Author: iambeastwood

The Beastwood Files: March(ish) 2026

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Coming to you on a Wednesday evening halfway through the month because I did the thing freelancers like to do where they take on too many assignments at a time – which, if it wasn’t bad enough, was made worse by the fact that I did this at the same time as 1) tax season and 2) try-to-figure-out-after-school-care-for-your-soon-to-be-kindergartner season. At least no one in the house was sick.

Stuff I Wrote

Things I Did

  • Celebrate Pi Day with some close friends, approximately one pie per person, and a rule that anyone in attendance was required to take home leftovers
  • Bake Chocolate Crinkle Cookies, a classic winter holiday staple, on the approximate Spring Equinox
  • Leave the shovel and rock salt on the front porch – because we all know the day they go in the basement is the day there’s a thoroughly unexpected snowstorm
  • Fail to take advantage of day-after-Easter candy sales (which frankly may have been for the better, as we still have Dark Chocolate Cadbury Mini Eggs, which are the better kind)

Adventures in Fatherhood

  • We revisited a past Pi Day tradition and made a Pie Shop from a gigantic Costco-sized box of paper towels, from which we dispensed dessert pies as well as pizza and seltzer (while supplies lasted). Why I neglected to take a picture of that and instead am tempting you with a poorly rotated, out-of-focus picture of cookies is something I’ll never be able to fully explain.
  • We made our first trip to the LEGO Discovery Center, and it went about as well as we could have hoped. If not for the next day’s visit from the Easter Bunny, we might even still be playing with the LEGO Delivery Van we got from the gift shop.
  • Speaking of the Easter Bunny … along with dutifully leaving some carrots for him to munch on, we pleaded with him to talk to his “friends” about not eating everything in our garden, please. This may come as a shock, but it didn’t work.
  • I made the mistake of telling my son that I occasionally spell my name wrong when I sign an email. Now, every once in a while, to crack himself up, he’ll just randomly blurt out, “Thanks, Brain!”

Happy spring. May the bunnies leave your garden alone. In addition, may your preferred baseball team remember how to hit the ball, which my team seems to have forgotten.

This Month in Digital Health: Beyond the Conversations With Well-Dressed People in Cushy Chairs

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Welcome to This Month in Digital Health, where I summarize articles that recently caught my eye to explain why I think they’re important. With ViVE and HIMSS behind us, I figured I’d shy away from all the product and partnership announcements that made headlines, which explains why this is a bit shorter than usual. There were still some compelling stories out there, from the usual AI and rural health challenges to ruminations about how seemingly competing health data exchange efforts will in fact complement each other.

AI: Everything everywhere all at once at the same time. A Health Affairs paper argued healthcare needs its AI bubble to burst, as organizations are chasing “innovation without substance.” It doesn’t help that large language models are susceptible to misinformation (just like people), health systems are still wrestling with human-in-the-loop approaches (focusing too much on individual outputs and not enough on scalable frameworks), and LLMs are impacting how people interact with search results (fewer clicks on reputable hospital websites, which of course isn’t a good thing). If nothing else, I suppose, robots can run the hospital cafeteria.

Rural health: Because healthcare loooooves to rush into things. KFF Health News is all over rural health transformation, where proposals range from investing most of the money (Wyoming) to using robots in maternity care (Alabama). Plus, apparently there’s some tension about plans that were drafted and approved, in no small part because states didn’t really have a lot of time to come up plans. That very well may have been the point – I’ve heard folks argue that CMS was looking to fund projects that were well past the planning stage – but the whole thing’s starting to look rather messy, if not ill-conceived.

CMS: TEFCA and the Health Tech Ecosystem are totally besties. It’s not the best look when you launch a data-sharing initiative and then have to come out and say it’s not competing with an existing data-sharing initiative with similar characteristics and motivations, as CMS and ASTP had to do regarding TEFCA and the Health Tech Ecosystem. Apparently, the ecosystem is an “accelerator,” and its work may (or may not) be folded into TEFCA at some point. Glad we cleared that all up.

ACCESS: With rates this low, who needs a doctor? The proposed annual rates for the ACCESS model (Advancing Chronic Care with Effective, Scalable Solutions) are, um, well, they’re not very high at all. A lot of folks are arguing that’s exactly the point, as the model’s meant to attract 1) entities that take a digital-first approach to chronic care and 2) patients that don’t necessarily need a lot of in-person care. I get it, but I’m not sure going out of your way to alienate physicians is really the best approach.

In other news:

See you next month, when there will be 95% fewer healthcare IT articles featuring photos of well-dressed people sitting in comfy chairs and holding microphones.

The Beastwood Files: February(ish) 2026

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The person in charge of maintaining my work schedule (me) gave me too many longform assignments in late February and early March, while the person in charge of maintaining my running schedule (also me) insisted I remain on track for my marathon on Memorial Day weekend, so (in what is beginning to be a recurring pattern) this post is appearing during the second week of the month.

Stuff I Wrote

Things I Did

  • Succeeded in getting my mother’s taxes done at the Senior Center in town (thanks, AARP volunteers!)
  • Went out of my way to participate in a social event (the annual party for the running club I recently joined)
  • Made Snow Mountain in the front yard amid two significant storms with “help” from my young assistant
  • Introduced my son to the concept of false spring during a 75-degree day in early March

Adventures in Fatherhood

  • A recent obsession with couch-cushion forts evolved into destroying said forts. It was determined that the dinosaurs living in the neighborhood should be made aware of the demolition schedule and potential for loud noises. “Be a news reporter,” my son said to me, not realizing just how prepared I would be for the moment. (Lest you think I’m a trombone player in my spare time, I’ve probably worn that fedora a half dozen times since buying it on our honeymoon in 2019 after failing to pack a hat for part of our trip.)
  • We all went cross country skiing for the first time (at Great Brook in Carlisle). My son took off on us as soon as he was strapped into his skis – which was great, except that neither of us were quite ready to chase him. (Not a bad problem to have, mind you.) We only went once this winter, but I’m pretty sure we’ll want to go again.
  • We spent quite a bit of time watching the Olympics, in part because it was 15 degrees out the first weekend of the Games. Our favorite sports were biathlon, bobsled, and ski mountaineering. I did not subject my family to watching the 50-kilometer cross country ski races in their entirety. We also really, really got into the ads.

Happy early Pi Day, which is one of the most important days of the year in the Beastwood household (because of pie, not math).

This Month (and Last Month, Too) in Digital Health: It’s Been a Long Time, So Here Are Some Long Reads

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Welcome to This Month in Digital Health, which looks at trends that got my attention and attempts to unpack why I think they’re important. We’re actually looking at almost two months’ worth of stuff here, as life caught up with me in January. As a result, there’s less focus on hard news – besides, you already read about all those AI releases – and more on analysis and commentary that looked interesting to me.

Will Oracle have to sell the EHR formerly known as Cerner? Oracle has committed $500-plus billion to AI data centers – enough that the company may need to lay off 30,000 people and sell off Cerner, which it bought for more than $28 billion less than 4 years ago. One report suggested Amazon, Google, and Microsoft are probably the only companies with enough cash to buy Cerner – and even then, would they want it? (Or will Epic decide now’s as good a time as any to make its very first acquisition?)

Prior authorization is better, but still not the best. As of Jan. 1, the timeline for prior authorization responses is half as long as it used to be. But providers say 72 hours for urgent care decisions is still too long – I’m not a doctor, nor do I play one on TV, but I think they have a point – and add that “delays and hassles” persist. Payers have pledged to step up real-time decisions, but providers argue promises don’t equal actions.

Providers, payers are also at odds over bill disputes. The independent dispute resolution process kicked off years ago in response to the No Surprises Act. Payers accuse providers of attempting to inflate reimbursements, while providers argue the nuance of regulation favors insurers. Meanwhile, both wait for regulatory clarity, especially on what people can actually dispute.

Medicaid is in trouble. You already know that. The nation’s largest publicly operated health plan is L.A. Care, which serves 2.2 million Medicaid beneficiaries in Los Angeles County. The plan projects 30% of enrollees dropping off the rolls by 2028 – and straining the insurer’s finances – thanks to One Big Beautiful Act cuts. Process automation and other efficiency improvements can only do so much, I’m afraid.

A Medicare Advantage shell game in Arcadia. In parts of Oregon, Optum removed a bunch of doctors from Humana’s Medicare Advantage network just in time for open enrollment. Guess who was the only other MA insurer in those areas? If you guessed UnitedHealthcare – owned by the same company – then you win, um, well, no one really wins anything here. Not even the insurance giant, which expects revenue to decline in 2026 as it makes less money off Medicare Advantage.

New York bucks the patient data access trend. Various states have been extending protections for personal health information, what with HIPAA being 30 years old and all. Legislation in New York would have done the same – but Gov. Kathy Hochul vetoed the bill at the end of last year, citing a broad scope coupled with stringent frameworks “which may discourage innovation.” Critics said the veto is a win for Big Tech; others described the bill as onerous.  

Seniors are quitting weight-loss drugs in droves. Roughly half of Americans over 65 who were prescribed GLP-1s stopped taking them within a year. There are plenty of possible reasons, from bad side effects to muscle loss (a particular concern for older patients) to loss of insurance coverage. Weight-loss pills could help, particularly for patients who don’t like injections, but daily doses present their own challenges.

Inpatient surgery won’t be a cash cow much longer. CMS is signaling it aims to phase out the list of inpatient-only surgical procedures, meaning more will move to outpatient facilities. That could save money for patients (and payers) but cut revenue for hospitals already strapped for cash. One option for bucking the trend: Optimize operating room capacity, largely through standardized processes.

Is it time for digital therapeutics to shine? In December, the FDA launched TEMPO, a pilot program for digital therapeutics tied to chronic condition management. The program could breathe some life into a struggling market segment; participating medical professionals can prescribe therapeutics before they’ve received FDA clearance, and real-world data from users would in turn inform clearance decisions.

For PCPs, fewer patients doesn’t mean less EHR time. Providers that make a concerted effort to reduce visit volume don’t spend equally less time plonking about in their EHRs. Researchers found PCPs who cut visit volume by nearly one-third only spent 21% less time in the EHR – and dreaded “pajama time” actually increased. There’s a straightforward explanation: After reducing visit volume, the patients that PCPs had left were in fact more complex.

Enjoy the rest of February, everyone.

The Beastwood Files: January(ish) 2026

A makeshift computer my son made using a box from a Costco delivery.
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The beginning of the year was, um, well, it was something, wasn’t it? I found it hard to be productive at times between the state of our nation, the pile of snow outside, the hole that has opened up in my schedule now that a retainer agreement is up, and the post-nasal drip that comes every winter but is still a heck of a lot better than the flu or COVID. (And this is despite my “assistant” building himself a “computer” to “do work” – complete with a “power source” he has the good sense to “unplug” when he’s all done, likely making the IT help desk veterans in my audience swoon.)

Stuff I Wrote

Things I Did

  • Succeeded in only having one coffee per day – and only occasionally hurting the tum-tum with too much black tea in the afternoon
  • Rediscovered salad kits as a good option for Busy Parents on the Go or Otherwise Unable to Locate Vegetables in the Refrigerator They Aren’t Already Sick of Eating
  • Failed miserably to put out a newsletter – though let’s be honest, 90% of it would have been the AI stories you already read
  • Learn what is a fatberg thanks to a children’s book about urban infrastructure
  • Read a book about Groundhog Day roughly eight times in the span of a week

Adventures in Fatherhood

  • During last month’s snow day – certainly justified, as we got close to two feet of snow – I found myself uttering the phrase, “If you want to interrupt Mommy’s meeting, she said it’s OK, but you need to put pants on.”
  • Also during said snow day, during my third trip outside to shovel, my son decided that we should have one big pile of snow next to our front walkway instead of two smaller piles. As a result, I dutifully spent an hour moving shovels full of snow approximately two feet to make Snow Mountain, which my son ascended and descended many times before it got too dark to keep playing.
  • We have discovered the Winters Olympics. Our favorite events so far are ski jump, ski and snowboard cross (with multiple simultaneous competitors), and biathlon (especially odd because we’ve never bene on skis and have never seen a rifle). We’ve also regaled our son with tales of how hard it was to watch Back In Our Day, when you were beholden to whatever NBC was willing to show you. This further reinforces my son’s proclamation at his self-determined conclusion of soccer (that is, not even halfway through the season): “I like watching sports more than playing sports.”

Happy rest of February. In case you’re wondering, People Who Prefer Summer: Yes, even though it’s very cold, I still prefer this to 85 degrees and humid, because in this weather I can bend over and tie my shoes without breaking into a sweat.

The Beastwood Files: December 2025

Mug that says "Brian Eastwood Writes" and has a cool logo that my wife designed for me
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Are you back to work? Do you know what day it is? Does time even exist as a concept? I’m hitting the ground running in January, bearing in mind that most of my running is actually at an easy, conversational pace and followed by a nice snack and maybe some hot tea.

Stuff I Wrote

Things I Did, Christmas Edition

  • Left a trail of pine needles from the living room down the stairs and to the curb after failing to learn for like the 12th consecutive year that a Christmas tree acquired in late November is effectively dead well before New Year’s
  • Assembled lots of LEGO ay my son’s behest
  • Drank tea from a swanky mug with a logo my wife designed (she also made business cards and a T-shirt, which I’ll show off when it’s not so damn cold)
  • Gave my wife a nice stapler, which prompted her to say, “Go look for the gold gift bag,” which contained … a nice stapler that she’d gotten for me (Kids, getting old is so much fun, isn’t it?)
  • Signed up, once again, for the Vermont City Marathon in Burlington over Memorial Day weekend

Adventures in Fatherhood

  • I had a Proud Dad moment when, amid one of approximately 1,234 random conversations over the holiday break, my son described how turning off a toy and then turning it back on is a good way to get it to start working again. Kid, you now know how to solve 75% of IT Help Desk issues!
  • Amid a few of the approximately 1,234 random conversations, I introduced a topic called Real Talk With Daddy, which is when I address important issues in our lives. One was having sweaty feet. Another was the pros and cons of Diet Coke and coffee as sources of caffeine, especially relative to short-term impact on the digestive tract. A third was the quality of English food. Open to suggestions for further discussion points.
  • Like many parents, we spent a good chunk of the holiday break answering the question “What are we doing next?” on days we’d made it clear we had no interest in actually leaving the house. In jest, I repeatedly suggested that we alphabetize our socks. On New Year’s Day, my son called my bluff and said it was time to go upstairs and do it. (In case you’re wondering: You organize my color, then put the colors in alphabetical order.) We did NOT do this with Daddy’s socks, as they are either boring black and boring white, with maybe a couple navy blue for good measure.

Happy January. I’ve resolved to drink less coffee, use my downtime more thoughtfully, better focus on cross training, publish two eBooks (one being the patient engagement one I really should’ve finished last year), be more thoughtful about one-off projects, and continue to get rid of stuff I don’t need. Nothing is earth-shattering, but collectively I hope they will make for a better year. Well, that and more tea.

This Month in Digital Health: Some things are actually looking up!

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Welcome to This Month in Digital Health, where I highlight articles and trends that recently caught my eye and attempt to explain why I think they matter. This time around, there’s actually maybe possibly some decent news about chronic care management and care at home, though rural health, AI, and support for the nursing workforce are all a bit messy.

AI is still complicated. HHS is setting a course to broaden AI adoption internally, with the hope of setting an example for the private sector to follow. It seems that healthcare organizations may benefit from any guidance they can get: They’re struggling with AI governance, feel underprepared for AI deployment, aren’t getting AI ROI fast enough, and aren’t yet seeing major productivity gains from AI.

Chronic care is getting good attention. CMS announced the ACCESS model for pay providers for using tech to support chronic disease management. Many see it as a “bold new model” for tech-enabled care, and vendors see it as an opportunity to prove their worth to providers who are typically skeptical of such things. That said, providers have a lot to consider when it comes to who to enroll, what tech to use, and how program structure ay change.

Finding rural health details the hard way. CMS isn’t talking about what states plan to do with Rural Health Transformation money, so KFF Health News filed public records requests and reported on the details. There’s a lot about improving access to food, medication, and lifestyle improvements – just not specifically for Native American tribes, who weren’t eligible to apply and have to rely on their state governments.

More care at home momentum? Former CDC director Susan Monarez penned a piece for Chief Healthcare Executive suggesting up to 90% of care can take place in the home. A JAMA Network Open study found care at home is especially effective in rural areas, which bodes well for programs looking to demonstrate value. Speaking of which, vendors are pushing for value-based contracts from Medicare, which would help with their own long-term stability.

The balancing act for supporting nursing teams. An interview with the Mayo Clinic in HealthTech Magazine (a client of mine, for the record) highlighted the benefits of AI to support nursing workflows – provided that nursing teams get a say from the get-go in what tools will do and how they’ll be implemented. Saving time should be a point of emphasis, as nurses who skip breaks or stay late are probably burning the candle at both ends.

Meanwhile, I found a bunch of odds and ends this month.

Happy Holidays. If you have children home from school for the next couple weeks, remember that no one’s going to judge you if they wear pajamas all day, eat candy for breakfast, and use every pillow and couch cushion in the house to make an obstacle course or fort – especially if you don’t tell anyone about it…

The Beastwood Files: November 2025

A very odd gingerbread house
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Coming to you at that lovely time of year when companies are either already hibernating until January or scrambling to finish things before Santa arrives. Meanwhile, I’m trying to operate somewhere in between – keeping busy yet attempting to shut things down roughly one week before Christmas. In that spirit, I’m writing this while wolfing down a sandwich at my desk

Stuff I Wrote

Stuff I Did

  • Spend a good chunk of the first week of November napping thanks to some viral thing that wasn’t serious enough to warrant taking time off but was nonetheless enough to make it hard to look at the ol’ computer screen for too long
  • Listened to my first holiday song of the season – Christmas Eve / Sarajevo from the Trans Siberian Orchestra, of course
  • Somehow – SOMEHOW – listened to The Wreck of the Edmund Fitzgerald for the first time
  • Cooked a 12-pound turkey for seven people, two of whom didn’t eat any (one for dietary reasons, one because he’s a very picky 4-year-old), which left plenty for turkey soup (which is really what I’m here for, let’s be honest)
  • Bought a Christmas tree and immediately decorated it, because said 4-year-old is also not the best at waiting
  • Entered the season of “do the tires *really* need air, or is it just that the temperature dropped?”

Adventures in Fatherhood

  • We continued our annual tradition of making gingerbread houses. I fulfilled my patriarchal duties of taste-testing the candy. My son managed to decorate his house all by himself, coming up with his own ideas and drawing inspiration from Mommy as well as our friend who joined us for the evening. For some reason, my contribution – pictured here – didn’t inspire him. I don’t understand why.
  • After largely ignoring our balance bike for the better part of two years, we randomly decided to try it out again. We got the hang of it but also seemed a bit frustrated as to why we had to ride on quiet paths and not one of the most well-trafficked rail trails in the nation.
  • We’ve started to play a game where, when Daddy leans forward in his seat, we sneak behind him and yell, “Squish me!” I respond to this by saying, “Son, the first thing they told us in all the First-Time Parent classes was that you shouldn’t squish your baby.” I now use this to explain other, not-fun things that I do – e.g., “Another thing they told me in First-Time Parent class is that you have to make sure your kid wears socks.”
  • We have discovered the Magic School Bus. This is great, except that we’re ALL IN like a poker player who just wants to leave the table. We’ve checked close to 20 out of the library – apologies to anyone in Eastern Massachusetts who hasn’t been able to put them on hold – and read them I’d say an average of five times apiece. I’ve gone hoarse more than once.

Happy holidays, everyone! May you get exactly what you wish out of the season. Talk to you in 2026.

This Month in Digital Health: Confirming Things We Already Knew

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Welcome to This Month in Digital Health. Here, I highlight news articles and trends that recently caught my attention and attempt to explain why they matter. The main theme for the last few weeks has been reports and stories confirming things we already knew – which is still important, because it always helps to hammer home the message.

AI is complicated. AI was a big talking point at HLTH, what with the AMA announcing its Center for Digital Health and AI (to develop policy and training resources, among other things) and the Cleveland Clinic CEO saying AI is necessary for solving big problems like access to affordable care. Easier said than done, though, as 49% of orgs are seeing AI innovation delayed, while AI’s many ethical issues resemble a can repeatedly kicked down the road and healthcare’s slow sales cycles leave AI vendors waiting for the check to come in the mail.

Insurers aren’t popular. Forrester found only 54% of consumers view health insurers are trustworthy, and only 53% understand claims decisions. Insurers are trying to curry favor by streamlining prior authorization, though most consumers said they’ll believe it when they see it. It certainly doesn’t help that 60% of consumers blame insurers for medical debt and 70% say healthcare is unaffordable – a problem that will get worse before it gets better.

Everyone wants ROI. Not everyone gets it. Half of digital health purchasers use performance-based contracts; the Peterson Health Technology Institute expects that number to rise as health plans, hospitals, and employers scrutinize contracts to ensure they deliver value. When it comes to virtual care, fewer than 30% of providers earn significant ROI, as Healthcare Dive put it, citing Sage Growth Partners. That might explain why Amwell is mulling the sale of legacy assets that aren’t part of its virtual care platform.

Private equity likes money. Two fairly damning reports from Health Affairs illustrate what private equity’s doing to healthcare. One found hospice facilities owned by PE had higher profits and lower per-patient spending compared to other ownership models, and another found specialists affiliated with PE negotiated higher prices than independent physicians. Mind you, other for-profit entities exist in healthcare, and non-profits don’t always hold up their end of the bargain; it’s still not a good look.

Other things we already knew or saw coming from miles away:

That’s all for now. Tune in next month to see if the trends are more of the same.

The Beastwood Files: October 2025

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Writing this one amid recovery from my first colonoscopy. As a few people told me, the prep was the most difficult part – in particular, trying to function without eating for close to 30 hours. I don’t know how people do this routinely. (I was ready to fight someone for a sandwich within seven hours of fasting, but it wouldn’t have been a very good fight because I had no energy.) All the more reason to 1) make less invasive options for cancer screening more readily available and 2) make sure people get the food they need.

Stuff I Wrote

Stuff I Did

  • Got my COVID and flu vaccines
  • Ran the BayState Marathon in 3:24:31 – the fifth marathon I’ve done since the spring of 2022 within a 2-minute range around 3:25, which if nothing else apparently means I’m consistent
  • Finally finished reading Barbara Tuchman’s The Proud Tower, which I started roughly a year ago
  • Started wearing a hat and gloves outside in the morning, which I’ll likely be doing until mid-April
  • Decorated several pumpkins, none of which stayed on our stoop for more than 48 hours because there are hungry rats in our neighborhood
  • Dressed as a car for Halloween to complement my son the crossing guard and my wife the crosswalk

Adventures in Fatherhood

  • The current phrase of the moment is A December to Remember. I initially said this in jest while fruitfully listing the months of the year, as I have no intention of ever buying my wife a Lexus for Christmas (nor does she), but it has since prompted serious conversations about what is and is not practical to give to someone as a holiday gift.
  • We have resumed the annual cool weather tradition of Family Star Pants, which is when we all wear navy blue pajama pants with white stars. (They’re from Primary; I’d add a link, but they don’t sell these specific pants any more). In an added wrinkle, I was asked to wear them to preschool drop-off. We walked. Did I mention these pants have no pockets?
  • We made it around the block for trick-or-treating. We’re still young enough to only pick one treat per house – and at half the houses, he picked either toys or candy that he knows other members of the family like. (Papa, for example, likes Peanut M&M’s.)
  • I made a group of tweens very happy on Halloween night at about 7:30 when I said, “I need your help. It’s time to put my kid to bed, and I want to turn off the porch light. Can you please just take the rest of the candy out of this bowl for me?”