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.
~ iambeastwood ~ 1 Comment

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 – 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?”

This Month in Digital Health: Everything Is Not Awesome

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Welcome to This Month in Digital Health, where I highlight news articles and trends that recently caught my attention and attempt to explain why they matter. The key theme for the month? Everything’s a mess.

Telehealth is in trouble. Medicare’s telehealth flexibilities expired at the end of September. With the federal government shut down and not authoring an extension, vendors and providers face a cliff, with some keeping services available and others opting not to. The hospital at home program faces a similar fate, as it too needs an extension from Congress to stay alive. Basically, care is now less accessible – just in time for flu season!

Rural health needs help. Applications are open for the Rural Health Transformation Fund – and just in time, what with multiple federal rural connectivity programs facing funding cuts. Amid the well documented rough road ahead, some rural providers are forming clinically integrated networks, though their aim is more about survival than about the traditional CIM focus on value-based care. Really, though – I feel like rural providers can and should do whatever it takes.

AI use isn’t equitable. HHS data released before the shutdown found an unsurprising digital divide in predictive AI use, with small, rural, independent, and critical-access providers all lagging. Groups such as the Coalition for Health AI fear safety net providers will only fall further behind unless they’re able to recruit the IT staff required to get AI efforts up and running. This is broadly consistent with pretty much every single type of healthcare IT, and sadly I don’t see it changing any time soon.

Insurance costs are going through the roof. No matter how you’re insured, you’re paying a lot more in 2026. Employers’ healthcare costs are poised to rise 9%, while Affordable Care Act premiums will increase close to 20% – and some will more than double is tax credits expire. The culprits? Drug costs (especially GLP-1s), the cost of care, and the impact of the One Big Beautiful Bill Act. Luckily, nothing else has seen significant price increases in the last year, right? Right?

Medicare Advantage is in trouble. Most MA insurers are scaling back their plan offerings in 2026, and annual premiums for the general MA population are expected to increase 22%. Many insurers are also trimming supplemental benefits from MA plans, too, as they say it’s getting too expensive to offer coverage. On a related note, non-profit MA plans didn’t fare terribly well in recent Stars ratings announcements. This all makes me wonder if the MA bubble is bursting: Though 54% of eligible beneficiaries are in MA plans, the pace of growth is slowing. (Remember the second derivative from AP Calculus?)

Also of note:

That’s it for now. Leave a comment if I missed something interesting. We’ll see you next month. Hopefully things will be less depressing.

The Beastwood Files: September 2025

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September was about puttin’ the nose to the ol’ grindstone after four weeks of being off more than I was on. I also intentionally worked half days every Monday last month, mostly to ensure I’d have time for my long runs and partly to help ease my way into the work week. (Garfield was right; no one likes Mondays.) Anyway, I have no lovely bylines to share, though I promise I was, in fact, working.

Also … as you may or may not have seen, I decided to start a monthly news roundup. The first post should go live in mid-October. As a result, I’ve decided to switch from Stuff I Read (which will be covered in said newsletter) to Stuff I Did. Is it as exciting? Probably not. Does it matter? Definitely not.

Stuff I Wrote

  • Custom content for clients in digital health, healthcare data management, enterprise resource planning, and more

Stuff I Did

  • I’m running the BayState Marathon in a couple weeks, so I devoted a good chunk of my non-working and non-catering-to-every-need-of-a-preschooler time to getting through the most important part of the training cycle. Now it’s taper time, which is when marathon runners rest their bodies and do their best to avoid every germ their children bring home from school.
  • I started writing to voters in California through Vote Forward. I did a lot of letter-writing while watching playoff baseball, because these days even when the Red Sox are playing I still have brain space left to do other things.
  • We have already done most of the stereotypical Fall New England Things: Go apple picking, buy several pumpkins, and run the heat and the air conditioning on the same day. (This is equal parts because of the weather and the insulation limitations of a 100-year-old house.) My wife had a pumpkin spice latte. I’ll break out the flannel soon enough.

Adventures in Fatherhood

  • Speaking of the Red Sox, my son and I went to our first game at Fenway Park back in August. It was roughly 90 degrees, and we lasted an hour. Highlights included the bus ride (we’re lucky enough to not need to take the very crowded Green Line), seeing Wally the Green Monster, and going to Ben & Jerry’s on Brookline Avenue once we decided we were too hot for the ballpark.
  • The other day, afternoon snack at school was pretzels, which my son doesn’t like. But instead of rejecting it, he asked to save it for me, since he knows I like pretzels. Kids, amirite?
  • I’ve been able to apply an important lesson in parenting to working with clients. Whenever my son is asking me to get him some milk and also read him a book and oh by the way throw away a soggy tissue, I tell him, “Daddy can only do one thing at a time.” This has helped me make sure I set priorities at work, too.

Happy fall. Happy Halloween. Happy conference season to my health IT friends. Until next time.

Scheduling a Colonoscopy Shouldn’t Be This Hard

close up photo of a stethoscope
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I recently hit a milestone birthday. Depending on whom you ask, I’m either “has a slightly better chance of qualifying for the Boston Marathon” years old or “needs to schedule a preventive colonoscopy” years old.

Fortunately, my patient portal happily reminded me of the latter. (I won’t say which portal it is, but I will say it rhymes with “Chai Mart.”) My portal even went a step further and surfaced a Request Appointment button.

“Hooray!” I said to myself as a classic borderline Gen X / millennial who likes talking to a stranger on the phone about as much as, well, getting a colonoscopy. I eagerly clicked the button.

My portal gave me three options for scheduling the procedure: My current PCP, my previous PCP, and my podiatrist. Now, all three are good doctors and lovely people – and not the least bit qualified to give me a colonoscopy.

There’s a cost of being too convenient

For years, keynote speakers have talked about making healthcare more convenient, much like many other industries. If you can order a burrito or plane ticket from your phone, the argument goes, then why not schedule an appointment?

I’d argue, though, that being too convenient does a disservice to the healthcare organization and the consumer / patient. The portal isn’t the ideal place to give patients free rein to schedule an appointment with anyone within a provider network, especially one as large as mine. (Again, I won’t name it, but it’s the one based in the Boston area that likes to spend a lot on both rebranding and construction projects.)

Limiting that functionality to providers with whom a patient has an established relationship is annoying, but it’s also a sensible business practice. What’s the business value of not just suggesting but making it possible for patients to do something they simply can’t and shouldn’t do?

If I tried to schedule a colonoscopy with any of those providers from the portal, it would probably trigger a six-step workflow that ends in some poor administrative staffer calling me when they should be eating lunch to recite a phone number that I could find after approximately 3 seconds of sleuthing online. (Finding the page with the phone number is one thing; scheduling the appointment is another. It took a while, but I got it done.)

More isn’t better, especially when it gets messy

I went through this experience as I started in earnest on my next eBook, which attempts to unpack the long and winding road for patient engagement technology over the last 10 years. (The timeline is only somewhat arbitrary; I made the move from journalist to research analyst in June 2015.)

There’s a duality at play here. On one hand, technology such as the portal is a lot better than it was a decade ago. It’s possible to schedule (some) appointments, log in for video visits, communicate with providers, view test results, and even link records from external sources such as your pharmacy. Each of those tasks used to require a different application or website, along with some combination of phone calls, CDs, faxes, and expletives. Some of this stemmed from portals developing these features natively; in other cases, they acquired the functionality from a once-burgeoning ecosystem of patient engagement point solutions.

On the other hand, there’s still a long way to go. For starters, more isn’t necessarily better. Just because I can do all that in my portal doesn’t mean I should, or that I want to. In fact, seeing a list of 20-odd things I can do is quite intimidating, especially if I’ve logged in with a very specific task in mind.

In addition, though there are clear benefits to having far fewer point solutions for patient engagement, we’ve lost a little bit along the way. For good or ill, those products were purpose-built to solve a single problem. They become homogenized once they’re folded into a portal trying to serve the needs of a patient population that may number in the millions.

The third issue is the general messiness of patient workflows. Effective technology needs automation, and automation is extremely challenging when workflows differ for quite literally every end user. Case in point: I called Large Affiliated Boston Hospital No. 1 to schedule my colonoscopy, only to find out my PCP has placed the order at Large Affiliated Boston Hospital No. 2, which then set up my procedure at Affiliated Boston-Area Outpatient Facility No. 13-A. (I think it’s near a Wegman’s. I may go there for lunch.)

Stop ignoring small problems with easy fixes, please

Here’s the thing. We can accept (albeit begrudgingly) that the workflow above is bewildering, and unlikely to be made simpler without systemic change irrespective of what technology is in place. But why do we have to accept that smaller problems with easier solutions have been largely ignored?

Let’s go back to the “Schedule a Colonoscopy” kerfuffle within the portal. If a patient clearly cannot go through with the workflow – in my case, not being able to receive a clinical service from my current roster of providers – then why not make that “Schedule” button go away? Or, leave it there but make it point to a page that says, “Hey, to schedule this procedure, you need to call this number?” Heck, I’d wager an error page would be preferrable for most users than a prompt to do something that’s straight up not possible. At least that way, the patient and the person they inevitably have to call on the phone can have a hearty guffaw at how the $1.2 billion EHR implementation can’t do something that’s laughingly basic and also a well-accepted clinical recommendation.

Is it extra custom coding? Yes. Is it difficult custom coding? At the risk of sounding like an overconfident and mediocre middle-aged white dude, I’m guessing it probably takes less time than it would take the provider organization and EHR vendor to get on the phone and argue over who, under their contract, is responsible for completing such work.

I know the industry isn’t going to solve the patient engagement problem quickly, with existing technology, and/or for the majority of patients, especially given the current reimbursement and regulatory environment for preventive care and the general state of balance sheets for digital health companies. Plus, let’s be honest: From patients getting kicked off insurance to funding streams drying up to the basic tenets of science and medicine facing an all-out assault, the industry has bigger fish to fry than ensuring a fairly seamless colonoscopy-scheduling experience for overconfident and mediocre middle-aged white dudes.

Still, when you hear leaders at all levels at all healthcare stakeholders talk about focusing on the proverbial low-hanging fruit in improving the patient experience – small fixes that could have a big impact – it’s hard to look at examples like this one and wonder why no one’s bothered to look under the hood.