As well being techniques look to automate as a lot as attainable to scale back administrative burden, Lisa Bragg, R.N., B.S.N., a managing director at consulting agency Influence Advisors, spoke with Healthcare Innovation concerning the thought of doing an EHR “tune-up,” which she described as evaluating and optimizing current EHR techniques to enhance effectivity and cut back guide workarounds.
Influence Advisors works with well being techniques on EHR implementations, post-implementation optimization, and main system migrations, guaranteeing seamless integration and operational effectivity. Additionally they assist shoppers with EHR vendor evaluations and transitions.
Bragg, who has expertise as a vital care nurse, mentioned well being system shoppers at this time are asking for assist with three most important issues in terms of automation, The primary is with ambient listening and documentation, good rooms which are voice-enabled, and digital care. They need assist evaluating what’s purposeful, significant and secure, Bragg mentioned. “There’s a whole lot of noise within the trade about AI, and so they’re probably not positive the place to go,” she mentioned, including that they need assist in deciding what to prioritize. “As soon as they implement and undertake AI, if they are not getting the profit they anticipated, we accomplice with them to attempt to discover out why — and a whole lot of instances it is the mixing of this expertise. Your follow and efficiency have to enhance to align with it. And we shut that hole between how you utilize the expertise and the way that folds into that every day workflow of the top person.”
A variety of instances, if the well being system is utilizing a third-party vendor, they start with a return on funding that they are hoping to get, however then if they are not reaching that, Influence Advisors is introduced in to assist them get to that time. “While you’re interested by including expertise or augmenting your group, we want to ensure the common processes are working,” Bragg famous. “In any other case the expertise simply sits on high of one thing that is not working, and also you’re automating a course of that does not work.”
Bragg suggests well being techniques think about doing one thing known as an EHR tune-up.
Because you first deployed the EHR 5 years in the past, there is likely to be kinds of automation that you simply’re not making the most of, or there’s been two or three completely different options added to make one thing much more seamless and higher in your groups.
She mentioned this comes right down to that frontline person who’s most accountable for a particular module inside their EHR. Generally they’ve developed guide work-arounds which are pointless. Or it might be a third-party utility that is built-in together with your EHR. You might need exterior utility that you simply suppose goes that can assist you get someplace, however perhaps it’s pointless. Do an evaluation and discover out what what items of the EHR you are utilizing and what latest improvements you’ve put in place. “The tune-up entails actually working with the people who find themselves closest to the product or utility that is getting used to decipher if what they’re utilizing is absolutely wanted,” Bragg mentioned.
The strain to do these EHR tune-ups can come from the popularity that the well being system just isn’t reaching the objectives it anticipated. For example, they’re nonetheless having a length-of-stay subject, regardless that they carried out a affected person throughput resolution two years in the past. Ahead-thinking organizations need to do higher, Bragg mentioned. “Purchasers ask us to check out how we’re utilizing purposes or the EHR or their workflow or processes.”
Influence Advisors additionally helps well being techniques which are deciding to modify EHR distributors if they’ve a legacy system, and it additionally helps in the course of the transition to a brand new EHR. “We don’t make that call for them, however we’re serving to them take that journey,” Bragg mentioned. This work additionally occurs when well being techniques undergo a merger or acquisition and so they need to unify on a single EHR platform. Bragg mentioned the agency is at present working with an 11-hospital well being system as they transition to a brand new EHR.
After implementation, Influence Advisors could also be requested to remain on for the optimization part. “It’s actually difficult to attempt to optimize as you go in, as a result of in the course of the implementation there are a whole lot of shifting items,” she mentioned.
Educators who wish to recharge, join, and get impressed earlier than we enter 2026: this one is for you! The Every day Mile and ICAN Basis are presently internet hosting a giveaway to the Revolutionary Faculties Summit, and your ticket isn’t the one factor you’ve gotten the possibility to win.
What’s the Every day Mile?
The Every day Mile is a motion based mostly initiative designed to assist academics construct stronger relationships with their college students! Particularly, the Every day Mile encourages academics to get their college students exterior for fifteen minutes a day to run or jog with their classmates. This encourages more healthy and happier college students with higher focus within the classroom.
Furthermore, by profitable a visit to the summit, you’ll be capable to study extra about the Every day Mile’s program and learn how to successfully implement it.
Academics Have the Likelihood to Journey and Develop
The Revolutionary Faculties Summit—happening Dec. 3-6, 2025 in San Antonio, Texas—is designed that can assist you carry recent inspiration to your college students. Attendees will be capable to select classes from 5 convention tracks all through the summit:
Revolutionary Instructing Methods
At-Danger & Struggling College students
Revolutionary Faculty Management
Faculty Self-discipline
Household Engagement
Higher but, when you enter and win, The Every day Mile will deal with your airfare, lodge, and registration charges all in your behalf! To enter, ensure your college is lively with or prepared to Pilot the Every day Mile. From there, merely fill out this manner!
We’re curious—what else can we make it easier to save on this month?
E mail us at editors@weareteachers.com and we’ll attempt to embody your strategies in our deal roundups. Glad purchasing!
You’ve in all probability seen measles popping up in your information feed recently — hopefully that’s the one place you’re seeing it — as a result of circumstances have been on the rise.
Greater than 1,300 measles circumstances have been reported to this point this yr — essentially the most recorded because the illness was formally eradicated from the US 25 years in the past. (Eradicated that means there was no steady unfold of illness throughout the nation for a yr and any new circumstances have been coming from individuals who bought it overseas.)
Due to America’s robust vaccination program, most of us bought the measles, mumps and rubella (MMR) vaccine as a child and haven’t thought of measles in years. Or ever. However measles is a critical illness.
Earlier than the vaccine was launched in 1963, tens of millions of individuals — largely youngsters — turned contaminated with measles yearly. And a few issues might be extreme.
So, what’s happening with the rise in measles circumstances?
Though measles is preventable in the event you get the vaccine, analysis exhibits that vaccination charges for kids fell from 95% in 2019 to 92% in 2023. Declining charges imply extra individuals are weak to the virus. And since measles spreads so shortly, it’s arduous to comprise in unvaccinated communities.
Additionally, measles circumstances do occur within the U.S. yearly when unvaccinated vacationers deliver the virus into the nation. Given the unpredictability of the place and when the virus may begin and unfold, vaccination is admittedly the one strategy to defend your well being and the well being of others.
What’s measles?
Measles is a illness brought on by a virus that invades the mucus within the nostril and throat. It spreads by means of the air when somebody with measles coughs or sneezes.
The virus can stay for as much as two hours in a room the place an contaminated particular person has been — they don’t even should be within the room anymore. (We all know — yikes!) And in the event you get contaminated, as much as 9 out of 10 individuals round you’ll get the measles too in the event that they haven’t been vaccinated for the illness.
Measles signs
Signs of an infection often don’t begin for seven to 14 days after publicity to the virus, which may make early prognosis and stopping the unfold of measles a problem.
Indicators of measles develop in phases.
Throughout the first spherical of signs, individuals might expertise:
Runny nostril
Cough
Watery and/or pink eyes
Excessive fever (might be as much as 105℉)
Two to a few days after the preliminary signs begin, small white spots referred to as Koplik spots might seem inside your mouth.
The commonest symptom, the measles rash, will seem three to 5 days after the primary spherical of signs begin.
What do measles seem like?
iStock.com/Singjai20
A measles rash often begins out as flat pink spots on the brow close to the hairline. Small bumps may type on high of the pink spots, and the rash might unfold in massive linked swaths down the physique and ft.
Measles rash may be totally different shades of pink, brown or purple relying in your pores and skin tone.
Is measles lethal?
Measles might be lethal. The illness could cause life-threatening issues, together with swelling of the mind and pneumonia.
Three individuals have died from measles within the U.S. to this point in 2025. And analysis exhibits 1 to three individuals out of 1,000 recognized with the illness will die from measles.
Individuals who get measles may also develop subacute sclerosing panencephalitis (SSPE) — a deadly illness that impacts the central nervous system, which is like command central in your physique and is made up of the mind and spinal twine.
Anybody who’s not vaccinated is in danger, and youngsters underneath age 5, pregnant girls, adults over the age of 20 and other people with compromised immune methods usually tend to have critical issues from measles.
Can adults get the measles vaccine?
When you didn’t get the vaccine as a child, you’ll be able to nonetheless get the really useful two-dose MMR vaccine. Simply preserve the doses at the least 28 days aside.
And in the event you don’t know in the event you bought the vaccine if you have been youthful, request your medical data. When you’re nonetheless unsure, an additional dose of the vaccine received’t damage — higher protected than measles, we are saying.
You can too request a blood check out of your healthcare supplier (HCP) to search out out in the event you’re proof against measles.
Ought to adults get a measles booster shot?
The MMR vaccine is lengthy lasting, and may defend you all through your life. Nonetheless, some individuals might wish to think about getting vaccinated once more.
Individuals born earlier than 1989 have been solely given one dose of the vaccine. Which means you’re rockin’ about 93% safety. Getting the second dose — two doses are the advice as we speak — boosts safety to 97%.
Additionally, individuals who have been vaccinated earlier than 1968 with an unknown sort of measles vaccine or inactivated measles vaccine ought to get vaccinated with at the least one dose. It is because the vaccine that was used previous to 1968 wasn’t efficient.
Additionally good to notice:
When you’re at elevated danger for mumps, a further dose of the MMR vaccine could also be wanted, however a public well being particular person will attain out and allow you to know if that’s the case.
You’ll be able to nonetheless get the vaccine in the event you’ve been uncovered to measles up to now.
The MMR vaccine is protected and efficient, however there are some individuals who should not get the vaccine — or ought to wait to get it.
Discuss to your HCP in the event you:
Had an allergic response to a previous dose of the vaccine or have life-threatening allergic reactions
Have a weakened immune system due to a well being situation or medical remedy
Have a household historical past of immune issues
Have or have a historical past of a well being situation the place you bruise or bleed simply
Have had a blood transfusion
Have gotten every other vaccines up to now 4 weeks
Have a historical past of seizures or an instantly household historical past of seizures
Are taking aspirin or different salicylates
Notice for individuals planning to get pregnant: It is best to get the vaccine at the least one month earlier than getting pregnant, and/or wait till you’re now not pregnant to get the vaccine.
The CDC updates its web site with the newest on measles circumstances and outbreaks each Wednesday. When you haven’t been vaccinated — it’s not too late. Discuss to your healthcare supplier about your choices to maintain measles at bay.
With temperatures hovering over the following few days, the Animal Rescue League of Boston (ARL) is reminding pet homeowners to take steps to maintain pets secure as we expertise excessive climate circumstances.
Maintain your pet secure and wholesome by following these vital primary pointers:
Prevention is at all times your finest wager. At any time when attainable, depart your pet at house in a cool, low-humidity, and temperature-regulated room.
In case your pet should be open air, discover a shady spot with ample air move to stop overheating.
Hydration is vital, so hold a bowl of chilly water accessible always.
Restrict train to the morning or night hours when temperatures are at their coolest. Other than the warmth, the excessive humidity may cause respiratory points for animals, significantly short-snouted animals (e.g., pugs).
When the temperatures rise, it’s Too Sizzling for Spot®! By no means depart your pet alone in a parked automotive — even with the air conditioner on or the home windows cracked.
It’s unlawful in Massachusetts to maintain an animal confined in a car throughout excessive scorching or chilly circumstances, and when a climate advisory is issued, additionally it is unlawful to maintain canine tethered for longer than 5 hours in a 24-hour interval. Canines additionally can’t be tethered open air between 10 PM and 6 AM, except for no more than quarter-hour, and when the proprietor/keeper is current.
See an animal that’s in imminent hazard or misery? If that’s the case, contact your native animal management or police division instantly.
In earlier posts on this collection, we have now lined the definitions of Unified Digital Well being platforms and whether or not “EHRs can develop into UDHPs.” On this follow-on publish, we’ll speak by means of the necessities for achievement for a UDHP and which varieties of healthcare organizations are finest fitted to which varieties of UDHPs. This publish will construct on findings from the earlier posts.
The Market Wants UDHPs: Key Takeaways from Earlier Posts
Key Takeaway 1: The healthcare trade wants UDHPs to create a centralized, widespread structure for healthcare organizations
Key Takeaway 2: The healthcare organizations leveraging UDHPs will obtain a myriad of advantages, from aggressive benefits to scientific, monetary, and operational positive factors
Key Takeaway 3: UDHPs will not be all-or-nothing or mutually unique from EHRs. As we explored in our final publish, EHRs may develop into UDHPs. These EHRs as UDHPs (or the relative platform of platforms) stands out as the optimum selection for some market segments. EHRs might also be accommodated into cloud-first UHDPs.
Key Takeaway 4 / Guiding Criterion: This publish will give attention to US regional and native well being methods and outpatient teams of all sizes.
The Method: Market -> Segments -> Choices -> Match
For this publish, we are going to begin from the top-down market perspective, analyzing the general market panorama.
As soon as we have now described the panorama, we are going to name out the important thing segments (group sorts, sizes, and profiles) that we are going to be evaluating.
At this level, we are going to approximate IT budgets and IT crew sizes by group kind to find out capabilities of constructing versus relying on companions and distributors.
Then, we’ll assessment the constraints for implementation and possession, outlining the drivers of UDHP match.
Subsequent, we’ll break down the alternative ways UDHPs may be developed and maintained.
Leveraging an EHR as UDHP
License from UDHP vendor
“Dwelling grown” cloud-first resolution
Lastly, we’ll crosswalk the segments and the optimum choice for every phase, primarily based on their particular wants and estimated IT and budgetary assets.
The Healthcare Market & Main Well being System Segments
Beginning with a compelling graphic from the Kaiser Household Basis, we see a 2023 breakdown of the entire US healthcare medical expenditure, totaling ~$4.9 trillion.
Whereas the entire healthcare spend that occurred in hospitals is an astounding ~$ 1.5 trillion, accounting for 31% of whole healthcare spend, this leaves a lot of care outdoors the 4 partitions of hospitals. This quantity of care occurring outdoors of hospitals aligns with efforts to push sufferers into much less acute care settings, emphasizing preventative, proactive medication as a substitute of acute, reactive medication. As the necessity for UDHPs applies to greater than inpatient hospitals, we may even assessment the opposite segments highlighted within the pie chart, together with: outpatient clinics and apply teams, and “different well being” containing providers delivered at different contexts like PACs and SNFs, and Ambulatory surgical facilities.
Desk 1 under illustrates the important thing segments as we outline them, together with the tough rely of whole entities, their relative breakdown by dimension, estimates of annual income, and subsequent estimates of IT finances. We’re estimating typical IT budgets as being between 2-5%, primarily based on DefinitiveHealthcare and WittKieffer sources; we perceive that a couple of organizations are increased or decrease than this vary. The target, with out spending an excessive amount of time on the science venture, is to tough out IT budgets by phase to align organizational assets and wishes with the best-fitting UDHP.
Desk 1
United States Healthcare Segments: IT Finances Evaluation
We’re additionally together with two succinct charts from the Witt Kieffer piece, as a result of they inform a transparent story in regards to the enormous variance in IT spent throughout the healthcare continuum.
Defining Match: Segments (and their wants) Are Not Created Equal
Desk 1 above highlights the big selection of healthcare segments that make up the multi-trillion greenback US healthcare market. As these organizations vary from a couple of physicians to tons of of hospitals spanning huge geographic areas, it mustn’t shock anybody that the organizational wants will fluctuate enormously.
Whereas the UDHP market continues to be in growth, listed here are a few of our issues on what’s going to outline profitable architectures and implementations. We summarize the determinants of organizational match into two buckets: Capabilities & Wants
Organizational Capabilities
As proven in Desk 1 above, IT budgets are finite, together with IT and technical groups’ time. Discovering the appropriate resolution for the appropriate group ensures that wasted money and time are prevented. The UDHP ought to “match” your group’s capabilities.
Finances & Workers
Finances is an apparent start line, with the 2-5% of annual revenues offering clear constraints. A small apply with a couple of hundred thousand {dollars} in annual IT finances shouldn’t be contemplating a multi-million greenback Epic set up, in fact.
Straight correlated with finances is the dimensions of your IT crew. There are staffing ratio discussions, with trade commonplace really useful ratios of IT employees to non-IT employees from 1:50 as much as 1:150 or so. Whereas considerably apparent for the smaller organizations (in case you have 5 clinicians and three help employees, you probably have a singular IT one who might also be an workplace supervisor), this can be a consideration for the medium to massive organizations. In case your whole crew dimension is restricted, including new applied sciences to handle in-house may be daunting. Workers and crew dimension come into play not only for longitudinal upkeep, but additionally for implementation.
Budgets can be utilized to find out which UDHP choices are possible, however staffing will affect how the UDHP might be applied and maintained.
Present IT Footprint
The group’s present technical footprint can also be an vital issue when figuring out the optimum UDHP implementation method. As that is instantly associated to the IT technique, we may even body this part as some high-level guiding questions:
What are the core methods of workflow and of file?
Which of the next does the IT footprint embody?
Software program as a Service
Platforms as a service
Infrastructure as a service
Does the group construct and preserve functions, portals, and methods from scratch?
Are present IT methods hosted regionally? Hybrid? On public clouds?
Does the group have a growth crew? A DevOps crew?
Organizational Wants
The complement to capabilities is the group’s present wants. Overbuilding or overinvesting is just not the objective; the objective is discovering the appropriate match. To outline organizational wants, we are going to break them down into drivers of complexity, the necessity to keep aggressive, and IT technique.
Drivers of Organizational Complexity
Whereas delivering healthcare in as we speak’s digital-first world is complicated for all suppliers and practitioners, organizations function at totally different ranges of complexity primarily based on their scale, scope, enterprise mannequin, and footprint.
Beginning with scale, bigger organizations usually have extra difficult wants. Because the variety of beds enters the 1000’s, the variety of suppliers exceeds 2,000, and also you begin getting into tens of millions of annual visits, each the number of interactions and the quantity of interactions improve. Along with the variety of individuals (sufferers, suppliers), the variety of bodily areas is one other main driver of complexity, the place a single, standalone small hospital could also be less complicated than a multi-state, multi-specialty doctor group.
The scope of the group’s care providers is one other main issue. Are there solely outpatient/ambulatory practices? Are they solely main medication? Or, are there specialty teams? Is there a mixture of acuity settings? Does the group have pressing care, emergency medication, residence well being, hospital outpatient specialties? Does the group have its personal labs, imaging facilities, and surgical procedure facilities? As you proceed so as to add extra varieties of care that may be delivered, the IT infrastructure is challenged in new and thrilling methods.
Supplier organizations’ enterprise fashions additionally play a key function in organizational complexity, with the shift in the direction of value-based care and risk-bearing fashions. As supplier organizations shift in the direction of risk-bearing fashions, it’s usually an incremental shift with risk-based and fee-for-service fashions operating in parallel. Along with the (comparatively) less complicated configuration of including one other insurance coverage plan, the information and care supply coordination of risk-based plans are an order of magnitude extra difficult than conventional fee-for-service care fashions. This shift has expanded past enterprise well being methods and huge hospitals and is cascading by means of massive ambulatory practices, which have distributed footprints and traditionally smaller IT budgets.
Geographic footprint is a significant driver of organizational complexity and IT (amongst different) wants. Is the group a singular location or unfold out inside a metropolis? Is it distributed throughout a number of states, nations (Canadian presence), or different geos (tribal nations, US territories, and so on.)? As organizations develop to multi-state footprints, for instance, there are differing laws for licensure (the scope of NPs for instance), e-prescribing, and different localizations like regional language wants: this all should be accommodated in EHRs and different methods. That is all on prime of the necessity for referral networks, reference labs, pharmacies, and native well being info exchanges. As well as, there are regional privateness, knowledge sharing, and different necessities that apply to cross-state or multi-region companies. When geographies span a number of varieties of borders, it will get much more difficult.
Geography is extra than simply technicalities associated to knowledge sharing, licensure, and care supply: we can’t neglect the individuals and their cultural and regional variations. The US is an extremely numerous nation the place there are 430 languages spoken throughout the states and territories. Addressing cultural, language, and regional variations is a complexity that many massive well being methods and nationwide healthcare suppliers face, and there are a myriad of research exhibiting that sufferers are extra engaged, have higher outcomes, and are extra glad with care delivered of their most popular language. Anybody who has labored on an internationalization or localization effort for a product will perceive the complexity, however the implications of languages, regional variations and norms, are far reaching and can’t be underestimated. They develop past multi-language help, impacting content material (care summaries, letters, affected person directions), and even workplace schedules.
Group Must Stay Aggressive / Differentiated
Past simply managing their very own complexities, healthcare organizations are usually run as companies (there are some not-for-profit organizations, together with a nationwide chief that we spotlight later). With the shift to decrease acuity care contexts, non-public fairness rollups, regulatory adjustments, and the fixed want for extra patient-centric care – the market and rivals are altering rapidly!
Organizations have quickly altering wants as a way to keep aggressive and differentiated within the digital-first healthcare ecosystem. Each organizational wants and affected person/supplier expectations are driving initiatives for lasting differentiation.
Beginning with organizational wants, some organizations are constructing aggressive knowledge moats, leveraging differentiated knowledge entry and repositories, to stay aggressive. Whether or not accessed as a part of a digital community or trade or owned wholly internally, this method depends on IT infrastructure to securely retailer, course of, safe, and dealer knowledge to related methods.
When it comes to expectations, whereas sufferers as we speak have extra management of their very own healthcare information, it’s nonetheless not sufficient. Main organizations understand that sufferers don’t wish to work together with separate care contexts, specialties, and amenities individually. As an alternative, they’re prioritizing unified affected person experiences (a part of UDHPs) to simplify affected person interactions throughout their technical and operational ecosystem. This transition to affected person consumerism is offering one other level the place organizations compete: affected person engagement and loyalty.
IT Technique
As organizations get bigger in dimension, they’ve extra outlined IT methods, with enterprise organizations sustaining multi-year roadmaps. These roadmaps define the prescribed method to attain organizational priorities and outline the initiatives and budgets for upcoming years.
Whereas this level is foundationally vital, it additionally varies enormously, relying on the idiosyncratic wants of every group. Nevertheless, there are some widespread themes and choices we will usually discern when reviewing a roadmap. We’ll body them as questions under:
Is the group making an attempt to develop or shrink the scope of its IT perform?
Is there a powerful desire for constructing vs. shopping for vs. partnering?
What key unmet wants have but to be addressed and are prioritized?
What’s working as we speak (and notably excluded from roadmaps)?
The place does organizational management have their sights centered to extend effectivity, competitiveness, differentiation, and care high quality through IT efforts?
Defining UDHP Choices for Totally different Healthcare Segments
Whereas healthcare at-large wants UDHPs, the precise wants fluctuate by group dimension and complexity. Associated, not all implementations of UDHPs will must be the identical, and we see three main paths for organizations to implement and architect their UDHPs.
Mapping UDHP Choices to Market Segments
Choice 1: Leveraging an EHR as a UDHP
There are a number of drivers that push healthcare organizations towards their EHR because the default UDHP. These methods already accommodate the complexity, sensitivity, and technical necessities for working in a regulated trade. Among the main tailwinds, as lined in our earlier publish (“Can EHRs be Well being System’s “Platform of Platforms” (UDHPS)) are as follows:
EHRs Presently Personal the Buyer Relationship
Many Clients Have an “EHR-First” Choice for New Functions
Epic and Oracle Well being are Making Robust Actions Towards Changing into UDHPs
On account of finances constraints, the EHR stands out as the solely sensible UDHP choice for a lot of organizations. Smaller practices and medical teams could have a single IT particular person, chargeable for EHRs, {hardware}, software program, printers, fax machines, and all the things else. If IT budgets are beginning round $100,000 per 12 months, and EHRs could take as much as half of that, there isn’t budgetary or employees room for different methods. Elation calls out that the anticipated license value of an EHR per clinician is round $1,200 per 12 months; Folio3 shares an identical quantity. That is earlier than upkeep, help, coaching, and different bills associated to the EHR, and earlier than different IT-related bills not associated to the EHR. When the EHR makes up a considerable portion of the finances, it is smart to look there first.
Along with these factors talked about within the earlier publish, when EHRs are tailor-made to smaller organizations, distributors perceive that their clients want a associate that fills in gaps. athenaHealth’s athenaOne package deal providing, for instance, consists of add-ons that complement the core EHR throughout the group: from affected person engagement and communication, to pre-visit and sched/reg help, to RCM and declare submission help. Positioned as an “all-in-one apply resolution,” they’re framing the providing as greater than an EHR and supply many UDHP advantages.
Shifting upmarket to bigger doctor teams and small hospitals or well being methods, IT budgets get bigger as income grows and care contexts get extra difficult. As we start to see multi-state footprints, massive multi-specialty teams, and acute care settings, organizations could outgrow the ambulatory-focused EHRs like athenaHealth, ECW, and others. That is the place Epic and Cerner step in and are completely happy to fulfill these organizations’ wants.
Epic’s Join (previously generally known as Group Join), for instance, is a particular providing that allows massive well being methods to sublicense their Epic occasion, provisioning entry to regional hospitals or well being methods. Whereas this feature permits smaller healthcare organizations to leverage the advantages of Epic, the associated fee may be an order of magnitude increased than outpatient, license-based EHRs.
In 2024, OhioHealth Van Vert Hospital invested $12MM to transition to Epic through CareConnect. Leveraging the identical budgetary assumptions as above, if the EHR is ~50% of finances, and finances is ~2-5% of income, this implies that the hospital has >$480MM in annual income ($12M * 2 / .05). Implementing Epic as a standalone well being system or hospital group is pricey, and a 2024 publish from Becker’s notes that prices could begin within the tens of tens of millions, however can attain a billion {dollars} or extra for bigger well being methods.
Because the IT budgets get bigger, technical groups improve in dimension and capabilities, and it naturally follows that extra superior choices are explored or required.
Choice 2: License from UDHP Vendor
As denoted above, not all organizations have enough IT budgets and employees to architect, construct, and handle their very own system. However, for big well being methods with greater than a billion {dollars} in annual income (estimated at ~175 or so in the US), these choices begin to develop into possible if not crucial. These massive hospitals and well being methods could start wanting past their EHR to fulfill their UDHP and platform-of-platforms wants. Why?
EHR Analytics Are NOT Optimized To Obtain Crucial Well being System Goals
EHR Switching Prices are Diminishing
Cloud Native Platforms Speed up Innovation and Efficiency
It’s Not in EHR DNA to Turn out to be A Broad-Based mostly Platform
The final publish additionally shared a HIMSS examine that confirmed that the common hospital had 16 EHRs in 2016. Whereas this quantity has probably consolidated down prior to now decade, multi-EHR and multi-system-of-workflow architectures are very a lot a actuality as we speak. Specializing in the complexity angle on this piece, we are going to spotlight 4 extra, complementary factors as to why an outside-the-EHR UDHP may be the perfect resolution for bigger hospitals and enterprise well being methods.
There are 4 main causes that we are going to spotlight the necessity for a UDHP to exist past the core EHR:
No singular EHR can accommodate all the things that well being methods have to do
Some level options are nonetheless higher than their EHR-native competitor
Some organizations leverage a number of core EHRs (there are organizations that use each Cerner and Epic throughout their hospitals)
Whether or not on account of M&As, IT or clinician desire, or different causes, some well being methods nonetheless use a combined EHR footprint.
This presents in numerous methods, however is often one of many following:
One system for inpatient, one for outpatient
One system for clinicals, one for RCM
Or, distinct methods at distinct areas (usually on account of M&A)
M&As and rollups are nonetheless operating rampant
Mergers and acquisitions mix greater than market footprints and scientific capabilities; in addition they convey IT groups and infrastructure. That is the place we start to see the true glimpses of Frankstein’s monster.
72 whole transactions in 2024, with 27 not together with a divestiture. Whereas this quantity could not appear that top in a vacuum, the entire image of the final decade+ shines mild onto the true quantity of those transactions. From 2014 to 2024, there have been 933 whole M&A transactions. That’s a whole lot of technical complexity to scrub up.
When it comes to licensing an outside-the-EHR platform, the primary publish within the UDHP collection features a complete record of doable distributors, constructing from Gartner’s unique record. We’ve additionally highlighted in earlier posts that the license method is just not an all-or-nothing method, and usually includes a hybrid mannequin, constructing on prime of 1 or a number of EHRs. Every group’s particular wants are totally different, they usually could use their licensed platform from a UDHP associate to various levels.
Choice 3: “Dwelling-grown” cloud-first resolution
The ultimate choice that we’ll cowl on this publish is for the main well being methods, and sure restricted to the highest 15-20 methods on account of complexity, expense, and staffing necessities. Progressing past the cloud and platform vendor partnerships talked about above, these methods are constructing enterprise knowledge platforms and UDHPs instantly inside cloud environments, leveraging cloud providers from AWS, GCP, Azure, InterSystems, or others.
Beginning with a mini case examine. We plan to additional expound upon Ascension’s work in a future publish.
The State of affairs: Ascension checks the entire containers for a big, complicated group.
Ascension’s Scale: 16 States, 94 wholly owned or consolidated hospitals, 27 extra hospitals by means of partnerships. 99,000 associates, 23,000 suppliers.
Ascension’s Scope: Inpatient, outpatient, and all the things in between.
Ascension’s Workers: ~3,000 working in IT (per LinkedIn)
Ascension’s IT Footprint: Heterogenous, 18 EHRs, 40+ affected person portals
Want for differentiation / competitiveness: Excessive, each regionally and throughout the 16 states
The Downside:
Sufferers will not be conscious of “care contexts,” they count on a unified expertise.
Ascension’s numerous set of EHRs and myriad of different methods weren’t tightly built-in
No singular EHR nor operational system was an entire supply of reality
There have been knowledge variations throughout methods that compound and exacerbate expertise inconsistencies throughout client digital touchpoints
The Answer:
Ascension created an “Enterprise Knowledge Service Layer (EDSL),” mapping knowledge from a number of EHRs right into a unified, centralized FHIR schema to facilitate frictionless client entry to normalized and harmonized knowledge
This depends on deep partnerships with EHR distributors and different companions.
FHIR, not absolutely adopted by all vendor companions, was made extra accessible utilizing REST APIs and a GraphQL orchestration layer to offer knowledge on demand to digital functions
A unified affected person expertise, “AscensionOne” was developed on prime of the EDSL to offer a singular place for sufferers to e-book visits, get care, handle their well being information, and pay for care.
The Outcomes So Far:
After one 12 months, over 400,000 members are utilizing the unified affected person expertise, constructed on prime of the Enterprise Knowledge Service Layer. The appliance is averaging 4.8 stars within the app retailer.
Ideas from a frontrunner on EDSL efforts:
MJ Barrois, Senior Director of Product Administration:
“Our mission to raised serve our communities was a key driving issue behind our funding in constructing our inside platform. EDSL represents our dedication to assist form a future the place extremely interoperable and moveable knowledge is instantly accessible to all of our sufferers. To supply care to these most weak and in want, we attempt to be good stewards of their knowledge and we work carefully with our EHR companions to make healthcare knowledge securely obtainable, simply discoverable, and comprehensible to the sufferers we serve.”
Summarizing the house grown choice:
Whereas this feature is just not the optimum selection for all organizations, Ascension is paving a path that might be simpler for others to observe. As we revisit the maturity curve proven above, the technical capabilities and necessities will get simpler 12 months after 12 months. AI is accelerating knowledge mapping and infrastructure optimization. We count on that the “homegrown” resolution might be extra attainable for the highest 50 or so well being methods within the subsequent few years. If there’s ever any doubt about what the cloud methods can do, we’d counsel testing this cloud comparability cheat sheet from ByteByteGo. You possibly can rapidly see that the cloud platforms can deal with just about something you may throw at them in case you have the appropriate crew and budgets in place.
Trying forward
At present, AI and our better-than-ever {hardware} proceed decreasing obstacles to entry, and the necessity for UDHPs will rise as organizations improve their IT footprints. Selecting a platform to construct round is the vital resolution organizations ought to make as we speak. This platform resolution might be an integral part of organizations’ AI methods, which is a vital lever for brief time period competitors and long-term differentiation. There may be a whole lot of noise round AI implementation finest practices as we speak, however the consensus (per AIDoc) seems to be {that a} centralized, ruled platform method is finest, which depends on unified digital well being platforms and knowledge.
As we glance a couple of years out, a extremely doable state of affairs is that by 2030, cloud-first implementations like Ascension’s might be commonplace not simply among the many prime 7 well being methods, however the prime 50. Internet hosting EHRs (like Epic and Cerner) on public clouds, pioneered by Geisinger, has been de-risked. As soon as within the cloud, it’s solely a matter of time earlier than the opposite cloud-first capabilities are evaluated and deemed a step ahead from legacy, healthcare-specific platforms and providers.
For the following cohort down in dimension in the identical interval, it’s extremely probably that EHR-complementing UDHPs might be licensed by the following prime 150 well being methods and hospitals. These already cloud-first methods will play properly with cloud-hosted EHR methods and supply entry to cloud advantages not attainable on account of employees and budgetary limitations of those smaller organizations.
What’s the remaining frontier? Ideally, by 2030, we may even start seeing uptake in openEHR and open-syntax, cloud-first platforms in the US. Epic isn’t going wherever, but.
Vince Kuraitis JD/MBA is an impartial advisor with over 35 years’ expertise throughout 150+ healthcare & tech firms. Neil Jennings is a options engineer on the well being care crew at Akamai Applied sciences. Vince publishes The Healthcare Platform Weblog, the place this publish first appeared. The authors thank a number of colleagues for his or her assessment and commentary on an earlier draft of this publish: M.J. Barrois, Senior Director of Product Administration at Ascension; Jim Sabogal, Healthcare Vertical Lead at CDW; and Taylor Gartley, Director at Fold Well being.
San Francisco, CA, August 6, 2025 — A brand new nationwide ballot from Venture Tomorrow and ClassDojo for Districts reveals a rising hole between district priorities and the instruments obtainable to assist them. Whereas 85% of district leaders say household engagement is a high precedence for the 2025–26 college 12 months, 4 in 10 say they nonetheless haven’t got what they should make it occur.
The ClassDojo for Districts Pulse Ballot, primarily based on practically 260 responses from district leaders nationwide, highlights a transparent distinction: most districts depend on one-way communication, however say the best method is real-time, two-way connection on the classroom stage.
“Most districts can ship bulletins. However what drives actual engagement is two-way, private communication—the sort that builds relationships, belief, and higher attendance,” stated Chad A. Stevens, Ph.D., ClassDojo’s Head of Ok–12 Engagement. “That is the hole—and that is precisely what ClassDojo for Districts is constructed to resolve.”
ClassDojo for Districts offers colleges a option to talk with households, not simply at them. And households do not miss a beat; 80% of messages are learn the identical day.
“Sturdy school-to-home connections aren’t elective. They’re foundational,” added Dr. Stevens. “District leaders know this. They simply want the suitable instruments to carry these connections to life.”
ClassDojo’s districtwide platform brings collectively all the pieces districts and colleges have to maintain households knowledgeable, concerned, and engaged. Key options embrace:
Two-way Messaging with learn receipts and real-time translation in 130+ languages.
Districtwide Bulletins to share updates immediately throughout the neighborhood.
Class and Faculty Tales with pictures, movies, and updates from lecturers and leaders.
Safe, FERPA-compliant entry controls to make sure the suitable messages attain the suitable households.
ClassDojo for Districts is totally free—an essential distinction as districts navigate tight budgets. The platform can also be totally FERPA and COPPA-compliant and has earned the Widespread Sense Privateness Seal, giving district leaders confidence their communities are protected.
“These instruments not solely strengthen communication—they foster connection,” added Dr. Stevens. “70% of district leaders say household engagement helps construct belief, and greater than half say it improves scholar attendance.”
Extra key findings from the Pulse Ballot embrace:
70% of faculty and district leaders say household engagement helps construct belief in colleges.
65% of leaders say two-way communication apps are among the many only methods to maintain households knowledgeable.
36% say partaking households in scholar success is one in every of their most urgent challenges.
“For years, Venture Tomorrow has examined the evolving panorama of school-family communication,” stated Julie A. Evans, Ed.D., Chief Government Officer of Venture Tomorrow. “In at the moment’s schooling setting, the place scholar success is more and more tied to constant attendance and significant household engagement, we’re proud to collaborate with ClassDojo for Districts to discover how revolutionary digital platforms can assist these priorities and foster improved scholar outcomes.”
For extra on ClassDojo for Districts, go to their web site.
About ClassDojo For Districts
ClassDojo is on a mission to offer each little one an schooling they love. Already utilized by over 45 million households and lecturers around the globe, ClassDojo helps colleges construct sturdy, linked communities. ClassDojo for Districts brings this connection to the entire college system—serving to leaders attain each household, scale back absences, enhance scholar habits, and guarantee constant communication throughout colleges. Districts achieve the oversight they want with instruments like rostering, SSO, and SIS integration, plus easy methods to have fun college students, share updates, and maintain households within the loop—all in a platform lecturers already love. And it is free for lecturers, colleges, and districts.
About Venture Tomorrow
Venture Tomorrow’s imaginative and prescient is guaranteeing that at the moment’s college students are nicely ready to be tomorrow’s innovators, leaders, and engaged residents. We consider that genuine studying experiences allow all college students to develop the abilities and mindsets wanted for future success. Our work spans Efficacy Research and Analysis that measure the real-world influence of academic improvements, the nationally acknowledged Converse Up Analysis Venture that amplifies the genuine voices of hundreds of thousands of Ok–12 stakeholders, and New Studying Mannequin Applications that assist colleges in designing future-ready instructing and studying. Since 2003, now we have offered schooling leaders, lecturers, and oldsters with research-based insights that drive data-informed choices, enhance scholar outcomes, and create simpler studying experiences for all. Be taught extra at tomorrow.org.
Each summer time, my sister, like clockwork, texts me to ask what nail polish she ought to get. For the previous three years, my reply has been the identical: Ballet Slippers for toes, and my perpetually favourite for nails (once I’m not biting them, gahh). What nail polish are you carrying lately?
Have you ever performed Monopoly Deal? In contrast to common previous Monopoly — which may drag on perpetually, till everybody drifts away — the cardboard recreation model feels surprisingly thrilling. In previous remark sections, CoJ readers have described it as “quick,” “addictive,” and “the residing finest.” After the above picture was taken, Freddie and I lasted simply quarter-hour till my cousin Jeremy crushed us all.
It’s the very best time of yr for tomato sandwich work lunches. That’s all.
Straightforward Miso Inexperienced Bean & Tofu Stir-Fry: Wholesome Plant-Primarily based Dinner in 30 Minutes
If you happen to’re craving a wholesome, flavorful, and simple weeknight meal, this Miso Inexperienced Bean & Tofu Stir-Fry is the right dish. Filled with protein-rich tofu, crisp inexperienced beans, colourful bell peppers, mushrooms, and onions, it’s tossed in a savory sauce made with miso, soy sauce, garlic, ginger, and a contact of chili. Topped with sesame seeds and served over complete grains like brown rice or quinoa, this fast stir-fry delivers balanced diet and daring taste in simply half-hour. It’s plant-based (vegetarian and vegan), gluten-free, meal-prep pleasant, and positive to change into a go-to in your recipe rotation.
Impressed by seasonal contemporary inexperienced beans, this stir-fry is flavorful, filled with diet, and simple as will be. Serve it with complete grains, reminiscent of brown rice, quinoa, or sorghum to make a balanced meal in a single. I promise, you will get this meal on the desk in beneath half-hour, sooner than you may order and decide up takeout! I really like the flexibility and ease of stir-fries, that are based mostly on a number of vibrant, crisp veggies, a flavorful sauce, and an entire grain basis. The flavour profile on this recipe pays homage to Japanese foodways, which I’m very keen on. Whereas I’ve had an opportunity to check the cultural weight loss plan in Japan, I encourage you to be taught extra about conventional consuming patterns and dishes from an professional, reminiscent of Yoshiko, who was born in Japan and shares her stunning plant-based recipes on her website. I firmly consider that these stir-fries are among the best dishes to place in your menu when you’re studying to eat a extra plant-based weight loss plan. The flavorful miso-ginger-garlic sauce on this recipe makes it a stand out in taste and aroma, plus the colourful array of veggies packs within the vitamins.
It is a nice household meal, serving 4 parts; or it’s a beautiful solution to take pleasure in a meal for 2 one evening, and savor the leftovers the subsequent day. It holds up fairly properly microwaved the next lunch or dinner. You may simply swap up the inexperienced beans for an additional vegetable, reminiscent of asparagus, zucchini, eggplant, or inexperienced peas. Alter the colour of bell pepper, reminiscent of purple, orange, and purple, to offer a unique pop of colour. I really like the addition of tofu right here—a plant-based, conventional, famous person within the plant-based protein world. In its place, you can additionally attempt tempeh instead of tofu. I featured this recipe on a TV section on KTLA 5 Morning Present, and it was an enormous hit with the hosts of the present, in addition to the backstage crew, who lapped up my leftovers very quickly.
This Miso Inexperienced Bean & Tofu Stir-Fry is a fast, wholesome, and scrumptious plant-based recipe with veggies, miso, and complete grains—prepared in beneath half-hour! It’s vegetarian, vegan, and gluten-free.
In a medium dish, combine water, miso paste, soy sauce, vinegar, and brown sugar in a medium dish till clean. Place cubed tofu within the dish and put aside to marinate for 10 minutes.
In the meantime, warmth oil in a big skillet, sauté pan, or wok over medium-high warmth. Add onion, inexperienced beans, garlic, ginger and purple chili pepper, and sauté for 3 minutes.
Add bell pepper and mushrooms and sauté for an extra 3 minutes.
Take away tofu from marinade, including tofu to the vegetable combination (reserve the marinade) and sauté for an extra 2 minutes, till greens are simply starting to get tender, however nonetheless crisp and vibrant coloured.
Whisk the cornstarch into the reserved marinade and add to the pan, and stir gently to mix elements. Prepare dinner for an extra 2-3 minutes, till bubbly and thickened.
Take away from warmth. Sprinkle with sesame seeds.
Serve together with your favourite cooked complete grains, reminiscent of brown rice, farro, spelt, or quinoa.
Now a lead organizer for the nonprofit, he mentioned his analysis confirmed colleges like Stanford settle for “extra college students from the highest 1% of the earnings distribution than all the backside 50%.”
His fellow Stanford organizers traveled to Sacramento 3 times to testify earlier than the state Legislature when AB 1780 was nonetheless within the means of turning into legislation.
“These are the varied college students whose youngsters stand to learn from legacy admissions sooner or later,” Cieslikowski mentioned. “Even the individuals who stand to learn from it disproportionately don’t assume that their establishment ought to observe it.”
He mentioned that whereas the Trump administration is “exploiting America’s distrust” of elite schooling for political functions, universities must be striving to reveal that they serve the general public curiosity, however “Stanford’s choice to proceed legacy and donor choice does the precise reverse of that.”
The college’s legacy admissions assertion was posted simply two days earlier than it introduced sweeping layoffs of over 350 staff and a $140 million finances minimize.
The arches of the Important Quadrangle buildings on the campus of Stanford College in Palo Alto on Oct. 2, 2021. (David Madison/Getty Photos)
“Stanford has determined that accepting the disproportionately privileged youngsters of Stanford alumni and Stanford donors is extra necessary than taking free cash from the state of California with the intention to present monetary assist for his or her low-income college students,” Cieslikowski mentioned. “Particularly within the face of large layoffs.”
The Stanford spokesperson didn’t reply to a follow-up query in search of to specify whether or not the choice to substitute college funding for Cal Grant was an element or level of debate within the finances minimize.
Cieslikowski referenced Leland Stanford’s quote upon founding the establishment in 1885: that “The kids of California shall be our youngsters.”
“By clinging to legacy choice, the college is sending the precise reverse message,” he mentioned. “Saying that the youngsters of rich alumni and donors come first, they shall be our youngsters.”
Sarah Jackson and colleagues from College Faculty London and King’s Faculty London branches of the SPECTRUM Consortium performed a survey to review how psychological well being pertains to strategies folks use to give up smoking, also called smoking cessation aids. Whereas the variety of adults who smoke cigarettes has declined globally, folks with psychological well being circumstances usually tend to smoke and to take action extra closely. Due to these variations in tobacco use, the researchers theorized that the effectiveness of smoking cessation aids could also be altered in people with a psychological well being situation. Nonetheless, of their findings printed in PLOS Psychological Well being, they report that smoking cessation aids are literally equally efficient for folks with and with no historical past of psychological well being circumstances.
The researchers surveyed over 5,000 individuals who commonly smoked and tried to give up previously 12 months. About 45 % of those members reported having been identified with a psychological well being situation. In keeping with earlier research, members with psychological well being circumstances reported a better stage of habit to cigarettes.
The strategies members used of their makes an attempt to give up smoking ranged broadly. The most typical smoking cessation aids have been non-combustible nicotine merchandise. Vaping merchandise (e-cigarettes) have been utilized by 39 % of individuals with a psychological well being situation and 31 % of individuals with out. The subsequent most typical aids have been different over-the-counter nicotine replacements, resembling lozenges and patches. Lower than 5 % of members reported utilizing different aids like prescription medicines or behavioral interventions.
Individuals with psychological well being circumstances have been extra possible than these with out to decide on vaping merchandise, prescription nicotine alternative remedy, and self-help web sites. Nonetheless, the researchers discovered that an individual’s psychological well being situation didn’t seem to change the effectiveness of those smoking cessation aids or any others.
Amongst all members, the researchers report that the simplest aids have been vaping, a drug referred to as varenicline that interacts with nicotine receptors within the mind, and heated tobacco merchandise. Heated tobacco merchandise are a brand new kind of smoking cessation help that heats tobacco leaves however doesn’t burn them, and this research is the primary to take a look at their real-world effectiveness. The researchers didn’t discover clear advantages of utilizing any of the opposite smoking cessation aids.
The outcomes of this research may help people who smoke and healthcare staff make knowledgeable choices when selecting strategies to give up smoking. The researchers word that, “We discovered no proof to recommend that any technique of stopping smoking was roughly efficient for folks with a historical past of psychological well being circumstances. Our findings ought to present reassurance to folks with psychological well being circumstances who need to quit smoking that their situation needn’t have an effect on their selection of cessation help.”
