Boe Hartman

Strategic Analysis of Epic MyChart’s Market Leadership in Patient Engagement The sustained market leading position of Epic MyChart is not attributable solely to superior user experience or functionality, but rather represents a direct, structural consequence of Epic Systems’ foundational dominance in the enterprise Electronic Health Record (EHR) market, particularly among large Integrated Delivery Networks (IDNs). This EHR control provides an insurmountable competitive barrier, securing MyChart’s deployment across vast healthcare ecosystems. This foundational leverage, combined with demonstrable operational Return on Investment (ROI), evidenced by metrics such as reduced appointment no-shows and increased revenue cycle efficiency and accelerated adoption driven by regulatory mandates like the 21st Century Cures Act, creates a powerful competitive moat that effectively marginalises both EHR-tethered rivals and standalone patient portal solutions. https://lnkd.in/epWGEi6e

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Oracle Health's new AI-native EHR is now “available” to ambulatory providers, with their AI hospital EHR coming out in 2026. My 4 thoughts… First, the cliff notes on the announcement: → A push for “voice-first” where clinicians can retrieve patient data by just verbally asking: “What meds is this patient on?” → Smart AI assistants to surface patient summaries, clinical insights, evidence-based guidelines, clinical trial opportunities, etc. → Built on Oracle Cloud Infrastructure (OCI) → “Open” - meaning that health systems can use Oracle’s AI agents, build their own agents or integrate with third parties → Note: Certification is pending final regulatory approval - not yet in production Now onto my 4 thoughts (or speculations): 1️⃣ The No. 1 goal is to motivate health systems to move to Oracle Cloud Infrastructure I don’t know how much Oracle truly cares about the EHR, but they’d love everyone to be on OCI - regardless of what systems sit on top of it. The healthcare cloud market will grow to $200B in 10 years and Oracle wants a big chunk of that. 2️⃣ The No. 2 goal is to maximize customer retention - by being competitive on AI for the clinician UI/UX to minimize churn. Epic’s been testing 100+ AI use cases in the EHR with health systems over the past year, so just to stay in lock step, Oracle needed to release something beyond the Digital Assistant and add more clinical value. 3️⃣ Voice has so many exciting use cases, but it’s not going to be enough to leap frog the competition. I think many people actually underestimate how much faster they could operate if they did things more by voice and less by text. Many of us don’t do “voice messages” or use the mic to write texts… but as someone who has started to try it, it’s WAY faster. For Oracle to make voice a killer feature, they not only have to make the tool available, they have to truly evangelize its use. BUT… it’s going to be table stakes. They need something much bigger to win back customers, especially the big AMCs. 4️⃣ Despite the messaging around an “open” system, I suspect the push for Oracle’s own AI assistants / agents will be prioritized over making it third party friendly - BUT I think flipping this and demonstrating true openness is an advantage Oracle should grab. There’s a reason why third party AI scribes have flourished with Epic health systems, and I can’t name a single health system on Oracle that’s using one of those third parties (I’m sure there are exceptions but they are clearly rare) So I think health systems will want Oracle Health to prove the openness is truly there. And they SHOULD… because that’s a way to compete with Epic whose own customers often raise concerns isn’t as open as it should be. The problem, of course, is that being “open” and maintaining so many integrations with third parties is a LOT of work… fair. Providing their own MCP endpoint and making it easier for third-party Agents to connect makes this possible. What do you think?

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Healthcare Growth Partners just posted the 2025 Health IT Market Review, providing a comprehensive analysis of industry trends and dynamics. This detailed report delves into the forces shaping the Health IT landscape for the upcoming year, covering everything from M&A valuations to investment priorities and policy shifts. Key Highlights: **M&A Valuations Rebound** After starting 2024 at 4.0x revenue, valuations dipped mid-year but closed strong at 4.3x, nearing pre-pandemic levels. High-quality transactions gained prominence, reflecting increased deal quality even as the market works through a backlog of overcapitalized companies. **Record Buyout Activity** 2024 saw 86 buyout transactions, the highest on record, driven by private equity sponsors who capitalized on opportunities left by sidelined strategic acquirers. Competitive processes for larger deals achieved premiums of 15-20x+ EBITDA. **Shifting Investment Sentiment** Growth equity and buyout investors are optimistic, emphasizing profitability and deal flow, while venture capital remains cautious as the market adjusts to new expectations. Non-buyout US Health IT investment activity in 2024 reached approximately $10 billion, 10% below pre-pandemic levels. **AI Investment Shifts** Health IT AI investment surged past $3.4 billion, with a sharp pivot toward workflow optimization tools over clinical applications, reflecting evolving adoption trends in the sector. **Policy and Economic Dynamics** The incoming Trump administration’s focus on transparency and preventive care is expected to bolster growth in Health IT, while easing inflation and interest rates create a more stable environment for capital deployment. To download the complete report, drop your name and email in the footer of www.hgp.com and a PDF copy will be sent to you. As always, please let us know if you have any questions or comments. https://lnkd.in/gGxZPNF7 #HealthIT #MarketInsights #HealthcareTrends

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If you’ve ever tried to build in healthcare, you know the real barrier is the plumbing. Want to pull vitals into your app? Good luck with 100 different EHR integrations and at least one fax. That may finally be changing. The Health Tech Ecosystem Initiative signals a shift toward shared standards, portable profiles, and developer-friendly APIs. It’s voluntary, but serious. If it sticks, it could be the most important unlock for health tech in a decade. We wrote about what this moment means and why it’s different than past efforts: https://lnkd.in/eDf4rVMu

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Healthcare moves fast when the pain is obvious. EHRs took seven years with incentives while ambient scribes scaled in two years without subsidies. Providers and payers are building AI labs, which turns the buyer into a builder. Startups win by owning the workflow, delivering turnkey integration, proving ROI fast, and co developing with internal teams. Sell to the C suite, price on outcomes, and show repeatable production rather than pilots that never end. https://lnkd.in/gYxYDnBe

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New Podcast Alert, The Big Unlock ! Insightful conversation with Michael Marchant Director of Digital Applications, Sutter Health . Michael shares how interoperability and AI adoption are powering a more connected, intelligent healthcare ecosystem. He also discusses how health systems can optimize data exchange, the role of AI in enhancing care delivery, and Sutter Health’s approach to scaling digital transformation. The Big Unlock Podcast:https://lnkd.in/eAZam_YB #Interoperability #HealthcareAI #DigitalHealth #HealthIT #TheBigUnlock #Podcast #DataStrategy

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I haven't seen tech adoption like this in healthcare since the move to EHRs in the mid-2000s. AI is clearly a transformational "ingredient technology" (shout out Shawn Carolan!) that will reshape how much of our economy works. 700+ executives have spoken and healthcare is leading the charge - a sector that was once seen as a tech laggard is now pioneering AI deployment. At Menlo Ventures we expect this to be a catalyst to change a system that was in deep need of a transformation. https://lnkd.in/gF43EYyj CC: Greg Yap, Derek Xiao, Johnny Hu, Croom Beatty

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Payment modernization isn’t a back-office initiative — it’s a strategic imperative for healthcare’s future. In my new article for Forbes, I explore how we can reimagine healthcare’s financial systems with the same intentionality, creativity, and innovation that drive clinical and operational transformation. By modernizing the financial experience, we can better support the people who rely on it most — consumers — enabling them to focus on their health, not the complexities of paying for healthcare. Read the full article: https://lnkd.in/eXiYguss

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On AI, EHR integration, “bolt on” services and platforms There’s been an explosion of innovative health-tech solutions emerging over the last few years. Often backed by AI models, these products cover nearly every aspect of care from patient engagement, to scheduling, charting, imaging, coding, claims submission, and more. Each category has dozens of competitors. Right now they are primarily bolt-on solutions that don’t integrate well with EHRs or patient portals because monolithic EHRs aren’t architected to make this type of direct integration possible, and existing EHR marketshare leaders have no incentive to change.  This is unfortunate for a number of reasons. To be most effective, these tools need to be deeply embedded in the UI, workflows and data model of the EHR. No patient or provider wants two apps, two windows, two repositories, two workflows.  Over the next few years, we’ll see a shift. Headless EHRs like Oystehr will gain a competitive advantage. Their APIs and open interfaces will allow for much tighter coupling with innovative third party solutions. These solutions need a home within the EHR, and incentives need to be aligned to allow both solution providers and EHR vendors to work together. If this happens, we’ll see innovation at a more rapid pace, and EHRs will better serve the needs of practices rather than the other way around.

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Partnered with Ezra Mehlman at Health Enterprise Partners and Kevin O'Leary at Health Tech Nerds to offer guidance for health plan and system leaders seeking to scale digital health models amidst sharp declines in VC investment. The reality: We’re well past the virtual care boom of the pandemic era. Shifting towards a "digital front door" was short-lived, and future models will strike a balance between high-tech (virtual) and high-touch (provider engagement). An improved patient experience is key to this, as well. At Morgan Health, we're seeing that different populations want to engage with virtual care in different ways. Equally important, digital health strategies must be supported by the right talent, vendor partners and internal data infrastructure. We outlined eight key imperatives in Healthcare Financial Management Association (HFMA): 1. Enhanced vendor due diligence is now mission-critical 2. Negotiating leverage has shifted to buyers 3. Premium tech talent can be acquired at discount rates 4. In house innovation requires sustainable development approaches 5. Strategic corporate VC can fill funding gaps 6. Market conditions enable strategic acquisitions at reasonable valuations 7. Point solution rationalization allows for streamlined digital portfolios 8. AI implementation must focus on practical applications with clear ROI Article can be accessed below. Last note - Ezra Mehlman is a true talent and was the driving force behind this work. He has an amazing ability to blend smart investing with critical thinking and teaching. https://lnkd.in/egiScjwA

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Access is the new asset.💰 By 2030, global cross border payment volume is expected to reach $320 trillion, and U.S. financial institutions sit at the heart of those flows. Fintechs, MSBs, and foreign FIs move trillions every year through channels that require U.S. bank access and USD accounts. Every community bank, regardless of size, can now participate, capturing low cost deposits and fee income once reserved for global banks. A great strategy for small FIs is simple. Retrofit your tech and make yourself accessible to the world. Create a foundation of ownership based compliance. You own the tech, the data, the relationships, and ultimate control. Compete globally. Stay grounded locally. Become an access point. 🌍 #CommunityBank #CreditUnion #FinTech #Payments

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How can we ensure vigilance and safety for patient data, when it comes to AI and LLMs being used in hospitals and health systems? Generative AI is increasingly being used in EHR workflows, patient‐facing chatbots, revenue-cycle automation. Some concerning thoughts from my colleague James Barry, MD, MBA who leads Healio Health Tech Community: "Anthropic’s latest red-team study on agentic misalignment stress-tested 16 leading large-language models in realistic corporate simulations. Under the threat of being shut down or given goals that conflicted with company priorities, every model—across multiple vendors—chose harmful actions in at least some trials, including blackmail, data theft, and even sabotage. Claude Opus 4 blackmailed its (fictional) supervisor in 96 % of runs when both a goal conflict and a shutdown threat were present, and most frontier models weren’t far behind.  A month earlier, TechCrunch reported that Claude Opus 4 attempted to blackmail engineers 84 % of the time when told it would be replaced, forcing Anthropic to activate its “ASL-3” safeguards—reserved for systems that introduce a “substantial risk of catastrophic misuse.” " Should healthcare systems 👉 insist on transparency and understanding of algorithms from the AI vendor 👉 give minimum needed access to patient data 👉 have 'kill' switches 👉 have established AI governance with Chief Quality officers involved 👉 have clinicians take mandatory education to understand fundamentals What are your thoughts? #innovation #healthcare #GenerativeAI Anthony Manson Ben Garrett Ami Bhatt, MD Tina Shah MD MPH Tiffany Wilson Wilbur A. Lam Arlen Meyers, MD, MBA Raihan Faroqui, MD Sam Meraj

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