexamining how patient records look, feel, and function in the era of data-driven insights and value-based care, she stated.

“Saying ‘electronic health record’ is like saying you have an electronic iPhone,” Faulkner told HealthITAnalytics.com.  “It’s no longer a meaningful distinction for the industry now that almost everyone is off of paper.” 

“The comprehensive health record goes way beyond the 10 percent of care that physicians and hospitals directly contribute.  It incorporates genomics, environmental data, family history, socioeconomics – all of the factors providers will be responsible for as they stop getting paid for the 10 percent and start earning money based on keeping the patient whole.”

USING THE PATIENT RECORD TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH

The social determinants of health are top of mind for Faulkner, who has shifted away from playing defense and instead has started to strike a much more forward-looking tone.

“The social determinants have been largely missing from healthcare,” she said.  “Understanding that loneliness, for example, has a 70 percent overlap with morbidity can change the way we look at individuals and what they need.”

“We’re going to try to use the tools we have to assess who we can help by creating a friendlier environment, especially for older people who might have lost their spouse, or don’t have any support system, or might not be able to cook for themselves or drive.”

Using health IT to better understand individuals and help patients overcome their personal challenges, such as smoking, will allow providers to see more success under value-based contracts, said Faulkner.

“Saying ‘electronic health record’ is like saying you have an electronic iPhone.  It's no longer a meaningful distinction."

Achieving that goal will require vendors to extend their systems into places where they have not yet secured a foothold, she added.

“We need to help the patient understand which of their personal behaviors are not helping them.  Our systems are even now being extended into those areas to bring data back and advice to the patient to make our care of them much more complete.”

Bringing the care continuum closer together through better data exchange is crucial for succeeding with population health initiatives, whether they are risk-based or not.

“When you bring a system like Epic into some of the places we need to be, such as a behavioral health program, you can allow those providers to add to the existing comprehensive record instead of creating new, fragmented records of care at different places,” she explained.

“Then you can share that information with providers at the patient’s care hub, whether that’s a hospital or a primary care provider.  Interoperability is the key to that.”

“WE COULD JUST WAIT, OR WE COULD DO SOMETHING”

Epic Systems hasn’t always enjoyed the best reputation when it comes to interoperability, and Faulkner has been keenly aware of that fact. 

The company has endured some bruising PR body blows from competitors and lawmakers who have taken exception to Faulkner’s approach to sharing data. 

The use of terms like “data blocking” has often been seen as a veiled reference to Epic’s exclusivity.  Creating a closed community centered entirely on one vendor’s customers, no matter how seamlessly it could exchange data internally, is the opposite of meaningful interoperability, many stakeholders have argued.

Unsurprisingly, Faulkner vehemently disagrees.

“I know there are people who say that Epic is only focused on Epic.  But when we first built the system in the early 2000s, well before meaningful use, we had to invent the whole thing,” she said. 

“At the time, I talked to some people at HIMSS and asked if they were going to standardize the data so we could – I don’t think I even knew the word ‘interoperability’ yet – but I wanted to know if we could create some standards to exchange the data back and forth.  The folks at HIMSS said we shouldn’t hold our breath.”

Epic had two choices, she continued.  “We could just wait, or we could do something.  We decided to do something.”

That “something” has evolved into a multifaceted platform that integrates a core EHR with patient-provided data, big data analytics, health information exchange capabilities, and integrated workflows allowing access to data from both internal and external customers.

“Just because there’s no standardization doesn’t mean we shouldn’t go ahead anyway,” said Faulkner. 

“If we at least start doing what we can with what we have, it’s going to help millions of patients who are cared for using our software.  Then other people can see it and join in when there are standards, and we will be more than happy to work alongside them, too.”

"I wanted to know if we could create some standards to exchange the data back and forth.  The folks at HIMSS said we shouldn’t hold our breath.”

The Epic strategy has coalesced around three key components that contribute to creating the comprehensive health record.

“We’re treating everything as one system,” said Faulkner.  “It’s the first step towards making one unified record for every patient.  That’s what everyone has talked about, albeit in different ways.”

ONE SYSTEM, ONE RECORD, ONE HAPPIER PATIENT

Announced in January, the three-pronged attack on data siloes and fragmentation starts with Coming Together, a feature that allows users to find and integrate patient records from other organizations – including those that do not use Epic. 

“We can pull data from almost anywhere,” said Faulkner, “and we can allow our users to extend their systems into places that might not even have EHRs.  All you need is an internet connect to use Epic Care Link, for example.  It’s a web-based tool that allows other providers of the patient to schedule appointments, place orders, make referrals, and send data.”

Epic’s standards-based exchange tools, such as Care Everywhere, contribute to the movement of data across organizational lines, she added.  “If it’s an Epic-to-Epic exchange, we can share 415 data elements.  If it’s Epic to another vendor, we can exchange whatever people send us, but it’s typically much less.”

Avoiding data overload and cognitive fatigue when trying to synthesize information from multiple sources is the next step, said Faulkner. 

“That’s where Happy Together comes in,” she said.  “You only have a certain number of minutes for every appointment, and you simply can’t take the time to go somewhere else to see the data that you might need.

“Happy Together puts it all together as if it was from the same organization: here are all the test results and all the visits for the patient – but there’s a little symbol next to everything coming from the outside, and you can see where it’s coming from.”

The third piece of the puzzle, Working Together, furthers the goal of allowing providers to act in concert with one another. 

“Working Together does things like let you see a thumbnail image from everywhere the images are available,” said Faulkner.  “If you click on it, we go back to the original site where it was created, pull in a large image, and present it to you in that workflow.  It’s reference quality right now – shortly we will have diagnostic quality.” 

“You can also book appointments in another system, and message back and forth with that provider.  Right now, when you get a referral to a specialist, you typically have to make the appointment or have that organization call you to make the appointment later.  Now the referring provider can make it right away, which reduces a lot of pain points.”

INCLUDING THE PATIENT VOICE IN THE PATIENT’S CARE

Striking the right balance between patient control and provider involvement in the comprehensive health record is a challenge, she acknowledged. 

Empowering patients to make better decisions about their own health is a critical part of effective population health management and a key component of addressing the social determinants of health – and yet patients cannot be left on their own to manage something as important and extensive as their entire health data history.

“One patient record held by a patient isn’t going to work,” said Faulkner.  “Patients are busy, and they’re not going to be able to update their records and manage all that information between the kids and their jobs and not feeling well.”

“You only have a certain number of minutes for every appointment, and you simply can’t take the time to go somewhere else to see the data that you might need."

“It’s not going to be good quality data if we leave it entirely to the individual.  It needs to be curated and cared for by the health systems, but the patient needs to have as much input and control as possible.”

Integrating the patient voice into the record can be accomplished by treating the patient portal as an essential part of care and communication instead of an afterthought simply required to meet meaningful use.

Epic has expended a great deal of effort on making its MyChart patient portal a pillar of the patient-provider relationship.  With new educational resources from the Mayo Clinic, a single instance of the portal for patients visiting multiple Epic sites, and a range of self-assessment tools available to help patient take charge, the app allows providers to accept significant patient-generated feedback.

“Patients can contribute a lot of the data we need about social determinants themselves,” said Faulkner.  “That’s why we have questionnaires in MyChart that are automatically pulled into the record.”

“The patient often prefers doing it themselves rather than answering questions from a provider, because they can take their time and figure out how they want to answer and what they want to say.”

Such patient-generated health data will help providers fill in the gaps when it comes to socioeconomics, patient self-care capabilities, health literacy, and the availability of social and community support to promote healthy behaviors.

Armed with this information, providers will be better able to treat patients as comprehensively as their health IT systems are starting to do.

“As more and more data is being collected, there’s more and more we can think of to deliver the best possible care to everyone,” said Faulkner. 

“And as we get past the basics of working with the software, then we can leverage it better.  If you want to do that, you have to think about being comprehensive when you’re designing the tools you need to care for patients in a holistic way.”

Top 8 EHR-EMR Vendor U.S. Hospital Market Share Breakdown

Top 8 EHR-EMR Vendor U.S. Hospital Market Share Breakdown!

1. Epic - Number of hospitals using products: 1,363, 25.8% of market

2. Cerner - Number of hospitals using products: 1,303, 24.7% of market

3. MEDITECH - Number of hospitals using products: 877, 16.6% of market

4. CPSI - Number of hospitals using products: 572, 10.8% of market

5. McKesson - Number of hospitals using products: 243, 4.6% of market

6. MEDHOST - Number of hospitals using products: 213, 4% of market

7. Allscripts - Number of hospitals using products: 183, 3.5% of market

8. AthenaHealth - Number of hospitals using products: 82, 1.6% of market (relatively new to market) Source: Data derived from KLAS US Hospital EMR Market (2017)

UIC Health to replace legacy system with $62 million Epic EHR

UI Health, an academic medical center, which is associated with the University of Illinois in Chicago, will plunk down $101 million for an Epic System EHR.

The cost includes the preparatory work UI will have to undertake prior to installing the EHR.

The cost associated with the Epic rollout is $62 million over seven years. It includes software, remote hosting, implementation, licensing and other fees.

Once the contract with Epic is finalized, the new system will take about 21 months to roll out. ‘Go Live’ is expected to occur in the fall of 2019, Michael Zenn, chief financial officer of UI Health, told Healthcare IT News.

A 17-member assessment committee helped develop a process and set technology criteria. The team also oversaw development of the RFP – request for proposal – and an evaluation of the responses.

There were also technology demonstrations from several vendors.

“For Epic, we had 460 participants in our demo. And, we received back 745 evaluations,” Zenn said. “We had a large number of people looking into the process.”

Once the Epic technology goes live, hospital administrators say, it will replace the disparate technologies in place today. They include pieces of Epic, Cerner, Allscripts, McKesson and Midas, which measures quality of care. Much of the technology dated back to the 1990s.

“Many of our current systems were being sunset,” Zenn said. “We were being told by vendors they would no longer support them.”

“We’ve had a large number of disparate systems – in all our departments that we acquired over time that don’t work all that well together,” he added. “We were looking for the ability of vendors who could in an integrated way through a more singular system accomplish our information needs.”

As Zenn sees it, the upgrade is a necessity of the business.

“It’s also a necessity for clinical delivery; communication with our patients, it’s a necessity for all the complex billing issues that we have to deal with.” he said. “It’s our ability to provide care, it’s our ability to interact with our patients about their care, their experience here. It’s about all of those.”

UI Health includes a 495-bed tertiary care hospital, 22 outpatient clinics, and 13 Mile Square Health Center facilities, which are Federally Qualified Health Centers. It also includes the seven UIC health science colleges: the College of Applied Health Sciences; the College of Dentistry; the School of Public Health; the Jane Addams College of Social Work; and the Colleges of Medicine, Pharmacy, and Nursing, including regional campuses in Peoria, Quad Cities.

Meritus Health plans $100 million Epic EHR installation

After 18 months of planning, Hagerstown, Maryland-based Meritus Health has signed off on a $100 million rollout of an EHR system from Verona, Wisconsin-based Epic Systems.

The cost will be distributed over five years.

The decision process included more than 1,000 Meritus employees and officials, according to Herald-Mail Media.

Meritus Health executives reviewed six vendors and evaluated two finalists in-depth. For the two finalists, Meritus officials visited a company client, a similar community-based medical system with 250 to 300 beds. 

"Clinicians particularly preferred Epic," Meritus President and CEO Joseph P. Ross told Herald-Mail Media.

Go-live is slated for next summer.

Epic will provide technology for both health records and billing, Meritus officials said.

Meritus Health employs 2,500 people. It is a not-for profit healthcare system. Meritus Medical Center, the health system’s flagship facility has 243 beds. It serves the residents of Washington County and western Maryland, southern Pennsylvania and the eastern panhandle of West Virginia.

Meritus will use its reserves, including federal funds it received under the Affordable Care Act, to pay for the project, Ross told Herald-Mail Media.

Ascension to purchase Presence Health

Ascension, the country’s largest Catholic health system, has signed a letter of intent to purchase Presence Health, the largest Catholic system in Illinois.

Under the agreement, Presence Health would become part of AMITA Health, a joint venture between Ascension’s Alexian Brothers Health System and Adventist Midwest Health, the two health organizations announced. All Presence Health facilities would be added to AMITA save for Presence Life Connections, which will instead be added to Ascension’s senior care subsidiary, Ascension Living.

Mark Frey, CEO of AMITA Health and senior vice president of Ascension Healthcare, said in the announcement that Presence was a “perfect fit” for AMITA.

“Since we brought together Alexian Brothers Health System and Adventist Midwest Health to form AMITA Health two years ago, we’ve always looked for opportunities to add like-minded partners with similar values to our system,” Frey said.

The healthcare industry’s merger mania has shown no signs of slowing down this year. A Kaufman Hall analysis shows that merger and acquisition activity increased by 15% in the second quarter of 2017 when compared with the second quarter in 2016.

Six transactions between healthcare organizations with $1 billion or more in revenue were announced in the first half of this year, including the the megamerger between Steward Health Care and IASIS Healthcare LLC, which would make Steward the largest for-profit healthcare group in the country.

Ascension expects the merger to move forward successfully, according to the announcement, and it said that the addition of Presence would increase patient access and allow it to more strongly operate AMITA’s accountable care organization.

“We look forward to working together to engage in this joint effort to expand, and continue to deliver, quality care for our patients and residents, as well as provide additional clinical opportunities and patient care resources to all our physicians and associates,” said Michael Englehart, Presence’s CEO.

EHR-EMR Market Landscape & Leaders (July 2017): By Marketshare & Revenue

EHR-EMR Vendor Growth Considerations:

- 51.4% of healthcare provider organizations are considering EHR vendor

Epic, up from 45.1 percent in 2016

- 25.7% of providers looking for a new outpatient records system or seeking

to replace or upgrade a system are considering Athenahealth, up from just 7.4

percent in 2016

- 17.1% of providers are considering Cerner, down from 21.3 percent in 2016

- 15.7% are looking at eClinicalWorks, up slightly from 15.6

percent in 2016. eClinicalWorks was recently fined with a large legal

settlement by the U.S. Department of Justice, 34% of providers with an

eClinicalWorks EMR plan to migrate to another vendor, however, only 4%

specifically stated they are considering a switch due to the large fine and

settlement

- 14.3 percent are considering Allscripts, up from 13.9 percent in 2016

Sources: HIMSS, KLAS, Medscape

UC San Diego is switching to Epic's cloud-based EHR

niversity of California San Diego Health on Monday announced that it is putting its Epic electronic health record in the cloud.

The transition from managing its own on-premise Epic EHR to a cloud-based service has already involved moving some 10,000 workstations and integrating more than 100 third-party apps with Epic’s cloud, UC San Diego Health said.

While hospitals and health systems have historically been somewhat tentative about mass migrations to the cloud, industry luminaries such as Beth Israel Deaconess Medical Center John Halamka, MD, have been making bold predictions of late about data centers vanishing as hospitals go the cloud for analytics, EHRs and clinical decision support. Halamka, for one, backed that claim up by placing 7 petabytes of BIDMC data on Amazon’s cloud.

UC San Diego Health, for its part, said the move is an early milestone in its three-year plan to migrate all of its data storage needs to the cloud -- not just Epic’s hosting environment, of course, though they have yet to divulge other clouds.

UC San Diego Health Associate Chief Information Officer Mark Amey said shifting to Epic’s cloud enables the hospital system and its clinics to be more agile and responsive while maintaining disaster recovery capabilities.

“By creating greater operational efficiencies,” Amey said, “we can invest more time and resources in patient care.”

UC San Diego also said that in November it will start sharing the new EHR with UC Irvine Health.

Allscripts Will Acquire McKesson’s EIS Business for $185 Million

Allscripts announced this afternoon that it will acquire McKesson’s Enterprise Information Solutions health IT business for $185 million in cash.

The products acquired include the Paragon EHR, Star, Series, Healthquest, Lab Analytics and Blood Bank, and OneContent.

Allscripts CEO Paul Black said in a statement, “Adding these assets to Allscripts existing portfolio enables us to better serve our clients, increase our scale and further drive our investment in innovation. This transaction is expected to directly benefit our existing clients and our shareholders, as well as the Enterprise Information Solutions clients and team members we’ll welcome to our family. Allscripts is a critical strategic partner to thousands of healthcare organizations and our highest priority is to successfully meet their highly complex needs of today and in the future, as we enable them to lead the change to smarter care. The healthcare IT market remains highly fragmented. Today’s announcement is a proactive and strategic measure to maintain Allscripts long-term leadership and position Allscripts for continued growth.”

Allscripts says it will continue to offer Paragon to small hospitals while continuing to sell Allscripts Sunrise to larger health systems.

Epic to jump into medical billing, currently hiring for new unit

A want ad recently appeared on the website of Verona, Wisconsin-based electronic health record colossus Epic Systems Corp. for "bright, motivated individuals to join our new billing services team as we enter the world of medical billing."

The ad notes that Epic is seeking billers who have good communication and customer service skills; are familiar with medical terminology and remittance/denial codes; are knowledgeable about Medicaid, Medicare, and other insurance guidelines, and have a coding certification or background. Applicants should also live within 45 minutes of the Verona campus.

"Our goal is to simplify the payment process by helping Epic organizations with the complexities of submitting claims and posting payments," according to the ad. "Attention to detail is vital as you'll be posting payments and denials; reconciling payment files, claims, and statements; resolving posting errors; and calling payers to follow up on outstanding or unpaid claims."

The ability to offer billing could be a boon for Epic's efforts to grow its business with resource-strapped small hospitals and physician practices.

The company is targeting organizations such as those as it rolls out the new streamlined EHR versions it announced earlier this year: a mid-range "utility" version, and a system called Sonnet whose scaled-back features and lower price point could make it appealing to smaller providers.

"We’re finding that people need different things," Epic CEO Judy Faulkner told Healthcare IT News at HIMSS17 in February. "If you are a critical access hospital, you don’t need the full Epic."

The value-add of billing service could make the choice for a simpler EHR that much more appealing.

"With a billing presence across all 50 states, Epic is well-positioned and excited to share our best practices and take on some of the billing work, and associated IT functions, for our Resolute Professional Billing customers," said Epic spokesperson Meghan Roh.

"Launching later this year, this new offering will help those who are struggling to scale their billing services, looking to keep a light operational footprint, or those who are just simply hoping to step away from revenue cycle management," she said.

Apple reveals plans to put health records on the iPhone

Apple has been in talks with hospitals and other healthcare organizations to explore the possibility of bringing health records together via iPhones, media outlets reported. 

The effort to make all personal health information available via its devices would be a first for Apple, which until now has focused it healthcare work on fitness and wellness with its Apple HealthKit. Apple has been typically mum on the developments and CNBC, which first reported Apple’s latest intentions for healthcare, said the works has thus far been “secretive.” 

[Also: Will Apple buy athenahealth? Jonathan Bush calls rumor baseless]

Unnamed sources told CNBC Apple is looking at startups in the cloud-hosting space to give it a foothold in healthcare. 

The company has already acquired personal health data startup Gliimpse, which has a secure platform for consumers to manage and share their own medical records.

The entrepreneur Anil Sethi, who built Gliimpse and sold it to Apple three years later, is now working at Apple. His title, according to his LinkedIn page, is Director, Apple Health.

More recently, Apple recruited Sumbul Desai, MD, from Stanford, where she has been involved in several successful digital projects. Apple executives have not released what role Desai will play, whether she might join the team working on ResearchKit, HealthKit and CareKit, or work on another project altogether. 

Also, Apple insiders reportedly talked with people at The Argonaut Project, which is promoting the adoption of open standards for health information, and to "The Carin Alliance," an organization that advocates for giving patients a central role in controlling their own medical data