Hey y’all,
Quick reminder: our next Atlanta happy hour is Thursday, February 19th and we just announced a volunteer event on March 7th. Come say hello, bring a friend, and if you’ve been meaning to plug into the community, this is your sign.
This week: ASTP/ONC (aka the federal government's health IT office) started issuing noncompliance notices to electronic health record (EHR) developers. Information blocking moved from rules to reality.
We're also watching Alabama’s proposal for using robotic ultrasounds in rural counties with no OB-GYNs. It's a debate that captures the tension between workforce gaps and tech solutions. And price transparency got uncomfortable at the ASTP annual meeting when 99% of attendees admitted they'd been overcharged for healthcare.
Let’s get into it.
Weekly Roundup
Robotic Ultrasounds for Moms in Rural Areas?
What’s happening: Alabama is exploring robotic ultrasound technology in rural counties with no OB-GYNs. CMS Administrator Dr. Oz called the concept “pretty cool.” Sen. Bernie Sanders countered that what communities need are actual doctors and nurses.
Why this is even being discussed: Alabama lost 30 hospital obstetric units since 1980. Only 15 of 55 rural counties still have maternity care. When access gaps get this severe, tech starts to look less futuristic and more pragmatic.
The provider view: LoRissia Autery, a rural OB-GYN serving five counties, worries that robots cannot substitute for hands-on expertise, particularly for high-risk pregnancies. Her clinic has been trying to recruit a fourth physician for years, highlighting the workforce gap technology alone cannot fill.
Reality Check: Alabama’s five-year maternal health plan directs far more funding to workforce than to robotics. The signal is clear: This is a workforce challenge. Technology can extend reach, but people are the foundation.
The opportunity: Alabama’s five-year plan allocates $24M for maternal and fetal health initiatives, including robotics, and $309.75M for workforce training, more than 13 times as much. The FY26 federal budget also reinforces maternal health across workforce, prevention, and care delivery. The opportunity for innovators is to build solutions that strengthen clinicians and make maternity care more sustainable in the communities that need it most.
Weekly Roundup
The 2026 ASTP Annual Meeting: From Policy to Practice
The big news: ASTP/ONC is issuing noncompliance notices to EHR developers right now. Information blocking enforcement moved from policy to reality.
Why it matters: HHS isn't just talking anymore. Patient data needs to move where it needs to go, when it needs to, compliantly (it’s about time).
What's moving forward:
Electronic prior authorization and Real-Time Benefit Check capabilities are now required for EHR certification
TEFCA — the national framework for sharing health data across networks — is growing in participation and exchange
Proposed updates to health IT certification standards (HTI-5 rule) were discussed
USCDI v7, standardized data elements that systems must be able to exchange, is open for public comment until April 13, 2026, at 11:59 pm ET.
AI governance (no surprise. we don't have clear standards yet)
Between the lines: The opening chat between Amy Gleason (CMS) and Tom Keane (ASTP) seem to show actual agency alignment. They're coordinating on the CMS Interoperability Pledge—a voluntary commitment where health plans and providers agree to improve data sharing. Keane called it "herding cats at scale."
The Pledge is voluntary. No enforcement mechanism.
Yet it's advancing because competitors are working together.
Patients are at the center.
Price transparency got uncomfortable: Cynthia Fisher from Patient Rights Advocate didn't hold back: severe price obfuscation, rampant overcharging, entities in the middle taking chunks of healthcare dollars.
Show of hands: ~99% of attendees have been overcharged for healthcare services.
Her line: "If we don't have transparency, we can't see it."
The bottom line: Technology and standards are necessary but not sufficient. We need the right data available in real-time, in the right hands, when it matters.
Keane's closing: "What we do matters."
Based on the enforcement news, HHS is making sure we know it.
Weekly Roundup
Here’s what else we’re reading
NBER Study: GLP-1s Don't Generate Promised Cost Savings: Analysis of 537,000 patients found GLP-1s increase total healthcare spending by $6,800 over five years, driven by more outpatient monitoring. No cost offsets appeared even five years out, contradicting CBO and pharma industry projections.
Trump EPA Kills Climate Endangerment Finding: The EPA revoked the 2009 finding that greenhouse gases threaten public health, eliminating the legal basis for federal climate regulations. California and other states are already suing, setting up years of court battles that could reach the Supreme Court.
RFK Jr. Reshuffles HHS Leadership Team: Health Secretary Kennedy promoted Medicare Director Chris Klomp to oversee all HHS operations while keeping his CMS roles. Klomp has been leading the administration's drug price negotiations with pharma companies using Inflation Reduction Act authority.
TEFCA Records Exchanged Jump from 10M to 500M: ASTP announced 500 million health records have been exchanged through TEFCA, up from 10 million in January 2025, as Epic and Athenahealth brought thousands of providers onto the network.
IHI Framework Helps Health Systems Navigate Equity Work: The Institute for Healthcare Improvement released guidance for continuing health equity work amid political pressure, recommending organizations frame it as integral to patient safety and quality improvement rather than DEI.
Apple Kills AI Health Coach After Leadership Change: Apple scrapped its planned AI health coach service after Eddy Cue decided it couldn't compete with Oura and Whoop. The company will release individual features into the Health app instead.
TIME100 Health List Features RFK Jr., Pharma CEOs, and AI Researchers: TIME's 2026 list includes Health Secretary RFK Jr., OpenAI's head of health AI, pharma CEOs from Novo, Lilly and Merck, plus brain-computer interface researchers and a Stanford scientist who found shingles vaccines reduce dementia risk.
What did you think of this week's Pulse Check?
Closing Thoughts
Happy Valentine’s Day from the Bonne Fire crew. If healthcare innovation runs on relationships, consider this your reminder to text someone you admire, thank a builder, and introduce two people who should know each other (like Pulse check 🤝 your bff).
Luv, Nadine
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