This month’s episode of “News You Can Use” on HealthcareNOWRadio features news from the month of August 2025
News You Can Use with your Hosts Dr Craig Joseph and Dr Nick van Terheyden
The show that gives you a quick insight into the latest news, twists, turns, and debacles going on in healthcare with my friend and co-host Craig Joseph, MD (@CraigJoseph), Chief Medical Officer at Nordic Consulting Partners, and myself, where every diagnosis comes with a side of humor. We hope you stay curious, stay engaged, and keep seeking the truth in healthcare in a world that thrives on information.
Buckle up as we dive into the ER of excitement, the ICU of irrationality, and the waiting room of wacky wisdom in this month’s show that features a review of:
- Inflation, prices, especially in Healthcare Insurance
- AI Innovations
- Generative models
- SIM Jacking and Hacking
- Epic UGM and all the buzz
Welcome to another episode of “Healthcare: It’s Weirder Than You Think.” This month, we dive into the glorious chaos that is healthcare news, from mind-boggling insurance hikes to AI that might just know you better than your therapist.
Babies Don’t Need Cell Phones
We spend a lot of time talking about the Epic’s annual User Group Meeting (UGM), the secretive, Wisconsin-based party where electronic health nerds gather to discuss things like why babies have cell phone numbers. Apparently, newborns aren’t just mastering peek-a-boo, they’re also racking up digits in their medical charts. This becomes a real problem when lab results for, say, a sensitive issue get shared to Mom’s phone instead of the actual patient. Cue the awkward family dinners. As Craig notes, Epic is working on solutions that gray out the cell field for anyone under 12. Problem solved….sort of.
AI Predicts Your Future, But Can’t Lower Your Premiums
Amongst the many presentations was one on Cosmos, its massive “anonymized” database with 300 million patient records and the AI trained on this treasure trove to predict everything from readmission risks to whether your A1C will hit double digits. It’s like a crystal ball, but with some questions on privacy and use cases, as I immediately wondered if insurance companies are already drooling over this data to raise premiums or, worse, move us towards a dystopian future as featured in the 2011 movie “In Time” where we all start counting down our expiration date.
We covered the economy, at least the healthcare economy, which while already stressful enough now with insurance open enrollment approaching and widespread reporting of premiums skyrocketing it is going to be a painful few months. Your choices? Pay up, go without, or hope you win the lottery.
Data Sharing: Because Your Doctor Isn’t Actually Psychic
In Washington, we cover the recent opinion piece from Amy Gleason pushing for smoother data sharing because, shocker, doctors kinda need your info to. And in a win for justice, a 23-year-old SIM jacker got 10 years in prison. Guess He Couldn’t Hack Healthcare. So, if you’re going to steal identities, maybe don’t. We’re not your boss. But maybe use those skills for good next time? Just a thought.
We hope you enjoy our take on the latest news and developments in healthcare and want to help you keep untangling the web of information, dodging the sensational pitfalls, and emerging victorious, albeit a little dizzy, on the other side. In the end, the stories we uncover and the discussions we ignite, all shape the narrative of our shared future. We want to hear from you, especially if you have topics covered or questions you’d like answered. You can reach out directly via the contact form on my website, or send a message on LinkedIn to Craig or me.
Until next time, keep solving healthcare’s mysteries before they become your emergencies and stay healthy, stay skeptical, and for heaven’s sake—check who’s listed as your emergency contact.
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Raw Transcript
Nick van Terheyden
That’s going.
Nick van Terheyden
Welcome to the month of August. I’m Dr
Craig Joseph
Nick and I’m Dr Craig.
Nick van Terheyden
This week, we will be dissecting the latest healthcare news, unraveling the twists and turns and making sense of debacles.
Craig Joseph
Just remember, life’s a lot like a breaking news story, unpredictable, often absurd, and occasionally leaving you wondering if it’s all just a cosmic prank.
Nick van Terheyden
This week, we take a look at inflation and pricing in healthcare,
Craig Joseph
and we dive into AI innovations, generative models and sim jacking updates.
Nick van Terheyden
But first off, this week, we have to cover the epic UGM and all the buzz that was everywhere. And I’m guessing it was actually at the event itself, since you were there, right? Craig,
Craig Joseph
I was there. I was were you buzzy? I was buzzy, yes. And buzz was it all
Nick van Terheyden
to do with the Star Trek logo and everything that was the Star Trek uniform.
Craig Joseph
So let’s just catch everyone up. Epic is the name of a very large electronic health record vendor based in in Verona, Wisconsin, right next to Madison, and over half of the United States population is covered by an electronic health record that that epic produces. So it’s a, it’s a, it’s a big deal. And so once a year, they get all of the invite all their customers to come to lovely Verona, Wisconsin and have multiple parties, but more importantly, to find out where, what Epic is doing, where they’re going in the future, and what everyone else, what other customers of epic, are doing, we learn as much from other customers as we do from the company itself. Really, yes, yes, I I’ve been, as some of our listeners may know, I used to, I worked at that, at Epic, many, many years ago. Think 15 and something like that, long time ago. But yeah, often you learn more, or at least the same amount, from the person sitting next to you, interesting as you do from the vendor.
Nick van Terheyden
And that sounds like a conference we should all go to. Can we?
Craig Joseph
We cannot. No, the only it’s, it’s, yeah, well, it’s, I don’t know if it’s few 10s, if many 1000s of people come, but they’re, they’re almost all customers. So it’s only open to Epic customers and a and a few, a few others. But mostly that’s the way you get invited, is to be a customer of epic, and then they you know that, and then you’ve got an invitation for X number of people to come, because oftentimes they have to turn people away because they just can’t have everyone come that wants to come, and so, and that
Nick van Terheyden
sounds almost as big as HIMS, or actually, maybe it’s bigger than hims is now, you said over 10,000 I mean, I’m genuinely asking. I’m not making fun of you. For once, I know that’s unusual.
Craig Joseph
I yeah, I some reason I’m thinking something like 14, 15,000 Wow, something like that. Something like that. Don’t quote me here people, but it’s a lot. There’s a
Nick van Terheyden
lot. I’m sorry you are you are being recorded? You know
Craig Joseph
that we not record? Are we recording this now, your My lawyer told me, You’re supposed to tell me
Nick van Terheyden
before. No, it was it was
Craig Joseph
that why there’s a microphone here? Dr, Nick, I’ve always been
Nick van Terheyden
all right, so what did you learn? I saw you learned all about babies and ages and telephones, and I was kind of interested in that, because I really had never thought about it, and it and it genuinely wasn’t a problem when I had my kids telephone numbers,
Craig Joseph
it was not a problem when you had your kids. That is accurate. Actually, this was the penultimate session, the second to the last session. Can I just pause you there for a second that I said the word penultimate? Take
Nick van Terheyden
note. Guys, girls, ladies. Gentlemen, Craig was still at the conference for the penultimate session. I want to say all credit to you failing by then.
Craig Joseph
Thank you so much. Dr Nick, that’s a huge thing. I flew in on Sunday morning, and the session started Monday morning, and the last session was, I believe, at 130 on Thursday. I want to say I did have to skip the last session. I did. Oh, you missed the final pen. I thought you were going to praise me for using the word penalty. That’s trivial term. No, I’m very impressed you. This was actually a really good session that you’re referencing. And. Was called something like, babies aren’t born with cell phone, right? And you know who’s not going to want to go to a session like that? And it was two Stanford physician leaders who gave a talk, and it’s actually quite interesting. So here’s here’s what they found. They found that the vast majority of babies and children at their health care system, when you look up their cell phone, have a phone number the babies and the children. I repeat that. I’m not talking about teenagers. Yeah, right, the babies and the young children, they all have cell phone numbers and and you might say, well, that’s not really a big deal. We know who those cell phone numbers belong to. It’s clearly, clearly one of the parents or guardian or something that those are those babies. Since we all know babies are not born with cell phones, no big deal. And you’re right, it’s actually not that big a deal when you’re a baby or a small child, but fast forward 12 or 13 or 15 years when they do and it becomes a little bit more important. And so what happened at this customer, and I’m sure happens all across the United States, is that someone from the lab. This is this actually happened. Someone from the lab called the cell phone number for
Nick van Terheyden
the patient. I know where this is going go on.
Craig Joseph
Keep tell them about a positive lab result.
Nick van Terheyden
I wonder. What the lab result? Did they reveal that in the but I’m not. No, I thought you might not. And
Craig Joseph
the person they thought they were calling was the patient, the I’m gonna assume, 14, 1516, years old, but the person they actually were calling was the parent. And so that’s a big, big problem. And so there’s the there’s a solution now, and there has been for many, many years, which is, hey, put that indication right. Put it in the right part of the chart, right. Put it in the right, in the right fields. So there’s, there’s mother information and father information and Guardian information, and you can put their names and their cell phone numbers and their home numbers, all of that can be in there, and that’s tied to the patient, right? So, yeah, that was the talk. And it was actually quite cool, because most of them that was a customer talk. However, at the end, they had an epic developer talk about all the code that they’re writing to help decrease the chance of that happening. So for instance, at some customers, they don’t allow you for children under some age, I don’t know, 12, some number you can’t put in a cell phone for that patient. It’s too it’s impossible, it’s dithered, it’s grayed out. And there are other solutions that you can kind of work around. But yeah, that’s the kind of thing where you’re like, I did not realize that was a problem. But when you hear about it, you’re like, Oh, that was definitely a problem. So, so
Nick van Terheyden
that’s just gonna call out dithered, because I haven’t heard that term before. But okay, so it’s
Craig Joseph
great. You’re welcome. You’re welcome.
Nick van Terheyden
I’m working the old chat GPT this
Craig Joseph
week. I’m really working on my vocabulary.
Nick van Terheyden
Maybe got one of those calendars tear offs? No, no,
Craig Joseph
I know, but I should lots of good things, though. I tell you the most, one of the most impressive things that I, I we heard about, I think, was there,
Nick van Terheyden
please not, dr, weed. Tell me you’re not going to bring up Larry weed.
Craig Joseph
I’m not going to bring up Larry weed. I thank you for doing so. I will not bring up
Nick van Terheyden
doc, because it was a great presentation. But really,
Craig Joseph
all of our listeners now think you’re talking about marijuana, and you’re not, and you’re not because they don’t understand. Larry, weed is a real physician we should who gave a talk?
Nick van Terheyden
I bet that was 60 in those days.
Craig Joseph
I don’t know. Sorry, I interrupt.
Nick van Terheyden
No. Coolest thing, here’s what I
Craig Joseph
was going to say. Epic, has this thing as a database called cosmos? Yeah. And many of their customers, not all, but many of their customers, upload data that I think are very well anonymized, although one could talk about that being theoretically impossible. You know, that’s a BMI bonnet, but I know, I know, but anonymized data, so information that should be virtually impossible to trace back to one
Nick van Terheyden
human. Dr Nick is using air quotes as he says that, but go on,
Craig Joseph
I fully acknowledge that. And so they have, I think, 300 million patients in this database, and these are all they eliminate duplicates. I don’t know how, but they’ve really thought through this through so have all these data sitting in a database, and they can now train a large link. It’s not really a large language model, but an AI. It’s. Against these data, and they put out a paper with epic authors, open AI authors, and someone from Yale, because you have to have that. That’s a requirement. Someone from an Ivy League school has to be on all of these papers anyway, legal, just any school. No, I believe the law says Ivy League, okay? I believe it’s a law, and it might be in Puerto Rico. I don’t know where the laws I’m making it up. Nick, I’m making it up. I know. Here’s what the here’s what they’re able to do. They trained the just like a large language model. It’s really just a word predictor, right? I mean, that’s it is. That’s really what it is. It’s, hey, you asked a question based on those words and all the words I’ve been trained on, what words should I put in what order to the to answer your question? So what this AI model does is, since it knows all kinds of it’s an event predictor. It’s an event predictor. So it’s not trained on any of the words in your notes, but it is trained on your vital signs, when you came to the office, when you came to the hospital, what your discharge diagnoses were, how long between when you got discharged to the next time you encountered that healthcare system? It’s an
Nick van Terheyden
individualized LLM.
Craig Joseph
It predicts events. It predicts what’s the next event. And so, what are the chances, some of the questions that you might ask, Hey, what are the chances that this patient is being discharged will be readmitted in the next month? What are the chances that this patient’s diabetes is going to have a hemoglobin a 1c above 10? What are the you know? So those are the kinds of questions that you can ask it, and it’s what they’ve shown. And this this first, and I’m going to call it a study in air quotes. It’s really just an article about what they’ve done, but they talk about this thing that I had to look up called they keep saying this, zero shot, z, E, R, O, zero shot. And what that means is, after I had another LLM explained to me what zero shot means they don’t have to pre train. And so normally, if you’re if you’re developing an AI that wants to predict if a patient’s going to go into sepsis or if a patient’s going to be readmitted in a short time after being discharged, you you kind of point that you have the data, but you also have to kind of pre train it, tell it, well, these are the important things to look at. These are, you know, this is how you can kind of figure it out, and you push it in that right direction. I’m oversimplifying this because I’m an over simplistic person. They don’t need to do that because they have so much data, and so they’ve been as effective, sometimes more effective, in predicting these things correctly than models that are based solely that are kind of one trick ponies. It’s kind of kind of amazing.
Nick van Terheyden
So I I think it is. I’m going to be the a little bit of Debbie downer here, and maybe I’m wrong, but my immediate question is that was trained on data. Did the relevant people get appropriate input? Should we call it, if you use my data, am I getting, you know, am I getting compensated?
Craig Joseph
So I can answer that question. Hold
Nick van Terheyden
on, I haven’t finished. Let me. Let me finish my push back on site, because I think it’s great. But the other part of me, the pushback is the nefarious side of this, which says, Oh, hello. This is your insurance adjusters who now will play into that movie, if you remember it in time with Justin Timberlake, and who was it, Olivia Wilde, where you essentially have a predicted time, and when it runs out, it runs out, and that’s essentially your predictor. So now the adjusters have something that says, oh, oh, we need to make your insurance high. So it’s much like the genetic predictors. It’s that worries me just because of those elements. I mean, I love the idea, because who doesn’t want to know? Well, actually, not everybody wants to know. A lot of people don’t. But, I mean, it’s, it’s absolutely intriguing, but once again, it comes with at least a couple of things that worry me.
Craig Joseph
Yeah, and those are all appropriate. Clearly, no one’s being no one’s getting paid for their data, no one’s getting the opportunity, but
Nick van Terheyden
is it available to everybody to use? Then
Craig Joseph
it’s highly restricted and so so that does, should make you feel a little bit better.
Nick van Terheyden
No, it doesn’t, because if you’re not getting paid for it, then you should say, make it an open source and, Oh,
Craig Joseph
I see where you’re coming from. Yeah, again, I don’t, I don’t think so I totally under it. So I can tell you it’s highly restricted. So if you’re, if you’re an epic customer that doesn’t contribute data, you don’t have access to it, access right? And if. You do contribute to it. It’s tightly, tightly controlled for, I think, some of the reasons that you’re justifiably for the nefarious use. Yeah, correct, correct. So it’s only, I think it’s only open right now it, you know, there are insurance companies that are epic customers, right? However, they don’t have any. They don’t contribute patient data, per se, right? So I don’t look at it. They just look at it. You’re 100% right. So I they have, they have a lot of systems of in place to try to make sure that nefarious users are not not allowed access. And those include an outside all of it’s actually governed by customers, so and so there are, there are many attempts to make sure that only the right thing is but it’s done. But you make very valid points.
Nick van Terheyden
So suffice to say, epic UGM had lots of revelations. There was all sorts of preemptive stuff the week before, and then, you know, we saw the announcements of George, Julie and Jeff, or whatever the AI instances are, I can’t remember, but suffice to say, I think we’ll definitely cover this next month, because it is intriguing. Lots of, you know, exciting, interesting things that we should talk about, but we do not have time. So true, we’ve got too many other things to go through, so let’s put a pause on that and be sure. We’ll come back to it. If anybody’s got some input, we’d love to hear your thoughts about some of the other announcements and anything else that came through. Meantime, you know, we’re getting into insurance re, re insurance season, or whatever it’s called. I can’t remember. It’s just this, I play, play the slots every, every year that you have to to say, What am I going to buy in terms of insurance for health care? And, you know, everybody’s worried about the price of eggs and gas and whatever. And Elizabeth Rosenthal wrote that recent piece in the kff health news that talked about this and said, you know, those are trivial amounts compared to what we’re facing down. I’ve, I’ve seen some extraordinary numbers, and this is for the employers as well as the employees. So it’s not just, you know, a rise and the percentages that some of these folks are talking about, I saw as high almost as 65% increase in the premiums that folks are going to have to pay. I mean, that’s just Whoa, yep, and that hits. And that’s we’re coming up, right? That should be at the point, have you received yours in your employment or? No,
Craig Joseph
we think we usually do ours in October, November, but yeah, people are going to be
Nick van Terheyden
getting a month away.
Craig Joseph
It’s a month is actually for four weeks or so, four weeks or so, so that’s four times as long as
Nick van Terheyden
one. Oh, glad you’re here to help clarify these things. I
Craig Joseph
was not good in math, so I don’t, I don’t understand all these concepts, but it’s coming up, and people are going to get sticker shock. Hmm. And you know what your choices? You have no choice. You’re gonna if you want health insurance, if you want health insurance, and
Nick van Terheyden
meditators always say there’s a choice, there’s okay,
Craig Joseph
I’m I’m fascinated by what that might be. You can certainly choose from your employer, or from the public option no insurance, or you can have known that’s
Nick van Terheyden
100% let’s be honest, in in many instances, for a lot of people, I mean, that’s a that’s an actual choice. That’s part of the reason some people are uninsured. A lot of the younger generation, I can tell you, don’t take out the employee provided insurance to get more money into their pocket. I’m not saying it’s a good choice, but that’s and, you know, with the high deductibles, I know, for many years, I would never reach my deductible, so I’d pay all this money. What I was really buying was a term policy for, you know, catastrophic insurance, which, you know, maybe that’s what we
Craig Joseph
should be looking anyway. That makes a lot of sense, actually, hmm.
Nick van Terheyden
So let’s talk about so Amy Gleason is working in the White House. She’s variously had a variety of titles. She She I’ve known her for a number of years she was a patient advocate. She has a complex, diseased daughter. I’m sure I’m saying that awfully, and forgive me if I put that the wrong way, but she has a daughter with very unique, specific medical challenges that she’s been trying. Navigate that’s been part of her driver. She’s now in this position, and she wrote an op ed that I thought was just kind of insightful. And, you know, we try not to step into politics too much here, at least I try not to, certainly not in this kind of a forum. I don’t think it’s a great place for that. But, you know, she talked about the challenge of just sharing information and then actually using some of that information in these AIs that you talked about, you know, that generative medical events from cosmos, the ability to do that and how it actually predicted something that was actually useful to her, and the desire by the government to try and open things up. I was really I was impressed and excited about it.
Craig Joseph
It’s difficult to argue with those aspirations, right? How do you argue with I would with a statement like I want it to I want my health care information to flow from doctor, a doctor and hospital, hospital freely, so that everyone that’s taking care of me can make the help me make the best decisions, right, based on all the information who, who could disagree with that. It’s the, of course, the the it gets sticky when we start talking about the execution and making sure to the points that you have already brought up that, hey, it’s, it’s data about me. I want to make sure it’s not used again
Nick van Terheyden
life insurance, absolutely
Craig Joseph
not, absolutely not, I think. And so, you know, that’s the problem. But I it’s hard. It doesn’t we certainly do try to to, you know, stay away from politics, but it’s hard for me to understand anyone who would be against what she was asking for and what she claims to be working towards, and same thing with so she, she works for a part of the current administration and and they’ve, they’ve gotten lots of groups together just last month to try to get have this outcome achieved. How do we make it easier to share information and usable format, right? That’s the other thing. It’s no help if it’s if I just throw, if you’re seeing a patient and I just throw two novels of information at you and say, Okay, well, you’ve got five minutes with this patient. Now go right? So it has to be usable and has to be presented in a way where it actually helps me make decisions and helps me guide the patient in front of me. And so it’s those little details, but, but surely everyone agrees that sharing information, maybe not everyone, but people who not, who don’t run large hospitals, all must agree. I
Nick van Terheyden
agree, and start calling me Shirley, but doomed, the naked whatever is back. I believe I saw that as a trailer or something for the movie. So needless to say, somebody like me would be looking forward to that Ralph Bremen, or whatever he’s called. And the character is kind of appealing, given that it’s a outside of his usual. He was the recovery expert for all of us who have daughters who went to Europe and worried about them getting kidnapped and all the rest of it. I have a special set of skills, as he said. Anyway, I use that line all the time. In fact, I use that on our Wi Fi here, when I want to call a meeting, I just turn the Wi Fi off.
Oh, wow. It
Nick van Terheyden
works really well. You’d be amazed. Anyway, moving. I’ll kick you out of the house at a time. So just a brief update. Those of you that listen to the show will know that I talk about, or I have talked about my sim jacking, and obviously I’ve spent some time in the space and documented the experience, which was pretty terrifying, and just recently, one of the perpetrators of what I would call The underlying one of the major elements of fraud around this, who you know, has fished smished, however, he did it to obtain credentials into some of the mobile phone companies to allow them to then repoint phones to the somebody that pays the money, I assume, I think, you know, it was a business to them, but he was arrested and got 10 years and, you know, I celebrate it, but only partially. He’s 23 years old, which is pretty sad. I wish somebody like that would spend their energy, clearly, a really smart guy, you know, use it for good. But on the one hand, I was pleased to see that the justice system in this particular instance seemed to work a little bit.
Craig Joseph
Yeah, it was the story that you’ve told was horrible and and you were very lucky. I was everything was kind of going in your directions. So I’m glad to hear that people that do this go get to go to jail because they they really can maybe not destroy lives, but really make your life
Nick van Terheyden
plenty of people that have you know so difficult, yep. So it’s quite right. Unfortunately, we find ourselves at the end of another episode of Exploring health care’s mysteries before they became your emergencies. Until next time, I’m Dr Nick and I’m Dr Craig.
