September 15, 2025: Patients now walk into doctors' offices armed with AI-generated diagnoses and treatment plans—but what happens when ChatGPT becomes your primary care physician? Ryan Bengtson, CEO and Board member at Panda Health, joins the This Week Health team to dive into this shifting dynamic while confronting an imminent government shutdown that threatens to pull the rug out from under telehealth programs and rural hospitals already hanging by a thread. As Epic makes its calculated move into ambient listening technology, disrupting yet another innovative startup space, the panel asks whether we're witnessing Epic stunt healthcare innovation or if it’s just business as usual. 

Key Points:

1. 00:55 AI in Healthcare: Patient Empowerment and Challenges
2. 12:25 Government Shutdown and Its Impact on Healthcare
3. 20:08 The Flawed Healthcare System and AI's Role
4. 30:18 Epic's Impact on Innovation and Future Trends

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  📍

  📍 I'm Bill Russell, creator of this week Health, where our mission is to transform healthcare one connection at a time. Welcome to Newsday, breaking Down the Health it headlines that matter most. Let's jump into the news.

  📍 Hey it's Newsday in the the chaos has already started here.

We've got Sarah Richardson directs to Ford as always, and today we're joined by. Ryan Bangtson CEO Board member at Panda Health. Ryan welcome to the Chaos.

Thank you. No, appreciate being here. And bill direct. Sarah Great. Great to be with all of you.

Always good to see you.

Yeah.

I'm looking forward to this conversation. We got a lot of stuff to talk about. Drex lets it meander becuase we just recorded one of these and it just sort of meandered all over the place. I'm disciplined. We are gonna be so disciplined on this. Yeah. You know, that's not the case. So there's a lot of stuff.

We've got healthcare shutdown potentially in September. We've got rural healthcare initiatives and things going on there. And we also we should institute something on this show that says every time someone says the word ai, they have to give like a dollar to Alex's lemonade stand.

Don't you think

like the AI counter,

I mean, how much do you think we'd raise this year if we like instituted that?

I feel like there should be. Yeah. Ryan kind of said it if there was a little counter down in the corner and the production team, every time somebody said ai, it was like, ding. It was just a little ching, a little chime.

Is there that we have to hit

or anything like that or,

I mean, we set our goal for 200,000 this year. We're already above the 200,000, so that's awesome. But man, with that we could like double it in six months, don't you think? I mean, every conversation we have now, well, anyway the first story, economic times patients are bringing AI diagnosis and prescriptions to clinics.

What does this mean? For doctors. It's interesting and Sarah, you started talking about this before I cut you off and said, let's hit record before we have this conversation. Where were you going with this?

Well, it's the reference back to Dr. Google. Think about WebMD and even like Mayo blogs, all these different things the patients have always sourced.

Since the advent of the internet, we have been sourcing opinions and perspectives on our healthcare, either for self consumption or to have more viable conversations with our physicians. The challenge with AI is that, and I'm not saying the Internet's ever been perfect, there's maybe more of a chance or it's changing so fast that some of those hallucinations may give you some false information, or if anything, there's as much about the education of the use of AI in seeking medical information and how to have a thoughtful conversation with your physician about information you have also.

Found about your condition as an example. So to me, that's what I do when I go to my doctor. Hey, I have researched this and here's what I have found. Tell me your perspectives on this. Not everyone's gonna walk in. Some people are gonna literally print it off their printer, but it does bring in a newer dynamic of how to have those thoughtful conversations with your physician.

Another reason why perhaps ambient listening is taking off. Because if your doctor's just clicking a bunch of boxes for your visit, you're not gonna have time for that thoughtful conversation.

Yeah. What I thought was interesting on this one, one is, and I mentioned earlier too, it, it kind of flips the typical narrative, right?

We, we were joking around the AI counter, which is always, what are the tools that are coming, how is there resistance to position adoption, or how is this gonna displace clinicians? And it's always the provider use cases. I thought it was interesting that this article focused on the patients and the empowerment that they have with ai.

And so just kind of a different spin on it. But I agree with you completely, Sarah. This has always been, a factor since the advent of the internet. What's interesting now though, is we are ascribing this kind of humanization to ai, which leads us to believe that it is more expertise or more important or more knowledgeable than just doing a Google search.

Right? So I could go on there and like you said, do Dr. Google or WebMD and say, oh, I think this is what it is, or this might be interesting. But now the patients are coming into the physician saying. This is my diagnosis, these are the tests that I want. And it's much more assertive, much more confident in that because AI creates this sense of expertise or, again, kind of that human aspect that traditional search engines just haven't provided.

It's kind of built like that too, right? To have that assertion that if what I'm saying is correct and good, and you should listen to me, and then when you have tools like chat, GPT, that has the voice feature where you can actually just feel like you're actually talking to a person, you almost feel like you're talking to a health coach who knows all this stuff and has been to medical school and has all the latest information and can get you to the place that you need to be before you talk to your doc.

It can be good and bad.

Do you find it correcting you? I find it sometimes parrots be, here's what I'm asking in a certain way, and then it parrots back to me what it thinks I want to hear instead of. I don't know. Certainly doctors don't do that. That's like the antithesis of what doctors do.

I mean, because we don't have a clinical background and we start, I have a headache and thirsty and all the time and I'm dehydrated, whatever. And the doctor would just look at you and say. Drink more water and get outta your office a little bit more and take a walk.

And after you're done researching WebMD and whatnot, you're sitting there going, I need to see a doctor. I might be dying. Right. do you find that AI parrots you a little bit and doesn't really act like as that? I don't know. That foil against your maybe, I dunno, bad thinking on something.

You can definitely prebi it, I think with the way you're prompting it or the way you're asking a question I think when I'm using it, I try to start a little bit more vague and based on the answers, kind of refine and drill down. becuase I do find what you're saying, bill. If I try to be too specific, it almost like you said, parrot or regurgitates back what I said and just uses slightly different words or something to reiterate the same concept.

And it's so overly sycophantic in its approach to actually tell it to be a little bit crankier at times. But what I loved about the article that you shared, Ryan, is a couple different perspectives. Patients know that AI is being used in their clinical narrative. Now, in theory, if they're using any kind of ambient listening, they have to disclose that.

And so if the doctor's using AI and trust it. What differentiation of the sourcing of the information allows the patient to trust it as well, if they're getting it from somewhere different. So you have that whole layer of what you need to explain to the patient to a degree. But then I think about it from a health equity perspective.

So you can tell ai, Hey, I read it a third grade level, or I need this information told to me in terms that I can explain it to a 5-year-old. If you go into MyChart and you pull up your diagnosis or your recent results. It doesn't, maybe it's eighth grade level, but it does not tell you what most those things mean.

And so how many people are loading their A1C or their lab results into it to have it understand what some of the interpretation could be before you have that conversation. And so to me, it becomes a bit of a health equity opportunity. But again, it's about teaching people how to use these things most effectively.

So this whole piece of AI education to a degree now starts to fall on the providers.

Doesn't this point for a need though?

Yeah,

absolutely. I think real quick, Sarah, building off of your point the other thing is I can incorporate nonclinical information into that request with the AI as well.

So you mentioned some of the other factors, but like, social determinants of. Issues. Like I'm, I live in a food desert, or I don't have access to certain things, or my power has gotten shut off. That, that can influence some of the prescriptive or recommendations that chat GPT can make and also help inform some of those situations that you're facing that, that need to be dealt with.

But yeah, I think it's bill, to your point, definitely points to a need. I mean, but it's broad, right? AI education. More broadly is gonna be important. Patient education has always been important. But I think as Sarah was alluding to it's a tool that's being used on the provider side.

There's a need for us to bring those types of tools to bear on the patient side as well, to help influence and bring a little bit of more control to their own healthcare.

All right. So, prognostication to put your crystal ball out for a second and three years from now.

What impact will AI have on the patient's experience in healthcare? And and what is that going to look like? Do you think it's still this three years from now where we're we're taking an image or a copy of what we have in MyChart or whatever our record is, and we take it over to our preferred ai.

We're dropping it in there and having conversations, or do you think it gets more integrated? Do you think health systems recognize this is happening and essentially maybe even provide their own model? That is, I mean, Emmy, is that right? That's Epic's announcement that they're gonna have Emmy, which starts that process of being a patient interface to the medical record.

I'm curious what you think what does three years look like in this? And I realize. In healthcare three years sometimes is not enough time for the kind of change that we want, but I feel like, the

Carac, Carac. Let me see. Most of our

audience has no idea who Carac is.

If Carac, then give us a, like, and if you don't give us a like, so, so Drex, what do you think? Three years? Yeah, so I'm with you. I think Emmy and tools like that become really important because there's a lot of things that our PCPs and others don't have time to ask us about when we go see the doctor, especially if we're healthy and we only see them for an annual physical.

So that idea of being more engaged with your healthcare by using an AI agent that's going to be able to access everything in your medical record, maybe access everything in the. Epic environment as you ask questions and disclose other things as Ryan sort of talked about, like, I live in a food desert.

Where's your nearest grocery store? Oh, it turns out it's 25 miles away. Or I live on a really busy street that has construction and there's a lot of dust in the air. There's a lot of things like that you might just casually have a conversation with an AI agent that turns out to be a really significant thing.

Once it's in your health record and other people can discover it. Especially with AI today, we can start to put a lot of these pieces and parts together about your environment, which may affect your health system reaching out to you proactively, and that often doesn't happen today. So I'm kind of excited about that.

All the other information that is about the environment for where people live that could really lead to better healthcare because our providers know about it.

How about you guys? You guys wanna pro, it's gonna go on the record, so people are gonna come back to you and stop you. Watch this later.

No I was thinking that along the same path that, bill, where you went and direct as well, the a lot of that patient to physician interface or patient to provider interface. Obviously the big hype of AI or the big hope of AI is getting much more into clinical diagnoses and be able to provide much more on the.

Clinical side of things that just by nature of healthcare is gonna take longer than three years to fully play out because you've gotta deal with regulatory and proof points and testing and all those types of things. But I think the less critical components that could still have a significant impact on health outcomes is what Drex just described, which is that patient to position interface.

Leveraging those tools to pick out little things that might get missed in irregular physician conversation or might not ever get asked because we're so crunched for time. And if you do a, pre-visit interview with an AI engine that you can take a little bit more time and pick up some of those things, it could identify many more interesting aspects of what's contributing to your health or lack thereof.

And you could potentially see the Democrats push for. Reversing Medicaid cuts from the one big beautiful Bill Act signed in July. So there's a lot of things, a lot of things at stake here. I don't know, I don't know what the question is here. Other than thoughts and Sarah, since you did not get to comment on the last one, we'll start with you.

I mean, what are your thoughts on this? This is the, this will be an interesting conversation becuase I know what you guys are thinking. We don't talk about politics here, but it's really hard not to talk about politics with this story.

It's always hard not to talk about politics when the government funds a significant component of healthcare and it's always up for grabs and then one side blames the other and it's always somebody's mess to clean up.

So if we just admit that the government doesn't make it better, in some cases they make it possible in other areas, it's probably a key thing to think about. Why I care so much about all of these aspects, not only for the amount of people that may become uninsured, et cetera, and this goes back even to food deserts, rural healthcare, et cetera.

Is the assumption that every single person has all the facts and information they need to make great decisions about their healthcare. And that's often not true. And when you go in and you cut programs, you cut access to programs. Heck, Providence is stated is losing up to $500 million. I love how they called it a poly crisis.

I just rounded with their team two weeks ago and or the state of Oregon is. One of the biggest healthcare deserts in the country, believe it or not, in mental health, is their number one issue that they face. Mm-hmm. And so we have a responsibility for not just the saying we have digital innovation, but really understanding how telehealth and ai, I'll put a dollar in the kitty.

Has a seismic shift on some of the outcomes and the systems and the things that we're doing. So partnering with our vendors or our partners truly about how can we accelerate virtual care, how do we really work through what we just talked about, the AI assisted diagnostics and conversations, and even some of the remote monitoring strategies.

Because if your community needs these types of tools, they need the strategic partnerships to make things happen, and they need to understand back to what I always say, health equity. Make America healthy again, is actually a pretty dirty initiative. When you dig into some of the layers, it sounds good on paper, but you look to see what's actually being cut, who's running some of the programs and how they're looking to fund it.

It's always, right now you're taking something away to give it to something else. There's gotta be a better balance across that continuum. So there's my perspective on the looming government shutdown,

as always, very articulate and well said. Did anybody wanna follow that?

For fear of not sounding as articulate.

I guess I'll fall on the sword. The couple things, going back to the one big beautiful bill I think Sarah, to build on what you said about kind of rural healthcare and really they're bearing the brunt of a lot of this, right?

So. Bill, you mentioned the disproportionate share, hospital cuts and some of the telehealth cuts. Those are disproportionately affecting the rural health areas. Right. So, and rural health also those organizations, safety net hospitals, et cetera, have a significant, much higher than the average health system volume of Medicaid spending as well.

So the thing that's being touted is there was $50 billion in the B, B to. Basically address rural health initiatives, and it's up to a hundred million dollars per state over the next five years. And it's allowing them to fund programs to support access and improved outcomes and physician recruitment.

All of these challenges that rural health face. But at the same time, the Medicaid cuts are projected to impact about 155 billion in those rural areas. So again, going back to Sarah's comment. You've got this additional 50 billion in funding that looks good. But when you do the math, you realize that it's only backfilling about a third of the loss that those rural health systems and rural areas are looking to face.

So, I applaud the fact that there's some, initiatives and money being put in there, but I think there's a broader concern of if you've got a wealth of the population that is losing access. Even if you are losing, insurance, they're not gonna be seeking access, they're not gonna be taking advantage of those programs.

So even if that money is invested to improve mental health services and maternity services and a lot of the areas that are targeted you've gotta question the uptake by the patient population of those when they lose their insurance and aren't sure what their options are. So I think that's a concern.

And I do feel like the rural health areas are a bellwether for. Problems that will be coming down the road for the rest of the healthcare system. They feel it first and more acutely, but it's an indicator of what the rest of the healthcare system is gonna start to feel as you get into this broader capacity constraint of, aging populations, declining number of providers available beds, et cetera.

So, yeah I think the fight over the shutdown and what's gonna be clawed back out of the big beautiful bill will be interesting to see.

You're right on the money. When you talk about the right hand is picking the pocket and the left hand is putting a couple of cents into the pocket, and then if you wind up breaking the healthcare exchange, you've got a bunch of other people now who also are gonna go on Medicaid.

Resources are lower than they've ever been before and projected to be lower than they ever have been before. And some of this Sarah pointed out, some of this is just the challenge of people who get their healthcare today don't really know where it comes from or how it works. They don't have that mechanism internalized.

They just know that they wake up on Monday and suddenly all the bills come to them and they're not being paid for in any other way today. and in inner cities because those hospitals have a lot of the same kind of food, desert, other sort of challenges, getting to your appointments being able to recruit people who want to live in the community where their hospital actually is, is a challenge.

Emergency services and being able to get access to emergency services, the lack of specialized care all those kinds of things. The socioeconomic barriers, the ability to like figure out do they actually have access to the internet? Do they have cell phones? All of these things compound the interest on rural and inner city healthcare and the impact that these cuts are gonna have on patients and families who live there.

This could be an interesting battle. I, direct while you were gone, I, and I know she commented on it, somebody did a extensive thing on, how much doctors make by specialty. And they were talking about, how our system is broken and that kind of stuff.

And my comment on the post was, fee for service equals responsive to market, misaligned to outcomes and value-based comp equals aligned to outcomes, but misaligned to labor markets. So, essentially it's broken.

I mean, if you want the TLDR on that whole article, that's it, those two lines that you said that is essentially.

That's the nutshell. It's not about how much your specialty contributes to the overall margins of the health system. The way we've built the incentives and how that has massive unintended consequences on how the system works or doesn't.

Yeah. Somebody asked me the other day, it's like, are you optimistic with AI and all the things?

And I'm like, I'm always optimistic of what technology can do and how it can do it and that kind of stuff. I'm frustrated because we operate it in a flawed system, and I can make the case on both sides of the flawed system. I could say, look, government's the largest payer. Okay. So it doesn't operate as a fundamental market.

It operates differently, so it breaks down the market. On the flip side, I could also say, look, we need to do that because it doesn't respond. There's no, the elasticity of demand that the whole demand curve doesn't exist in healthcare. Therefore, it's not a market. It's not an actual market. If I am dying, I'm willing to give my entire.

Wealth away to save my life. And so it doesn't respond real well to those things. And so the government has to step in and play around with those markets. The thing is, all of these things, you wanna make sure that whatever reforms you make, you don't pull the rug out from anybody.

So you look at these things, you go telehealth access, all right. Well, has it proven to be good? Absolutely. You have to extend telehealth. It's proven to be good. It's good for access. It's good for people to get care. Just in the past, two weeks, one of my kids, used telehealth to get in front of a doctor, get a prescription, do that whole thing.

Is it perfect? No, but it's what we have and it works pretty good.

And it, but, and it, but it's built inside of like this weird system of physician licensing and other things that keep it from working. Yeah. That's broken. Well, so everything is a suboptimal version of what it could be. And a lot of these fixes seem really easy, like, being able to say like, if you're licensed in Alabama, it's okay if you work in any state in the country using telemedicine or something like that. But I know that's really tough becuase there are people who make their living doing those credentialing efforts state by state, and you start to put those people out of business.

And that's what lobbyists are for in Washington is to keep the system from changing.

Although I would start leaning into AI for credentialing, I actually had that conversation last week, is because credentialing is such a hot mess. And if, let's just say, I don't know, you're a physician, you get a DUI, it doesn't show up for six months on a report.

And then you don't get reimbursed for those six weeks. But AI could have had a feed from, I don't know, the jail or something like that. So if you use the right tools that are available to streamline some of the things that, again, on the backend, no patient cares if they're sick in the middle of the night.

How their doctor got credentialed to use telemedicine in Alabama. They just want access to a physician cleaning up some of those backend processes so that it's easier to access care. That's where I see AI having a continued bigger win. We talk about it in RCM, we talk about it in, managing the service desk as an example.

What about some of those processes like credentialing that are so cumbersome that we could really make a lot better for the patient and the people providing those services?

I think you know the thing that's gonna happen, I think telehealth waivers are gonna go through, I think Medicaid, DHX cuts are gonna happen.

They're just gonna need to be phased as opposed to just a smack at October 1st. becuase you can't lose your safety net in rural hospitals. A CA subsidy will probably also have sort of a phased impact. I don't think we're gonna reverse the one big beautiful bill act, but I think there will be concessions made on Medicaid.

I do think that's what this whole battle is about, is that Bill and Medicaid is what I think it's gonna come down to. And I think at when we're done, both sides are gonna. Trumpet, what they have done to save Medicaid and those kind of things, which will be interesting.

I will say, bill, as it relates to the to the shutdown and some of those waivers, I did see that just an article came out yesterday that the house did propose a bill that's gonna extend the telehealth waivers by two years.

Up until now, everything's kind of been these smaller increments, and so a two year extension would be material to let these programs play out. And also included in there was extending acute care in the home by five years. So, obviously it's gotta work its way through the political process, but they're at least trying to get started on some of those first items and see if we can extend those waivers and create a little bit of capacity in the system.

But why do we keep extending them versus just making them. A standard. I mean, we talked about this earlier in a security perspective, if you just have waivers or extensions, I'm like, Hey, just put it into law as an example, a bill. Literally. It's like if you keep adding and never take anything away, we're talking about the ultimate application or policy rationalization to streamline things as much as we can.

As hospitalists working in these environments, we have to. Do this every day, and yet we're managing what's coming at us versus our own internal process is making us more efficient.

Yeah. Well, I mean, quite frankly, becuase making a bill is a lot harder than doing exte an extension.

Well, unless it's convenient to do something, decide an executive order and do it when we're seeing that a lot lately.

Yeah. Yeah, so that's why these things get extended. The question is, is there the potential for healthcare to fundamentally change? When you look at ai, when you look at telehealth, when you look at hospital at home, one of the, one of the questions we were asking, gosh, this was back in 20, oh gosh, 20 13, 20 14 in Southern California is how many more hospital beds do we need on our campuses if we start delivering care in people's homes?

Could those be our future hospital beds? And it does that bend the cost curve pretty significantly if we're providing various levels of acute care in those homes? And, quite frankly, the numbers were very promising. Because a bed on a campus is extremely expensive to run and operate, but delivering that care.

So that's one thing. Telehealth another thing, remote patient monitoring. Another thing ai, another thing, I mean, if we go through the tension, are we gonna see a different kind of healthcare that we don't even recognize today in 10 years?

Yes and no is my answer. And the reason why is because I started off my career 25, 30 years ago on the consulting side of things and we, I was installing revenue cycle systems and supply chain management systems.

And, the questions we were asking and the problems we were trying to solve, unfortunately are a lot of the same questions. We're still asking crowds we're trying to solve today.

Yep.

So the technology is newer, we've now got AI and we've now got, more web enabled technologies and we're certainly smarter and we're factoring in, I mentioned earlier, SDOH factors and all these other things to do it better.

So is there the capacity for change and will it look different? Yes, and I don't want to be cynical or jaded, but I, we've all been in this industry for a long time, and there's so many things that we're still asking the same questions we were asking 20 years ago, and that's disappointing,

I don't think we're gonna technology our way out of this. We have a really. Poor infrastructure design, not a network infrastructure, not that kind of infrastructure, just a business model around healthcare today, I think we continue to add technology to it which helps us see a. That we're, in many cases, you've heard me say this before, we're taking a train wreck and we're making it a really fast and efficient train wreck, which causes us to add more technology to work around that instead of actually fixing the core problem.

So we continue to build and glom on pieces of infrastructure that don't really solve the problem and. Are significantly inefficient and can be significantly costly to the system that already costs a lot. And that cost isn't just money, but it's clinician time. It's, lots of other. Impacts to patients and families?

I don't know that it gets better. I feel like for it to get better, we almost have to like dump all the toys outta the toy box and then start again from scratch. And I don't know that anybody's got the guts to pull that off from a political perspective.

So I think we're stuck. I think we're kind of stuck with what we've got for a while. We'll innovate around the edges and, hopefully make it better for some people, patients and families in particular.

Yeah . It is. The third rail. It is we saw it with Hillary Clinton early in the Bill Clinton era.

Tried to redo healthcare and if we're really honest about the AC affordable Care Act, it was really insurance reform more than it was healthcare reform and so when somebody asks me, are you optimistic, I sort of have the same answer that you had, Ryan, which is, I think technology will have an impact, but I think it's flawed system.

Like we have to do something about the flawed system, or we are gonna have this conversation 10 years from now. Well, hopefully, direction we're all.

I don't know. You guys wanna talk about? Anything else top of mind for you from the news and what's going on,

Ryan? Nothing else on my end. Like I said the most recent thing I saw was that, Congress is actually starting to address some of the things that, that we pulled up from last week. So I hope that's positive and, avoids the shutdown and gets us some improvement in rural healthcare.

One thing I wouldn't mind we could close on this, Ryan, there was a.

A leak just prior to UGM that, Epic was gonna release their ambient listening documentation tool. And man, that spun up LinkedIn pretty good. Got everything going of, what does this mean for the existing players in that space and whatnot? But specifically what I wanna talk to you about, becuase it's your area where you live is innovation.

A lot of those posts really focus in on is Epic killing innovation Because every time somebody innovates, they just sort of turn the ship and, and plow through them. I'm curious what your take is on those moves and and their real impact to the ambient AI market.

Yeah. I don't think it's killing innovation, but it's certainly thwarting it and making it harder.

Right? There's gonna continually be. New needs, new areas of opportunity and innovative startups, they're going to come in to, to fill those gaps and create great solutions. And until they reach a critical mass or a maturity curve level Epic's gonna let them do it. Once they become popular enough, like you saw with ambient listening, then as you said, Epic's gonna turn the ship and start going after that space.

And so. There's two things at play there. One is, where are there new areas that these startups can innovate quickly, establish good market presence, and, drive their business model for at least a certain number of years. Then there's, once Epic does kind of have you in their sights what is the additional innovation or differentiators that you need to focus on?

you can win against Epic, right? You're not gonna win on the integration battle. You're not gonna win on the cost battle. Epic's gonna have those things wired, but are there, feature functionality capabilities that truly differentiate those solutions that even when Epic comes into that space, they're comfortable with a good enough solution because they've got the integration and the cost factors.

But how do you make sure that margin between good enough and what your organization can deliver is truly differentiated? So I think it puts added pressure or a higher bar on those innovators. And that's unfortunate, but I think a bad analogy is Amazon. And when you see, the Amazon Basics products, which are ones that were hot sellers for somebody, and then Amazon decides to make their generic version sell it for half the price.

They're killing the very customers that made Amazon as great as it is. And Epic's kinda doing a similar tactic with with their approach, which again I think is unfortunate, but it's capitalism. Yeah. As I

hold my Amazon basics pen up for your display value, literally it says Amazon Basics on this thing.

Yeah. You

know what's, you know what's interesting about like, who makes the Amazon basic stuff? They have to go find somebody who's gonna make that stuff for them. Amazon doesn't have like a. A manufacturing. And the reason I bring that up is Epic's ambient solution is a Microsoft solution.

Nuance. Nuance, with a wrapper around it. It's not, they didn't go out and build a competitor to Nuance, ambiance, a bridge. They essentially picked one of them and then put their wrapper around it and their pricing model and everything else, which. It. I mean, that fascinated me. I was surprised they did that.

I,

if you think about that pen that, that Sarah just held up, it's a $3 pen and Amazon probably just went to that manufacturer and said, you can sell a hundred thousand of these at $3, or if you make them and give them to us for a dollar. We'll, you'll be able to sell 2 million of them.

And so they've just decided to pivot the business model and make Amazon Basics instead of making, Sarah pins. And so, it's something like that. I don't know what the business arrangement is between Microsoft and Epic. But I wonder if it has something to do with that.

And I think Ryan's analysis of this whole thing is actually so right on the money spot on. A lot of those companies, the bridges and Ambiences and others of the world are, if it's a mile long race, they're already three quarters a mile ahead before Epic kind of gets out of the gates here they will catch up.

And I think you're right, Ryan, that eventually it's gonna be like, this is the good enough product if you can't afford it. This is gonna be good enough and everybody in the organization will like it good enough. But if you really want to be innovators, you really wanna be out there, you're gonna pay a premium.

We see examples of that in cybersecurity. We see examples of that now in ambient listening. There are examples kind of across the board where folks are willing to pay the extra to go to a third party because it's just such a better product. And then there are those who just are never gonna be able to afford that.

That third party. Arrangement, and so they're going to use Amazon Basics.

For example, I don't think Cheers took a big dent outta Salesforce, but it certainly, thwarted some of the smaller CRM tools that didn't have that dominant market position or that level of great example, innovation or access.

So, similar vein with some of these other areas that they're gonna start focusing on.

I interviewed John Lee Who was up with Allegheny health system and now has his own practice as A-C-M-I-O. And he believes that the announcement was to Perry any momentum that Oracle might feel.

Right? Because Oracle's making this whole pitch like, Hey, ours is gonna be the AI at the center of everything EHR. And it's good. And part of that is the ambient listening built in and the whole tool and whatnot. And, his thing was okay, they just paired him. I mean, like, just like that partnership, put a wrap around it and Oh, yeah we do that too.

I'm not sure. I mean when he said that I was sort of sitting there going do you think Epic's really looking over their shoulder to Oracle right now?

No I think they did it because it's clearly a gap in the product that everybody wants and it was a good place for them to go. I think it's also really interesting to

see Epic do it and not overhype what it's going to be. They've been very clear about like, we're starting here, that we're going to build it up over time and figure it out over time, as opposed to the Oracle. What feels like it may be some over hype of what they're bringing to market.

So they're setting expectations high and they're probably gonna have a hard time hitting those expectations where Epic's coming in, setting low expectations. And they're probably gonna exceed them. They're not gonna be out on the bleeding edge, but they're, this is interesting. Good Judy thing.

Right.

it's an interesting play. And the other thing that I tend to tell people is that it's not monolithic. Every Epic client is not monolithic. They represent all sorts of different types of organizations, from critical access hospitals to children's hospitals, to with different budgets and different resources and different, and

all those community connect sites that they're also community connect sites, right.

Supporting.

And so, and really where I, I said that the most is when people said, why are they doing an ERP? Like, why are they spending the time to do that? And I'm like, you know what, for those small health systems, that's a huge deal. That's why Meditech has the position that they have, they're a complete.

ERP, the whole shoot and match. So it's not the best thing in the world, but it's good enough. That's gonna be, how many times did you pitch that to the board? That's good enough.

I'm gonna end my podcast for now and hope that was good enough.

Wow.

Increase our list. Amazing

expectations.

That's

good enough for now. I'm sorry.

And that's the close for this episode of Newsday. Just good enough. That's all for now. Hey, Ryan, thank you for being a part of this. Drex and Sarah, as always, great to catch up with you guys.

Thanks all.   📍

That's Newsday. Stay informed between episodes with our Daily Insights email. And remember, every healthcare leader needs a community they can lean on and learn from. Subscribe at this week, 📍 health.com/subscribe. Thanks for listening. That's all for now.