This month’s episode of “News You Can Use” on HealthcareNOWRadio features news from the month of January 2026
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:
- Apple Watch’s Hypertension Study
- Cardiovascular Risk Scores
- Lawsuits in EMR World
- Health Insurance Challenges
- AI Tools in Healthcare
Trust, Verify, and Panic
This week, we dove headfirst into the AI chaos, noting that the physician-only tool called Open Evidence, which is trained on medical literature, just raised a $250M Series D at a $12B valuation, reinforcing its position as one of the most valuable and widely used AI platforms in clinical care. With many others entering the space, including Amazon and OpenAI’s new Healthcare option which neither of us have seen, we discuss the challenges and risks, including outdated guidelines like yesterday’s cafeteria mystery meat. It’s a stellar tool if you use it like a suspicious doctor, trust nothing, verify everything, and always double-check that critical lab value. These chatbots are brilliant interns that still need supervision to stop them from making mistakes.
We talk about the Apple Watch’s latest efforts as a cardiologist and while getting Hypertensions warnings is cool, we are reminded of the original time it came along as an AI detection alert.
We’re all for innovation, but flooding already-drowning doctors’ offices with a tsunami of false positives, especially for the worried well? Not the win we need. We discuss some of the cardiac calculators available, including the MESA Score risk calculator. Useful, perhaps, but not a full toolbox. You and your actual doctor have way more data, and since we are not a statistical average but we are all unique, these scores, like AI need to be used cautiously and preferably with the help of additional guidance from experts
We talked about the latest in a line of EMR-related lawsuits, including the Epic suit against Health Gorilla, which, while we are only seeing one side, reads like a soap opera, with alleged abuse of medical record access to hunt for lawsuit plaintiffs instead of patients.
And we finished our discussion on the health insurance market? It’s a masterpiece of systemic failure where families now pay mortgage-level premiums for coverage that’s basically a “Good Luck!” parachute. This unsustainable mess just floods our overwhelmed ERs and burns out the staff.
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
Welcome to the month of January. I’m Dr Nick and I’m Dr Craig. This week, we’ll be dissecting the latest healthcare news, unraveling the twists and turns and making sense of the debacles.
Craig Joseph
Just remember, life’s a lot like a breaking news story, unpredictable, often absurd, and occasionally leaves you wondering if it’s all just a cosmic prank.
Nick van Terheyden
This month, we take a look at the Apple Watch hypertension paper, cardiovascular risk scores,
Craig Joseph
and we dive into lawsuits in the EMR world and health insurance challenges.
Nick van Terheyden
But first off, this week, we’re going to take a look at AI for a change, and indeed, the open evidence, recent valuation and some of the folks that are jumping into this space. So what I saw recently was that open AI, I’m sorry, not open AI, but open evidence just raised another round at a 12 billion valuation that’s, you know, certainly way past unicorn status, and I think at this point, probably one of the most valuable, widely used platforms. I’ve got to say, I certainly use it. I don’t know about you, Craig, but I find it extraordinarily useful. I’m excited about it. I think there are plenty of players, but there’s folks jumping into this that maybe do not deliver, or it doesn’t deliver what we would need for equal distribution of healthcare. And by that I mean I access open evidence when I’m looking for questions. I get references, but I always dive deep, and I’m always a bit concerned as we sort of democratize access to these things. And I know I’m going to be receiving all sorts of flames from patients, left, right and center, saying we should have access to everything, and that’s not what I’m saying. What worries me is that there’s just a little bit of you need to be discerning, not least of all, because these things are not perfect, and you need to go at least a level or two below just to check. And you know, I don’t know what they’re doing in terms of hallucinations and some of the errors that these things can produce, but you know, you have to assume that some of that’s in there. How do we put guardrails around this? And is this the right sort of trajectory for democratization of access.
Craig Joseph
Those a lot of good questions. I’m not sure there’s a ton of good answers. Just to take us back, at least, you know what is open, open evidence, right? So at this point, it’s a website that is only accessible by physicians and advanced care folks who have who have a license or a National Provider ID Number, and it’s basically just a chat bot that’s trained exclusively on the medical literature. So think textbooks and research articles and that
Nick van Terheyden
scientific content is, yeah, I think
Craig Joseph
that’s fair. And you would think, well, it’s just, it’s, it’s trained on Only it’s not trained on the internet, which has a bunch of junk in it, but it’s trained on stuff that’s all real, so no problems. But there, as you point out, are problems and, and it helps to, I mean, it’s a great tool. I do use it regularly, for sure, but much to your point, like, I’m a discriminating user, I have a BS detector where I’m like, Ooh, I don’t does that. That doesn’t feel right exactly. That doesn’t feel right. What? I can’t really point it out, maybe, but I’m going to do a little bit more, maybe ask a question a different way, definitely go back and look at some of the things it’s pointing to. And I’ll give you one example where I was smarter than open evidence for a particular disease process that I have. I am well aware of the recommendations of the of the, you know, the specialty group, and I know that they came out with one, a new list of recommendations, a new article last year, which was updated from the one from four years from four years ago, and when I asked open evidence a question about me, it was giving me answers, clearly giving me answers from the one from four years ago, not the most current guidelines,
Nick van Terheyden
which raises an important point about these tools. They’re not. I mean, look, chat GPT certainly the free version. I don’t know if the paid version is, but that’s not up to date. It was locked in whatever year month, right? And that must be the same for open evidence, no.
Craig Joseph
Well, I know. I think what? Yeah, I’m the rich guy that pays the $20 a month for chat GPT. T, so I want to put that out
Nick van Terheyden
listeners, just for your information. That’s a jab at me, because I’m the cheap guy. Just saying, but
Craig Joseph
I’m just saying, like, it’s not $8,000 a month, $20 a month, or $240 a year. I do pay that to chat, G, P, T, and it is up to date. So I can answer that. I can at least I assume I don’t know. I don’t think it’s locked in. And I assume that none of these things are locked in at this point. That’s so a year ago. It’s a it’s a good question, but to kind of bring back to your point, like, if you just look at what someone, even the well trained chat agents, are saying, you’re going to be wrong sometimes, either you asked a question that is a little open for interpretation, or it’s looking at evidence that may not be the most relevant or the most recent, even if it’s available in its database. And so there does need to be a some level of skepticism, right? And I think as physicians, it’s, it’s built into our DNA, right? When a, and I think we’ve talked about, I remember vividly when a nurse would call and say, Hey, I got a critical lab value the patient’s, you know, hemoglobin is six, which is very, very, very low. And you know, you’re, you’re as a medical student, your first reaction is to panic and to start running around and trying to order blood. But as a physician, you know, as you’re trained, as you go through your training, like, wait a second, why would the patient’s hemoglobin? What was it before? Oh, it was, it was 12. Well, when was it 12 yesterday? Okay, well, how could it go down that much in one day? It can’t or there’s really no reason for it. It’s unlikely to be accurate. We question that, and then we what should we do? Let’s repeat it. That’s That’s it. That’s what we’re going to do. We’re going to repeat it because it doesn’t make any sense. And it’s that kind of skepticism or cynicism that I think helps keep patients as safe and healthy as possible. We do need that when we’re applying when we’re getting answers from chat bot, chat bots, whether it’s from chat GPT, which, again, is often
Nick van Terheyden
which has launched a health care version, albeit neither of us have gotten in
Craig Joseph
that is correct. So it’s a it’s launched a beta version that you need permission to get to, and both of us are on the waiting list. So I don’t know what it does. I suspect it’s, it’s not a lot. I think it’s really, I don’t think it’s there to be smarter. I think it’s there to keep to make people more comfortable with uploading and connecting their health data to open AI servers,
Nick van Terheyden
you know. But this raises another issue that’s related in my mind, which is the recent Apple Watch hypertension paper that they published, and it was, I want to say, self published. It wasn’t in a journal or anything, but they sort of detailed their study with, you know, relevant specificity and so forth. And it, in my mind, the same issue sort of arises with this, which, you know was something I don’t remember if we talked about it, but I know I thought it, and I certainly talked with some folks about this when they did the AF atrial fibrillation capability on the watch, and suddenly everybody was and the first thing I heard from cardiologist friends was they created a template to say, Yeah, forget what your Apple Watch said you’re fine, which is the worried well, not least of all, because you know, Who were the people that they surveyed, and whatever. And to be clear, that Apple Watch feature, which they’re talking about, which is to measure hypertension on a watch, I’d be the first one in line for that. I would love to have that. I think it would be hugely valuable. But it’s just is, are all these tools doing everybody a service or not?
Craig Joseph
Well, they’re certainly doing a service if they properly diagnose you with high blood pressure and or a fib, right? Your question is about false positives, right? When the when the watch or your other ones that they miss, false negatives. The false negatives, they’re
Nick van Terheyden
not hurting, yeah? So formal, false positives, false negatives, just
Craig Joseph
don’t ask me, please don’t ask me for the equations, the calculation. Oh, over here. Yeah. No, I will, yeah. I will always miss those. Specificity, sensitivity, no way. Yeah. You know, I listen, this is the way we make forward progress and with innovation. And I agree that you’re causing some problems because you’re telling people that they might have. And I think it always says, it doesn’t say you have, says you might have, and you. Consider talking to your doctor. It doesn’t tell you you’re going
Nick van Terheyden
to die. Go, come on, to be fair, that’s a cop out. That’s just, you know, cya type of
Craig Joseph
but it’s also, it’s also the company trying to diminish what you’re talking about, which is the risk of everyone being told that they have this thing and they better go to their doctor right away, or to the emergency room right away. And we don’t want that either, but we do want to be able to there are going to be people who are going to be diagnosed, who have been diagnosed because their watch said that they’re having, you know, this abnormality, and as long as the false positives are relatively low, I’m going to keep going with that. I don’t care what you say.
Nick van Terheyden
I think, hold on a second. I’m just gonna say I think it’s worth it a security camera that says, Oh my God, there’s a 17 armed assailants outside your door. They’re trying to break in, but check with your security expert first, just in case we’re wrong. I mean, really
Craig Joseph
doesn’t say that this is, it’s not these things are not things that you’re going to run to the emergency department for, right? But I do think it’s worth the conversation if these if, and again, your point’s well taken. If, five times out of six, in my experience as a cardiologist, I’m not a cardiologist, but if, if I’m a cardiologist, and you know, 70% of the time, 80% of the time when, when people call me and say, hey, it’s telling me this, and you come in and you do a bunch of expensive tests and like, you don’t have this, then grant I totally agree with I totally agree with you. But if that happens 10 or 20% of the time, and the rest of the time, 80 or 90% of the time, they’re like, Wow, you do have afib, you do have high blood pressure. We do want to do something about that and be aware of it, or or we just want to be aware of it. We’re going to follow you in six months or 12 months.
Nick van Terheyden
All of this would be great if we didn’t have a system that you can barely get an appointment.
Craig Joseph
But well, that’s a whole nother problem.
Nick van Terheyden
Yeah, unfortunately, it’s a whole different problem. Speaking of cardiovascular risk, have you? Have you assessed your cardiovascular risk based on some of the calculators I have? And how are you doing?
Craig Joseph
I am lucky to be alive. That is pretty much,
Nick van Terheyden
again, my concern about these things is it really telling me what I need. I was talking to one of my friends recently, and they were saying that, and they’re younger than me, to be clear, and they were told that, based on your metrics and whatever your your actual biological age is 86 or something, and I’m going, oh my god,
Craig Joseph
which is good because you’re 107
Nick van Terheyden
it’s, I see the value of it a single score, but I’m not so sure that it actually delivers the real proposition. I mean, hey, I use it. But again, to our point earlier, I think it’s about, you know, pick, pick something, and then dig into it. Don’t just accept it blandly as I think that the key correct, right
Craig Joseph
and, and, to your point, I’m just going to, I will continue to say that we need to kind of think cynically and and question, you know, question these things, and
Nick van Terheyden
I’m just gonna say for you and I that’s not difficult, but go.
Craig Joseph
But like to defer to expertise as well. So, I mean, I will tell you that I’ve looked at these scores, and I just years ago, I was just taking it. I was taking an aspirin. I was, I was I was told by my cardiologist, I should take an aspirin a day. And then he told me, 10 years later, stop taking an aspirin. You know, we have new research, and you probably don’t need to take this aspirin. I think we’ve been overdoing it, and so you should stop. And so I was like, gladly, I would gladly stop taking an aspirin. And then I moved I got a new cardiologist, and this guy
Nick van Terheyden
said, he said, take it. You need to take it out. Oh, my God, get on it right now. All right now. Now, two different from experts, I
Craig Joseph
understand, but I said, I said to him, like, hey, you know, I’ve seen this guy did this, calculate this calculator thing, and it tells me my, you know, my risk is low, relatively speaking, and and some other information that already come to bear that the other doctor didn’t know. And basically this, this guy told me convincingly, that, yeah, that’s great. That calculator is great for the average person, but you are no longer the average person, because we have more information about right than we do about the person walking and off the street. So that calculator is of no use to us. Now for you, for you, I think
Nick van Terheyden
that’s I’m gonna, I’m gonna call it out, because I think that’s a really important point. The calculator only has a limited number of inputs. It’s and when you put the individual in front and then take in all of it, that’s really that’s the differentiator, right? I mean,
Craig Joseph
it’s a tool, right? It’s a tool that you should use, just like any tool. If you have a hammer, that’s not your only tool. If that’s all you have to help you build a house or fix a project, you’re in deep, deep trouble. And so it’s a tool, and it needs to be used appropriately. And it’s, it’s not for everyone, and again, it’s really just a hey, there are, there are people who, you know, they’re more worried about bleeding than they are about preventing heart attacks, which is a valid that is a valid concern, and and that’s a reasonable statement to make and to have a good conversation with your physician about. So yeah, I think what we’re really coming down to, Dr Nick, is there’s no simple answers in life, no shocking and when people tell you there are simple answers, they’re mostly trying to get your money.
Nick van Terheyden
Yes, I agree. So moving on electronic medical records and lawsuits, and one of our major players in this space epic is both the subject of and actually initiating, I think. And it was the initiated lawsuit that I looked at. And I went, Hmm, they are suing health guerrilla, plus a couple of other companies, I believe, as part of this whole consortium. And I did read the legal documents, because I’ve spent a lot of time reading legal documents the last six months for a variety of reasons. So I thought, Oh, I must go read. And I gotta say, I was struggling to see the other side of the case. Obviously, I’m looking at one perspective that came from Epic it seems. I don’t want to say cut and dry, because obviously it never really is. Well, maybe it is, but they are suing health guerrilla because they’ve essentially used the sharing of information rules and regulations to not just take the information, but then to use it to create lawsuits. Was what I read in all of this. What are your thoughts?
Craig Joseph
Gregg, yeah, it’s a thorny subject. And let me put out the disclosure that I used to work for Epic. I no longer work for them, and I have no financial ties to Epic, however, much like you, I read the entire lawsuit, which is very difficult.
Nick van Terheyden
This is a really sad commentary on you, and I that we have the time
Craig Joseph
very sad. I agree it was very sad, but it kind of read like a soap opera. I think that was why it was so good. I just kept reading it, and they and and let us be clear that we do not have a response, a publicly available response, so all we have is assertions made by one party or several parties against several other parties. Health grill is one of them. And so, yeah, so all we’re doing is basing this all on one side. However, it’s pretty I, you know, I struggling to understand the other
Nick van Terheyden
side. The data was compelling, right?
Craig Joseph
I mean, oftentimes you hear something, you’re like, Well, I hear that, but I could also see the other like, I’m having trouble seeing the other side. And basically what, what this a few of Epic’s customers and epic are alleging, is that some bad players gained access to the system by which we share electronic health records and share medical data. And the way it works, it’s all voluntary. And the way it works is, if you say you’re a medical office or a hospital treating a patient, you can look at their information. That’s how it works, and there’s no proof. Typically involved. It’s just you are asserting that you are seeing them for because you’re practicing medicine and you need to have that for the care of the patient. And the allegations are that there were companies that were helping other entities who are not taking care of patients, get information, and that’s okay to try to do that, but it’s not okay to do that and say, and we need that information because we’re treating the patient. If you’re a law firm, you are not treating the patient right? You are. You are probably trying to find people who you think are damaged, who were, you know, hurt by something? Oh, you took this medicine. We’re looking for people who will join our class action lawsuit. That’s great. You should do that, but you can’t do that by cheating the system.
Nick van Terheyden
It’s a next level version of the ads that I always see. Have you had this exposure to bloody blah? No, no. Why? Let’s not bother asking. Let’s just go search all the data we can steal.
Craig Joseph
Why would we pay it? Why would those law firms pay all that money to be on TV? Why not just look through every single person’s information in the United States, right, and find them and then reach out to them? But again, we didn’t approve. Like no one asked me if it was okay, right for law, for lawyers or anyone else trying to sell me something to look through my information, when asked me, and I would say no, if they
Nick van Terheyden
did, once again, you and I think are big proponents of, you know, sharing, open sharing of clinical data for the benefit of the patient, but once again, assuming that it’s proven correct and all to remains to be seen. You know, a bad actor or two or three or whatever it is, spoils it for the rest of us. It’s just, it’s really, it’s so frustrating to you know, anyway, I just, but I was, it was, I don’t want to say, I can’t say I enjoyed reading it, but I was certainly my I had to pick my jaw up off the floor a few times. Anyway, let’s, let’s talk just briefly about health insurance, because I want to say that’s been, I’m still not quite sure where we are, because I’ve seen sort of various attempts to try and, you know, recover from the loss of subsidies for people that are losing insurance. I’ve heard lots of different numbers. Where are we with that? Do you know?
Craig Joseph
Well, I just read a story in The Wall Street Journal this morning, and there’s a lot of people who are kind of in the in between area in terms of their income, who have are going to be going without insurance because they’ve lost the subsidies. And so think about a family of four, making $100,000 a year. They make too much money to get subsidies now or to qualify for Medicare or Medicaid, but they don’t have insurance through their employer, so they have to get it themselves on the on the public market. And there are so many stories of insurance, of the of of being forced to get worse coverage, so less coverage, and paying two, three times as much a month. And I think in the headline of the story that I read today, it mentioned approaching what people are paying for their mortgage to pay for their health insurance, which is often bad health insurance, right? It’s low, not horrible, but it’s both basically like, yeah, if you’re not dying, it’s not helping. Helps a lot if you’re dying, but if you’re not dying, it’s not helping. And I read even one they had one example. This is not typical, but one example where I think, though it went from like $150 a month that they were having to pay to 1500 10 times, 10 times, right? Again, that’s an outlier, but that’s not sustainable. People can’t do that and so and then they’re now caught in. Some of these folks are caught in this trap where someone said, Well, I was going to try and get some extra pay, you know, do drive an Uber or do something like that, but if I make too much money, then that pops me into even higher you know, bracket where I’m I have to pay even more, and that money doesn’t cover the so it’s, there’s, yeah, so this is bad for everyone. It’s certainly bad for those people who are either losing good coverage now they have bad coverage or losing all their coverage so they don’t have any coverage, because guess what, they’re going to end up in the emergency department when they get really sick. And guess who’s going to pay for that? You and I are paying
Nick van Terheyden
for that. That’s exactly right. And by the way, you’re overwhelming the emergency department and overwhelming the staff there, who are completely and utterly injured beyond belief, with moral injury and burnout. It’s just, it’s, it is so unsustainable, you only have to go spend time there. I know it was always, at least, when I was practicing in in the ER, you know, you would find people that you go, Really, why are you here? And this was in the free system, to be clear, this was in the NHS. But it wasn’t ever terrible. I mean, there were, but mostly you were doing good work. Now, I don’t know it’s, it’s a i, and this just adds to it, makes it even worse. It’s, it’s truly shocking, truly shocking. It we have to find a solution. Unfortunately, that’s not something that we’ve been able to do or even come up with an idea, but, and as usual, we’ve run out of time. We find ourselves at the end of another episode exploring Healthcare’s mysteries before they became your emergencies. Let’s hope until next time, I’m Dr Nick
