MedCity Pivot

AliveCor built its name on a single-lead ECG that let ordinary people check their heart rhythm at home. In this episode, CEO Priya Abani explains how the company is now building a healthcare enterprise business around a newly cleared 12-lead device, a GE Healthcare integration and a Medicare program, while its consumer business keeps growing and its long legal fight with Apple continues.

• The 12-lead expands the market rather than replacing the hospital cart. Cleared for 39 cardiac conditions, including heart attacks, the device goes where a $15,000 to $20,000 ECG cart never did: primary care, concierge medicine, urgent care, hospital at home and even dentist offices.

• Integration is the answer to the point-solution problem. AliveCor is building into GE Healthcare's Muse platform, which sits in 87% of large US hospital systems, and is choosing EHR partners carefully for new markets.

• The consumer business funds the enterprise push. Gross profit from direct-to-consumer sales is being reinvested in the healthcare enterprise, employer and payer, and biopharma channels instead of chasing profitability right now.

• Engagement comes from a path forward, not just a diagnosis. About 350,000 KardiaCare subscribers take roughly 30 ECGs a quarter, and that base became the testing ground for blood pressure and diabetes services.

• Medical grade is the dividing line. Priya argues the winners will be the companies that clearly separate wellness tech from FDA-cleared, clinically validated AI.

• Connect with Arundhati Parmar: [email protected]

• Arundhati Parmar (@aparmarbb) on X: https://twitter.com/aparmarbb?lang=en

• MedCity News: https://medcitynews.com/

• AliveCor research library (mentioned in the episode): alivecor.com/research

AliveCor, Priya Abani, KardiaMobile, 12-lead ECG, portable ECG device, personal ECG, consumer wearables to enterprise, digital health business model, FDA-cleared ECG AI, GE Healthcare Muse integration, medical-grade AI, remote cardiac monitoring, atrial fibrillation detection, KardiaCare subscription, Kardia Access Medicare, cardiometabolic care, AliveCor Apple lawsuit, point-of-care ECG, MedCity Pivot podcast

• [00:02:10 - 00:03:40] Priya runs the numbers: 400 million ECG recordings, 6.4 million patients, nearly 40 countries.

• [00:03:40 - 00:04:20] The 12-lead device is cleared for 39 cardiac conditions, including heart attacks.

• [00:05:15 - 00:06:00] A pocket-sized 12-lead opens up dentist offices, airplanes, cargo ships and schools.

• [00:10:40 - 00:11:45] How the GE Healthcare Muse integration answers the point-solution problem.

• [00:15:20 - 00:16:15] Why a 12-lead ECG that doesn't require disrobing matters for women around the world.

• [00:18:30 - 00:20:00] Priya on a 180-person company standing up to the largest corporation in the world.

• [00:23:30 - 00:24:30] Printing every customer review and highlighting what patients wanted next.

• [00:30:15 - 00:32:00] Clinical AI versus LLMs, and why Ask Kardia only talks about heart health.

Insurance companies are moving fast on agentic AI, and Aetna is one of the clearest examples of what that looks like in production. In this episode, Nathan Frank, Chief Digital and Technology Officer at Aetna, the insurance business of CVS Health, explains how AI agents are cutting administrative burden for nurses, why Aetna refuses to use AI for care denials, and what it will take to give every member their own AI health agent within the year.

• Aetna's AI agents pull data from multiple platforms, providers, and EHRs to prepare clinical notes automatically, giving the company's 12,000 care management nurses 90 minutes back per day.

• Aetna does not use AI to deny care. Nathan Frank draws a hard line here: AI supports auto-approvals and administrative work, but clinicians review any case with missing information.

• 84% of providers in Aetna's annual survey believe AI and agentic AI will lead to better outcomes, a signal the company is using to justify deeper investment in interoperability and clinical data exchange.

• An early version of an AI scheduling agent is already in production, handling the "homework" of booking appointments. Nathan expects a fully autonomous AI health agent for members within the next year.

• Model cost management is becoming a core discipline: Aetna is routing workflows to lower-cost models where possible instead of defaulting every task to frontier AI.

• Connect with Arundhati Parmar

• [email protected]

• Arundhati Parmar (@aparmarbb) on X — https://twitter.com/aparmarbb?lang=en

• MedCity News — https://medcitynews.com/

agentic AI healthcare, Aetna AI, Nathan Frank Aetna, CVS Health AI, AI in health insurance, ambient listening healthcare, AI care management, administrative burden AI, health insurance AI trust, AI claims processing, AI appointment scheduling, health plan AI agents, payer AI strategy, CVS Health Ventures, AI model cost management, interoperability healthcare AI, AI care denials, MedCity Pivot podcast, healthcare AI startups, member experience AI

• [00:03:00 - 00:04:00] How Aetna's AI agents pull data from multiple EHRs to prepare clinical notes for nurses before patient visits

• [00:04:00 - 00:04:30] The result: 90 minutes back per day for clinicians, redirected to patient care, not homework

• [00:06:00 - 00:07:00] Aetna's 10-plus years of AI and machine learning history, and its 3,000 data scientists

• [00:12:00 - 00:12:30] Nathan Frank's direct statement: Aetna does not use AI to deny care

• [00:13:00 - 00:13:30] The provider survey finding that 84% believe agentic AI will lead to better outcomes

• [00:16:00 - 00:17:00] How Aetna sorts signal from noise among healthcare AI startups

• [00:21:00 - 00:22:00] An early version of the AI scheduling agent is already live, with a fully autonomous member health agent expected within the year

SUMMARY

Arundhati Parmar speaks with Jill Schwartz-Chevlin, Chief Medical Officer at Vinca, about the evolution of palliative care from a hospital-based, end-of-life service to a community and home-based model for patients living with serious illness. Jill explains how Vinca grew from an advanced care planning platform into a value-based palliative care company serving patients across five states, primarily through Medicaid and Medicare Advantage plans.

The conversation covers the critical distinction between palliative care and hospice, the cost savings data that health plans are paying attention to, and what it will take for Medicare to finally build a sustainable reimbursement model for the specialty.

KEY TAKEAWAYS

• Palliative care is not hospice. It is symptom management and whole-person support for patients still pursuing active treatment for serious illness, including cancer, COPD, and advanced heart failure.

• More than 75% of hospitals now have palliative care teams, but their positioning around end-of-life discussions has created a widespread misconception that palliative care equals dying.

• Home-based palliative care through Vinca produces a 42% reduction in ER admissions and a 53% reduction in hospitalizations.

• Only three states (California, Hawaii, and New Jersey) have established a Medicaid benefit specifically for palliative care. Traditional Medicare offers no such benefit.

• The current fee-for-service model for palliative care is not sustainable. Most palliative care programs linked to hospices survive only because the hospice subsidizes them.

KEYWORDS

palliative care at home, home-based palliative care, serious illness management, palliative care vs hospice, Vinca health, value-based palliative care, Medicaid palliative care benefit, Medicare Advantage palliative care, community palliative care, advanced care planning, hospice length of stay, ER reduction palliative care, whole-person care, serious illness, home health palliative care, CMO interview healthcare, palliative care reimbursement, MedCity Pivot podcast

Links and resources

• Connect with Arundhati Parmar

• [email protected]

• Arundhati Parmar (@aparmarbb) on X

• MedCity News

EPISODE HIGHLIGHTS

• [00:02:04 – 00:02:36] Jill defines palliative care: symptom relief, patient wishes, team-based approach
• [00:03:11 – 00:03:46] Why hospital palliative care teams created the end-of-life association
• [00:06:13 – 00:07:06] Vinca's 15-year journey from advanced care planning to full palliative care services
• [00:11:43 – 00:12:07] The data: 42% ER reduction, 53% hospitalization reduction
• [00:12:52 – 00:13:31] Patient story: metastatic pancreatic cancer, golf one month ago, ER the next
• [00:18:47 – 00:19:29] Jill clarifies the hospice misconception: 90% of hospice care happens at home
• [00:22:50 – 00:24:10] Why Medicare's fee-for-service model for palliative care is failing and what should replace it

Particle Health CEO Jason Prestinario joins MedCity Pivot to assess the state of U.S. healthcare interoperability with clear-eyed candor. He grades the technical infrastructure a B — data can move — but gives access governance a C, because the rules around who uses data, and how, remain murky and poorly enforced. Jason draws a direct line between true interoperability and the viability of value-based care: without frictionless data access, accountability for patient outcomes is impossible.

The conversation also covers Particle's antitrust lawsuit against Epic, now past its first major legal hurdle, and the broader wave of litigation challenging Epic's market dominance. Jason urges nuance: there's a meaningful difference between patients authorizing their own data use and bad actors harvesting records without consent — and conflating the two risks setting back the entire data-sharing ecosystem.

• The data infrastructure gets a B — but access governance is still a C. The technical pipes for moving health records exist, but who can use them, when, and for what purpose remains the critical unsolved problem.
• Interoperability is a 'nice to have' in fee-for-service care — but it's a hard requirement for value-based care. When a provider is accountable for outcomes that happen outside their four walls, they need data from outside those walls.
• Information blocking penalties need teeth. Until healthcare organizations believe violations will result in real consequences, the rules won't change behavior — just like speed limits only work when drivers believe tickets are real.
• There's a critical distinction between patients authorizing their own data use and third parties accessing data without consent. The current Epic lawsuit debate conflates two very different scenarios that deserve separate legal and regulatory treatment.
• True patient data ownership is still largely a myth. Despite portals and progress, patients still face significant barriers — forgotten logins, provider-controlled systems — to accessing their own medical records programmatically.

• Connect with Arundhati Parmar
• [email protected]
• Arundhati Parmar (@aparmarbb) on X
• MedCity News

healthcare interoperability, Particle Health, Jason Prestinario, Epic lawsuit, antitrust healthcare, value-based care, CMS interoperability, TEFCA, Carequality, health data access, information blocking, 21st Century Cures Act, patient data ownership, HIPAA compliance, health information exchange, payer interoperability, digital health data, EHR data sharing, CommonWell, ONC rules

• [00:04:22 - 00:05:16] Jason grades the interoperability 'pipes' a B-plus but gives data access governance a C at best.
• [00:10:56 - 00:12:37] Interoperability shifts from 'nice to have' in fee-for-service to a hard requirement in value-based care.
• [00:17:05 - 00:19:27] Jason explains why Particle sued Epic and what the case means for the broader healthcare data ecosystem.
• [00:25:11 - 00:27:11] A key distinction: patient-authorized data use versus unauthorized third-party data harvesting.
• [00:28:34 - 00:32:44] Why patients still can't easily access their own records — and what it would take to change that.
• [00:29:02 - 00:29:41] Information blocking penalties only work when organizations believe the consequences are real.

In this episode of the MedCity Pivot Podcast, host Arundhati Parmar sits down with Javier Gonzalez (Abarca Health) and Tanvi Patel (Amazon Pharmacy) to unpack one of healthcare's most frustrating processes: prior authorization.

The conversation explores how outdated systems, lack of transparency, and fragmented communication are eroding patient trust and delaying care. From policy complexity and data gaps to operational risks, the guests break down why prior authorization remains such a challenge—and what it will take to modernize it at scale.

They also highlight the critical role of transparency, interoperability, and consumer expectations in shaping the future of healthcare. With insights from both payer and pharmacy perspectives, this episode paints a clear vision of a more patient-centered system where access to medication is faster, clearer, and more trustworthy

• Connect with Arundhati Parmar

• [email protected]

• https://twitter.com/aparmarbb?lang=en

• https://medcitynews.com/

prior authorization healthcare transparency patient trust interoperability digital pharmacy healthcare innovation medication adherence health tech ePA patient experience healthcare systems PBM reform Amazon Pharmacy Abarca Health

• 00:00–00:25 – Introduction to prior authorization challenges and patient frustration

• 00:01–00:49 – Overview of modernization efforts in healthcare systems

• 00:01:27–00:03:31 – The three core challenges: policy complexity, data quality, operational risk

• 00:04:11–00:04:29 – Real-life impact: delays in critical care (cancer case)

• 00:04:36–00:05:22 – How prior authorization erodes patient trust

• 00:05:59–00:07:00 – Medication adherence begins before the first dose

• 00:07:00–00:07:18 – 20–30% drop-off due to prior authorization failures

• 00:07:18–00:07:39 – Transparency as the key to patient engagement

• 00:08:20–00:09:45 – Benefits of electronic workflows (60–70% efficiency gains)

• 00:11:18–00:12:24 – What should be eliminated in a redesigned system

• 00:12:47–00:13:55 – Employers' role in improving benefit transparency

• 00:15:23–00:16:21 – Rise of modular PBM models and industry shifts

• 00:20:46–00:22:11 – Misaligned incentives across healthcare stakeholders

• 00:23:51–00:24:45 – Consumer expectations reshaping healthcare timelines

• 00:25:14–00:26:11 – The future: invisible, frictionless prior authorization

In this episode of the Med City Pivot Podcast, host Arundhati Parmar speaks with Lars Petersen about one of the most remarkable corporate transformations in modern business history.

Facing a catastrophic collapse of its core film business in the mid-2000s due to the rise of digital photography, Fujifilm executed a bold and strategic pivot into healthcare and life sciences. The company diversified aggressively, leveraging its deep expertise in materials science, imaging, and innovation to build a thriving biotechnology and medical technology ecosystem.

Today, Fujifilm operates as a global Contract Development and Manufacturing Organization (CDMO), partnering with leading pharmaceutical companies and startups alike. The conversation explores how strategic investment, diversification, long-term thinking, and innovation—including AI—enabled Fujifilm not just to survive, but to lead in a completely new industry.

• Connect with Arundhati Parmar

• [email protected]

• https://twitter.com/aparmarbb?lang=en

• https://medcitynews.com/

Fujifilm Pivot Healthcare CDMO Biotechnology Biologics digital transformation business strategy Innovation AI in healthcare Pharma Manufacturing monoclonal antibodies gene therapy cell therapy Diversification corporate strategy MedTech

• 00:00–00:23 – Introduction to the concept of "pivot" and Fujifilm's survival story

• 00:00–00:47 – The collapse of the film industry and existential crisis

• 00:00–01:15 – Fujifilm's transformation into a healthcare company

• 00:02:39–00:03:28 – 2006: the pivotal year and 60% revenue loss

• 00:03:28–00:03:45 – Strategic decision to diversify long-term

• 00:04:22–00:05:08 – Why Fujifilm succeeded while competitors failed

• 00:05:35–00:06:26 – Key investments and acquisitions (including Biogen assets)

• 00:06:52–00:07:30 – Why healthcare is a stable, long-term growth industry

• 00:07:53–00:08:29 – Expansion into medical devices and imaging technologies

• 00:09:42–00:10:34 – Core therapeutic focus: biologics, gene therapy, cell therapy

• 00:10:49–00:11:22 – Serving both startups and global pharma giants

• 00:12:39–00:13:40 – Competitive positioning vs. Samsung Biologics & Lonza

• 00:15:08–00:15:44 – "Partners for life" philosophy and long-term trust

• 00:17:52–00:18:49 – AI integration across manufacturing ecosystems

• 00:18:54–00:19:42 – Final takeaway: building shared ecosystems for the future of medicine

In this episode, Arundhati Parmar interviews Shalin Shah, CEO of Marius Pharmaceuticals, about Testosterone Replacement Therapy (TRT) and the long-standing regulatory classification that places testosterone as a Schedule III controlled substance.

Shah explains that testosterone was scheduled in 1990 following Olympic doping scandals — despite opposition at the time from the FDA, DEA, and the American Medical Association. More than 30 years later, he argues that the regulatory framework no longer reflects current clinical evidence and may be doing more harm than good.

The conversation explores:

• The scientific evidence surrounding cardiovascular and prostate safety

• The differences between injectable and oral testosterone therapies

• The stigma and logistical barriers created by controlled substance status

• How GLP-1 drugs intersect with hormone health and muscle preservation

• The possibility of expanding testosterone therapy access to women

• Whether the current regulatory environment may revisit testosterone scheduling

At its core, this episode examines whether testosterone is being regulated based on outdated controversy rather than modern clinical science — and what that means for patients navigating care today.

• Connect with Arundhati Parmar

• [email protected]

• https://twitter.com/aparmarbb?lang=en

• https://medcitynews.com/

Testosterone Replacement Therapy TRT regulation Schedule III classification Controlled substances Hormone therapy stigma Men's health Women's hormone therapy TRAVERSE study Cardiovascular risk Prostate cancer risk Oral testosterone Injectable testosterone Hematocrit levels GLP-1 muscle loss Hypogonadism FDA regulation Healthcare policy Hormone optimization

00:00–01:40 - Why testosterone became a Schedule III controlled substance in 1990 01:40–02:30 - Political backlash after Olympic doping scandals 02:30–03:56 - Testosterone as the only controlled hormone 03:56–04:58 - The physiologic role of testosterone across multiple organ systems 04:58–06:19 - Cardiovascular and prostate cancer risk: What the TRAVERSE study showed 06:19–07:04 - Physiologic vs. supraphysiologic dosing 07:04–08:49 - How controlled status creates stigma and access barriers 08:49–10:10 - Provider tracking, pharmacy hurdles, and patient friction 10:10–11:48 - Would deregulation increase abuse or doping? 11:48–13:20 - GLP-1 drugs, rapid weight loss, and muscle preservation 13:20–15:08 - Testosterone in women: The overlooked half of the population 15:08–16:22 - Injectable vs oral TRT: Mimicking natural diurnal rhythms 16:22–17:40 - Hematocrit elevation differences between injections and oral therapy 17:40–19:07 - Side effect profiles and hormone signaling differences 19:07–20:32 - Go-to-market strategy: Cash pay vs insurance coverage 20:32–21:24 - Stigma among payers and barriers to reimbursement 21:24–22:43 - Expanding label indications and idiopathic hypogonadism 22:43–22:22 - Could the current administration reconsider testosterone scheduling?

Summary

Tune into MedCity Pivot Podcast with host Arundhati Parmar as three healthcare tech leaders—Serge Perras, Ton Roelandse, and Bertil Chappuis—decode AI's true potential in healthcare. Explore its role in enhancing efficiency and busting myths about AI supremacy.

Episode Highlights

00:00:19 - The high bar for AI safety in healthcare.

00:01:29 - AI's current hype and exaggerated promises.

00:03:57 - Misconceptions about AI replacing healthcare roles.

00:05:51 - Meaningful AI use cases: Prior authorization automation.

00:06:52 - AI in triage and its capacity enhancements.

00:08:10 - AI's role in modernizing healthcare infrastructure.

00:10:46 - Clarifying AI vs. RPA in tech solutions.

00:13:30 - Importance of governance and guardrails in AI.

00:16:38 - Humanizing healthcare through AI.

00:18:27 - AI's potential and challenges in medical coding.

00:21:31 - AI's impact on job roles and productivity boosts.

00:24:25 - Use of AI in personal life for everyday tasks.

Episode Resources

• Connect with Arundhati Parmar

• [email protected]

• https://twitter.com/aparmarbb?lang=en

• https://medcitynews.com/

Keywords

• Artificial Intelligence

• Healthcare Innovation

• AI Applications

• Healthcare Safety

• Technology Hype

• Serge Perras

• Abarca Health

• Ton Roelandse

• Trexin Consulting

• Bertil Chappuis

• Xtillion

• Machine Learning

• Generative Media

• Super Agents

• Risk and Reliability

• Clinical Prediction Models

• Automation Bias

• Prior Authorization Process

• Agentic Systems

• Healthcare Infrastructure

• Modernization

• Robotic Process Automation (RPA)

• Data Quality

• Governance and Guardrails

• Human vs AI Roles

• Healthcare Workforce Transition

• AI Augmentation

• Patient Care

• Medical Coding

• Electronic Health Records (EHR)

• AI Ethics

• Data Fragmentation

• AI Engineering

• Healthcare Economics

• AI's Net New Jobs

• AI Sounding Board

During the episode, MedCity News Associate Editor Katie Adams interviews Dr. Hamad Husainy, chief medical officer at PointClickCare, and Dr. Barbara Bond, a physician at Sutter Health, about how AI can help improve patient outcomes in the emergency department.

Episode Resources

• Connect with Arundhati Parmar

• [email protected]

• https://twitter.com/aparmarbb?lang=en

• https://medcitynews.com/

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I interviewed Adriana Ramirez and Matt Gibbs, and we spoke about how a new approach to pharmacy benefits management.

Episode Resources

• Connect with Arundhati Parmar

• [email protected]

• https://twitter.com/aparmarbb?lang=en

• https://medcitynews.com/

• Connect with Adriana Ramirez and Matt Gibbs

• [email protected]

• [email protected]

Review, Subscribe and Share

If you like what you hear please leave a review by clicking here

Make sure you're subscribed to the podcast so you get the latest episodes.

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