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Please Stop Conflating Sports Betting Handle With Spending On Entertainment
Editor’s note: The Cashout for paid subscribers will publish on Tuesday. Every September there’s a huge uptick in how much people bet on sports with the start of football season. Which means it’s time to get ahead of a ridiculous narrative before it picks up steam on social media or in mainstream media. Subscribe Every few months I see some version of this: [ Charlie Bilello@charliebilello Americans bet over $165 billion on sports last year, which is more than they spent on movies, books, concerts and sports tickets - combined. 1:00 PM · Jun 28, 2026 · 4.1M Views 258 Replies · 674 Reposts · 4.23K Likes ](https://x.com/charliebilello/status/2071217050328895935?s=20) Fortune published this in July. The headline and start of the story tell the same narrative (emphasis added): Gambling becomes America’s favorite pastime as Americans spend more on sports bets than movies, arts, museums, and music combined: The North American box office totaled $8.87 billion in 2025, which is still 22% below pre-pandemic levels. Recorded music revenue hit a record $11.5 billion. Live music like concerts and festivals brought in $18.51 billion. Meanwhile, book publishers tracked by the Association of American Publishers reported $14.6 billion for the year. And the U.S. museum industry generated an estimated $16.4 billion. Add it up and the total comes to roughly $70 billion, which is less than half what Americans wagered on sports. The story, to its credit, goes on to tell us why sports betting is entirely different, although people who only read headlines will miss that nuance. (The tweet above definitely skips over the nuance.) I will mostly be preaching to the choir here, but it’s worth saying out loud: Wagering money on sports is not the same thing as spending on entertainment from a financial perspective. When you spend money on a movie or concert ticket, that money is gone. You exchanged money for an experience. It’s a good trade! I get to have fun for “x” dollars. (Unless the movie sucks, I guess.) When you bet money on sports, the money is not necessarily gone every time you wager it. It could be gone, but sometimes it’s not and you actually get more money back! That’s not “spending” money or something you should try to compare directly to entertainment spend. A far better comp would be how much people lose at sports betting. That number was more like $17 billion in the US last year, at least for state-regulated sportsbooks. Why are we trying to equate handle and entertainment spending? I dunno. It makes for splashy headlines, I guess. Now, people should be betting for entertainment, and not because they expect to win in the long term; no doubt about it. Anyway, here’s hoping I don’t see people saying Americans “spent” hundreds of millions of dollars on sports betting this fall. Mindway AI and DraftKings Expand Responsible Gaming Drive with Launch of Gamalyze American Football In time for the NFL kickoff, Mindway AI has expanded its partnership with DraftKings to launch Gamalyze American Football the second title in the neuroscience-based Gamalyze Sports collection. Following the success of Gamalyze Football (soccer) during the FIFA World Cup, this gridiron-themed update replaces static questionnaires with immersive, stadium-inspired gameplay. Backed by 10+ years of Aarhus University research, Gamalyze evaluates real-time decision-making to deliver instant, unbiased player risk assessments. Integrated into DraftKings’ platform and nationwide activations, it engages fans when excitement peaks. Ready to upgrade your player protection? Contact Mindway AI to try Gamalyze Sports today. Gambling news roundup 🚨The important stuff 1st NFL Sunday of Season ‘Champagne-Popping Day for Bettors’ (Covers): “The first NFL Sunday of the season was a champagne-popping day for bettors, while the book was left cleaning up the corks,” Caesars’ head of football Joey Feazel said prior to the Sunday night game. “Caesars Sportsbook reported that Detroit’s Jahmyr Gibbs, Baltimore’s Derrick Henry, Indianapolis’ Jonathan Taylor, and Atlanta’s Bijan Robinson were among the top five most-bet players to reach the end zone, and all of them cashed tickets.” [ Ben Fawkes@BFawkes22 A @CaesarsSports oddsmaker on how Week 1 has gone so far: “The first NFL Sunday of the season was a champagne-popping day for bettors, while the book was left cleaning up the corks.” ➡️8 of 10 most popular anytime TD scorers cashed 1:31 AM · Sep 14, 2026 · 276K Views 16 Replies · 16 Reposts · 615 Likes ](https://x.com/BFawkes22/status/2099310001927995849?s=20) 🔍 Are we already getting a “customer-friendly results” narrative in Week 1? NFL Commissioner Roger Goodell spoke with CNBC about the prediction markets industry: “We think that there needs to be stronger regulations into the predictive markets,” Goodell said. “We want to see that to protect the integrity of our game. We want to make sure we’re protecting the consumers that are on those platforms for the NFL. So, we’re continuing to have conversations with them and talk to them about the things that we think they need to do to strengthen that so that they could be potential partners at some point in the future.” More on the NFL + PMs: [ Straight to the Point Quid Pro Quo The NFL has asked Kalshi and other prediction markets to remove certain easy to manipulate markets. Does a potential partnership hang in the balance… Read more 6 hours ago · 19 likes · Steve Ruddock ](https://straighttothepoint.substack.com/p/quid-pro-quo?utm_source=substack&utm_campaign=post_embed&utm_medium=web&embedding_publication_id=1472492) Kalshi was on my podcast?: Kalshi was on my podcast [ The Event Horizon Episode 32: Talking Prediction Market Enforcement With Kalshi’s Robert DeNault Kalshi? On my podcast? Yep… Listen now 5 hours ago · 6 likes · 1 comment · Dustin Gouker ](https://nexteventhorizon.substack.com/p/episode-32-talking-prediction-market-enforcement-kalshi?utm_source=substack&utm_campaign=post_embed&utm_medium=web&embedding_publication_id=1472492) DraftKings Enhances Responsible Engagement Efforts With New Customer Initiatives, Tools and Education (press release): DraftKings Inc. today announced a series of new initiatives designed to promote responsible engagement and increase awareness and use of the tools and resources to help customers make informed decisions and engage responsibly. The efforts include a new digital advertising campaign featuring Kevin Hart and Nick Jonas that promotes responsible engagement, a PGA TOUR sweepstakes that promotes customer engagement with responsible engagement features, the launch of Gamalyze American Football in collaboration with Mindway AI, and new custom cool-off options that give customers enhanced flexibility when choosing a cool-off period. The initiatives build on DraftKings’ commitment to making responsible engagement an integral part of the customer experience and providing players with accessible tools and resources that help them make informed choices about their gaming experience. “At DraftKings, responsible engagement is embedded in how we operate and is essential to building trust with our customers and our long-term sustainability,” said Lori Kalani, Chief Responsible Gaming Officer at DraftKings. “We’ve continued to invest in tools and resources that give customers enhanced access to information about their play and more choices for managing how they engage. From My Budget Builder and My Stat Sheet to player-set limits and new custom cool-offs, we’re continuing to evolve our approach while promoting awareness and use of the tools and resources available to help customers play responsibly.” … DraftKings is launching a new digital advertising campaign featuring Kevin Hart and Nick Jonas that continues the pair’s road trip and promotes responsible engagement and awareness of the tools and resources available to help customers make informed choices about their gaming experience and engage responsibly. The campaign was initially launched on Sep. 10th and will reach customers through digital channels, bringing responsible engagement messaging to fans in an engaging way. bet365 Launches “The Matchup,” a New Weekly Video Podcast Hosted by Super Bowl Champions Chris Harris Jr. and Emmanuel Sanders (press release): "bet365, a global leader in online sports betting and gaming, today announced the launch of “The Matchup,” a new weekly video podcast hosted by former Super Bowl Champions Chris Harris Jr. and Emmanuel Sanders. Featuring current and former NFL players, the original series marks a significant, intentional investment in football as bet365 works to become a go-to destination for U.S. bettors throughout the season. “The Matchup” premieres September 10, with new episodes released weekly in both video and audio formats. Full episodes will be available on YouTube, Apple Podcasts, Spotify and wherever podcasts are available, with clips and additional content rolling out across YouTube, X, Instagram, Facebook, Threads, and TikTok. The show is being produced by Last Row Digital Media. Each week, Harris and Sanders will be joined by guests from across the game to break down the biggest NFL matchups, unpack the latest league news and share perspectives that go beyond the box score. By bringing together two former players with distinct perspectives and firsthand experience, “The Matchup” will give audiences timely context and a deeper understanding of the teams, players and storylines shaping the week ahead. “Every great football conversation starts with a matchup—who has the edge, what everyone is overlooking and what could change the game,” said Chris Harris Jr. “Emmanuel and I have experienced the game from different perspectives, and we want the audience to feel like they are part of the conversation and leave every episode knowing more about the week ahead.” Today’s iGaming companies face new litigation threats as expansive consumer protection statutes spark lawsuits with sky’s-the-limit aspirations, sometimes backed by private funders. Clients of Ifrah Law have a staunch defender in Robert Ward – an agile litigator and case tactician who responds to the changing state of play with creative legal defenses and efficient case-closing strategies. Robert draws on federal clerkship experience and appellate defense work to advise iGaming clients on litigation exposure, white-collar risk, and regulatory defense across multiple jurisdictions. Read More: Robert Ward on Helping iGaming Clients Outmaneuver Lawsuit-Obsessed Adversaries 🔮 Prediction markets Update on legal action in Connecticut: [ Daniel Wallach@WALLACHLEGAL Connecticut says gaming service license holders which received subpoenas over sports prediction markets “are not under investigation” by the @CTDCP but may possess information that could assist the state “in evaluating the conduct of prediction market platforms.” 2:31 PM · Sep 13, 2026 · 844 Views 5 Likes ](https://x.com/WALLACHLEGAL/status/2099143914271670576?s=20) American Gaming Association Opposes CFTC Bid to Block New York Prediction-Market Enforcement (DeFi Rate): “The brief points to the Ninth Circuit’s Aug. 28 decision in KalshiEX LLC v. Assad, which the AGA says supports New York’s authority to regulate sports contracts as gambling. It also cites Kalshi advertising, product comparisons and reporting on Kalshi’s sports volume to argue that the economic product resembles a sportsbook wager more than a conventional financial hedge.” [ Daniel Wallach@WALLACHLEGAL AGA intervenes in CFTC v. NY case to oppose CFTC request for preliminary injunction, says the CFTC’s arguments “obfuscate a simple truth: prediction markets offer sports betting.” Highlights CA9 decision, @DustinGouker (6x), and $1.32 billion in OSB taxes for NY (0 from PMs). Daniel Wallach @WALLACHLEGAL High stakes hearing on Monday in CFTC v. New York State. If SDNY judge Lorna Schofield denies the CFTC’s motion for preliminary injunction, the New York AG would have a clearer path for securing a state court geofencing order against Kalshi, Coinbase, and Gemini Titan. 2:08 AM · Sep 13, 2026 · 4.78K Views 1 Reply · 2 Reposts · 8 Likes ](https://x.com/WALLACHLEGAL/status/2098957043474280584?s=20) Gaming Commission remains member of gambling council after questions raised over ties to Kalshi (Mass Live): “The Massachusetts Gaming Commission will not follow the leads of gaming regulators in Ohio and Michigan and drop ties with the National Council on Problem Gambling over its new association with Kalshi.” Sponsor’s messageTrusted Voices: Conversations About Betting is designed to equip adults, including parents and coaches, with tools and resources to talk to young people about gambling, including information on warning signs, risks and proxy betting. The program is led by retired professional basketball player Randy Livingston and his wife, basketball agent Anita Smith, who share their personal stories related to problem gambling, with the hope of preventing others from experiencing similar harms. Learn more and join the conversation here. 📣 Industry news Gaming M&A: Latest Mergers, Acquisitions and Deals (SBC Americas): “But what else is happening in the world of gaming mergers, acquisitions, investments, and partnerships? Here, we round up some of the news you might have missed.” BetMGM Named Official Sports Betting and Online Casino Partner of the Minnesota Vikings in Canada (press release): BetMGM, a leading iGaming and sports betting operator, announced a multi-year partnership with the Minnesota Vikings, naming it the Official Sports Betting Partner and Online Casino Partner of the team in Canada. The agreement gives BetMGM rights to use Vikings marks across approved sports betting, online casino and marketing activities in Canada. In addition, Vikings Big Kick LuckyTap™, a casino game by Design Works Gaming, is available now exclusively at BetMGM Casino in Alberta and Ontario. “Vikings fans bring a level of passion and loyalty that extends well beyond game day,” said Matt Prevost, Chief Revenue Officer at BetMGM. “As the home of one of the largest collections of sports-themed casino content in North America, BetMGM is uniquely positioned to combine sports fandom with iGaming. We are eager to start football season off strong with another fantastic partnership especially as we expand our reach in Canada to Alberta.” Martin Nance, Minnesota Vikings Chief Marketing Officer, said, “As we continue to deepen our connection with Vikings fans across Canada, we’re proud to welcome BetMGM as the team’s official sports betting and online casino partner in Canada. Their commitment to innovation and fan engagement aligns well with our organization, and we’re excited to create memorable experiences that celebrate Vikings football and connect with Canadian fans in new and meaningful ways.” Caesars Entertainment Launches Ball Rush Jackpots™ in New Jersey,the Latest Proprietary Online Title from Empire Creative™ (press release): Caesars Entertainment, Inc. (NASDAQ: CZR) (“Caesars”) today announced the launch of Ball Rush Jackpots™, a new ball-and-peg style online casino game developed by Empire Creative™, the Company’s in-house game development studio. Now live in New Jersey across Caesars Palace Online Casino, Caesars Sportsbook & Casino and Horseshoe Online Casino, Ball Rush Jackpots is expected to become available in additional jurisdictions where Caesars offers online casino gaming following regulatory approval. The title expands Caesars’ growing portfolio of proprietary online casino titles, following the successful launch of Ca$hline™ earlier this year and further diversifying the Company’s lineup beyond traditional slots and table games. Ball Rush Jackpots follows the traditional ball-drop gameplay experience where players drop a ball down a board filled with pegs to land in a prize slot. As balls navigate independently through a field of pegs, every drop creates new opportunities to collect feature symbols, unlock bonuses and pursue jackpots, delivering a different experience with every round. “Ball Rush Jackpots delivers a different kind of casino experience for our players, combining easy-to-understand gameplay with meaningful customization, exciting bonus opportunities and jackpot potential,” said Matthew Sunderland, Senior Vice President and Chief iGaming Officer at Caesars Digital. “As we continue expanding our proprietary content portfolio, we’re focused on creating games that are simple to pick up, rewarding to revisit and designed around the features players enjoy most.” Bally’s Corporation Secures New Financing to Support the Development of the Bally’s Bronx Project (press release): Bally’s Corporation (NYSE: BALY) (“Bally’s” or the “Company”) announced today that it secured new financing led by WhiteHawk Capital Partners, LP to fund further development of the Bally’s Bronx project and general corporate purposes. The new financing comprises closing date term loan commitments in an aggregate principal amount of $400 million and delayed draw term loan commitments in an aggregate principal amount of $160 million (together, the “Facilities”). … Bally’s Chairman of the Board, Soo Kim, commented, “This important financing allows us to progress the pre-construction planning process so that we are ready to complete the remainder of the capital raise and remain on schedule. Furthermore, the additional liquidity provides us greater flexibility for other capital opportunities.” WORLD JAI ALAI LEAGUE LAUNCHES CENTENNIAL SEASON AND ENTERS NEXT CHAPTER IN MIAMI (press release): The World Jai Alai League will open its 2026 fall season on Tuesday, September 15 at Miami’s JAM Arena, beginning a milestone season that marks 100 years since professional Jai Alai first arrived in Miami. Season X, the tenth season of the Battle Court team-based competition launched in 2022, will also be the first since entrepreneur and sports asset investor Rob Gough acquired the World Jai Alai League in August 2026. The acquisition marks the beginning of a new chapter for the league. World Jai Alai League will maintain the existing Battle Court competition and operating format, with Chief Operating Officer Scott Savin overseeing Season X. Gough and his team will use the coming months to listen to players and fans, evaluate opportunities across the league, and execute plans for a broader evolution of Jai Alai’s presentation, live experience, media, marketing and commercial strategy beginning in 2027. “This is a really unique moment for Jai Alai,” said Rob Gough, Owner of the World Jai Alai League. “We have a sport with more than 100 years of history in Miami, extraordinary athletes and incredible speed, but I also believe there is enormous untapped potential.” bet365 reveals most popular online slots in 3 US states in August (SBC Americas): “In its monthly Gaming Insights and Performance report, growing online casino operator bet365 tracks player trends and game performance in online slots across its North American online casino markets.” The Closing Line is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
VIDEO: Champion Immersive's Buddy System In The Paddock
Every winning horse race is a team effort, but some require more teammates than others. Ahead of last Saturday's Grade 2 Fleur de Lis Stakes, Eclipse Award winner Immersive was accompanied by outrider Lee Lockwood and his horse LM Jokester in the Churchill Downs paddock, providing the 4-year-old ...
Trump keeps stacking up ‘emergency’ wins at the Supreme Court
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She was already a top producer. Video changed her business
The agents who'll win in the next era of real estate will be the ones who decide to take action and lean into video marketing.
macOS 27.2 Further Hints at MacBook With Touch-Enabled OLED Display
The latest macOS 27.2 beta released this week further hints at the long-rumored MacBook with a touchscreen, which is expected to be unveiled by next month. Specifically, when you click and hold on an app icon in the Dock on the third developer beta of macOS 27.2, the icon gets a little bit larger. A similar animation occurs when you long press on an iOS or iPadOS app, so the fact that the animation now extends to macOS could be another subtle clue that a touch-enabled MacBook is coming.
MLB postseason turns to wild card Games 2 on Wednesday
The Dodgers could find out their National League Division Series opponent as early as Wednesday, with four more wild card games on the docket on the second day of the 2026 postseason. The Braves beat the Phillies on Tuesday at Truist Park in Atlanta thanks to a three-run home run in the eighth inning by […]
Supreme Court justices explain increased use of shadow docket
Justices Amy Coney Barrett and Elena Kagan testified on Capitol Hill on Tuesday
Epic v. Health Gorilla: “Working as Designed”
We’ve been on a bit of a legal bender since just before Labor Day, so let’s keep a good thing going! As predicted, Epic does not want its case against Health Gorilla consolidated with the data breach cases, so it filed a motion to vacate the conditional transfer. And because they had to explain to the Panel why this case is different, they put a good chunk of previously unseen Epic v. Health Gorilla discovery record on the public docket! Roll the tape! The Case Against Consolidation Before we get to the fun stuff, let’s do the housekeeping. Epic's motion boils down to three arguments (sorted in ascending order of how well they land): A judge has already decided this. Judge Olguin declined to relate the fraud action to another ELU case (Patterson v. UVA Health), holding that the two do not call for determination of substantially similar questions of law or fact. Epic asks the Panel to treat that (a Rule 42 ruling) as law of the case. The overlap is thin. The three common questions Health Gorilla and the Panel identified are neither numerous nor complex (the qualities the Panel looks for before centralizing). Moreover, they are outnumbered by the questions unique to each side: The breach cases turn on security architecture, notification timing, and patient-level access. The fraud action turns on false treatment attestations and breaches of the framework agreements. Consolidation costs more than it saves. 17 of 21 parties in the fraud action do not appear in a breach case. The cases are also at very different stages: Olguin has a scheduling order running through a January 2028 trial while the breach actions are much more nascent. I like the last two more than the first because they attack the basic economics of an MDL: there just may not be enough shared discovery here to justify dragging all the defendants and a relatively mature fraud case all the way to Florida. On the other hand (while I know exceedingly little about MDL and Rule 42), I have a hard time seeing why a district judge's decision about his own docket would control what the Panel does with the separate § 1407 question. I might be reading between the lines too much, but I sorta think Epic's own brief half-concedes this, framing the two provisions as "two sides of the same coin" but then adding "respectfully submit" (which is often lawyer speak for “we know this is a reach”). The Ladder Gets More Rungs Anyway, the arguments are not why you're here (aside from the lawyers, maybe). Back in June, we discussed how Epic was using the smaller defendants to build an evidentiary ladder toward Health Gorilla and Unit 387. Turns out discovery has been adding a few rungs of its own.
Factbox-Top cases on the US Supreme Court's docket
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Leaders of church fear Smith's vision could turn historic Japantown into 'Japandock'
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CD Projekt Red showcases new The Witcher 3: Wild Hunt - Remastered Switch 2 gameplay and control options
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Belkin launches new 14-in-1 Thunderbolt 5 dock with 140W charging and triple 4K display support
Belkin has launched a 14-in-1 Thunderbolt 5 Dock in China priced at 2,299 yuan (approximately $338). The Belkin dock ships with a 180W adapter and 1m cable and delivers 140W USB Power Delivery over a single Thunderbolt 5 connection, with bandwidth scaling from 80Gbps to 120Gbps for high-resolution display use. Belkin briefly listed the dock on its global website at $350 before removing the page, hinting at a global launch.
Docktober invites folks to join citizen scientists in peeking under docks
In the month of October, naturalist Luan Roberts organizes events and encourages everyone to look at the wildlife living under their local docks and report what they see. She's on a mission to get more people involved in the emerging citizen science known as “dock fouling.”
Eyewitness Sports Scoreboard for Friday, October 2
The push for the playoffs in fall sports is heating up by the day, and the race to make your case for Cortland or Syracuse is on! We had a full docket of sports in the high school ranks on Thursday, and you can catch up with all of last night's action on the Friday edition of the Eyewitness Sports Scoreboard!
13 Practical USB-C Gadgets You'll Use All The Time
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Sonos launches Play and delivers portable desk sound with IP67 protection
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Muramasa: Revenant Blades resolution and frame rate targets revealed for PS5, Switch 2, and Switch 1 docked
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Digimon Story: Time Stranger on Switch 2 is a solid port and very good handheld, but needs some more work
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The $299 Viture Pro 2 Are The Company's Lightest And Most Comfortable Smartglasses Yet
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Supreme court to release opinions with several high-stakes rulings to come including birthright citizenship
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Dragon Undocks to Return Science Experiments to Earth
At 12:25 p.m. EDT, the unpiloted SpaceX Dragon spacecraft undocked from the forward‑facing port of the International Space Station’s Harmony module after a command from SpaceX ground controllers. Flight controllers delayed the undocking slightly to power‑cycle a navigation sensor and restore full redundancy before departure.
Saving the trees: Decades of work lead to UTC faculty publication in Science
The first American chestnut tree Dr. Hill Craddock ever saw was one he grew himself. He was about 15 years old, working out of a small greenhouse his father built beside their home. A neighbor gave him a handful of chestnut seeds and suggested Craddock try growing them.
Annapolis boat shows bring big sales to City Dock businesses
This year’s boat shows are the first fall shows since the City Dock project started in November. One restaurant said last Saturday was its “busiest day in history.”
Brutally honest reviews of every VMAs performance, including Madonna and Raye
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The Witcher 3 Remastered details Nintendo Switch 2 frame rate and resolution, physical release teased, mouse controls supported, mods confirmed
During a live stream event today, CD Projekt Red detailed the frame rate and resolution for The Witcher 3 Remastered on Nintendo Switch 2 and commented on other aspects like a physical release teased, mouse controls, and mods. The game is said to run at 720p in handheld mode while 1080p is the target when docked. For frame rate, it’s...
Docktober invites folks to join citizen scientists in peeking under docks
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Five Paddock Market businesses ordered to close over unlicensed activity
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Review: In a deluge of free entertainment, Alternating Currents 2026 flowed into a loading dock, record store and the QC's coolest venues
The Quad Cities’ annual Alternating Currents Festival landed on a rainy weekend this year (Aug. 13-16), but the weather didn’t dampen the spirits gathering for over 200 events across Davenport, Bettendorf and Rock Island. The smiles outlasted the downpours as free music, art, comedy and film events carried on, albeit with few a cancellations, a […]
BUSINESS UPDATE: Port Perseveres Despite Tariffs’ Negative Impact
‘We are hanging tough ... in an environment that is incredibly difficult to do business in right now,” the port’s director says By Stefan Yablonski Tariffs imposed by the Trump administration have hurt the Port of Oswego by slashing Canadian aluminum cargo volumes and reducing revenue. “We’re doing good. We are hanging tough. It is a tough time for our line of business in general, you know with these tariffs and the amount of Canadian aluminum that we see through our docks,” said the new executive director, Tom Drumm. “Compared to 2025, we are doing exceedingly well in traffic coming in; not necessarily the volumes we were seeing, but yeah we are hanging tough in an environment that is incredibly difficult to do business in right now.” “I don’t know where people get these numbers to be honest. We have never publicly stated how much our revenue is down or up or left to right. We don’t have a strong sense of those revenue numbers until the shipping season really closes up. We won’t have an accurate picture of the revenue standpoint until after the shipping season, typically in late November,” he added. “What I can tell you is several of our Canadian vessels that carry the aluminum cells — the volume of aluminum on those vessels we have seen decreasing. That is attributed to a few factors. One is where Novelis is in in their restart process. Novelis is rocking and rolling right now. They are starting to pull a lot of aluminum from the port of Oswego, the aluminum that they roll down into coils. “Another factor plainly is the tariffs. Canadian aluminum is tariffed at 50%. So, on those vessels we are seeing lower numbers than we would like. We’d like to see vessels carrying roughly 10,000 metric tons of aluminum. Over the course of this year, we have seen more in the range of 4,000 to 6,000. “Every piece of that aluminum that we receive here by vessel at the port is from Canada and is subsequently hit with the 50% tariff. It directly affects us because we’ve received less volume than we would traditionally see pre-tariff times.” When the port receives less aluminum from those vessels it means less hours for the ILA (International Longshoremen Association) as far as folks that work on the dock, he said. When cargo declines, it affects everyone, fewer hours for longshoremen, fewer loads for truck drivers, fewer rail shipments and less business for local suppliers. “Outside of the aluminum that comes in by vessel, the port topped out at having roughly 4,600 aluminum ingots stored on site at the port. That project had never been done before. The port of Oswego had never had that many of those size ingots in our yard,” he said. “It has been a busy summer for the ILA. Would we like to see more work for them? Sure. They are working all those barges when they come in, but as opposed to working 15 hours they might be working seven or eight hours. It hasn’t been a distinct decline in ILA hours. There has been plenty of work to keep our guys busy throughout the summer.” More salt “We just brought salt back to the port in several, several years. Around Harborfest time at one point we had a salt barge here with about 24,000 metric tons of rock salt and we had an aluminum barge here the same week. We had close to 40 men working,” he said. “Yeah, the other products definitely keep us busy. The salt project was a massive project, one that we are proud of. I’ve got 24,000 metric tons of salt on site that has to go somewhere — that’s going to be another project.” It is important for the port to continue to look at different products, different commodities to try to diversify some of its revenue, he said, adding, “We have done a pretty good job of that in my first five months here … particularly with the rock salt we have on site right now. It is important to continue to try to stand out and work through some projects outside our usual business. I enjoy it. It is a challenge every single day we put our head down and we try our best.”
August Monthly Review: ChatGPT In Epic
Death, taxes, another frontier lab healthcare launch inspiring truly insane LinkedIn takes. As much as I want to stay away, I repeatedly am the crewman unplugging his ears whenever we pass these sirens. So it’s not the first and probably not the last time we dial up the typewriter rather than tie ourselves to the mast. The full blow-by-blow timeline: Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe The End of the Standalone PHR (Jan 8): ChatGPT Health arrives for consumers, at the time powered by b.well. I was bullish on the approach in that the best way for the PHR to finally solve distribution was to meet consumers were they already are (i.e. When Horizontal Meets Healthcare (Jan 9): OpenAI for Healthcare puts out the shingle for enterprises, with SharePoint ingestion standing in for the EHR integration the product actually needed. Another One: Anthropic’s Healthcare Debut (Jan 16): Claude's version, on HealthEx rails instead of b.well, with Agent Skills for FHIR development as the one true vertical-specific investment. ChatGPT for Clinicians: The Trap Sprung (Apr 24): OpenAI filled in the missing GTM middle with a free product for verified clinicians, effectively peeling the enterprise wrapper off ChatGPT for Healthcare and taking the PLG fight directly to OpenEvidence. OpenAI’s Second Attempt at Health (Jul 31): a relaunch of their patient specific app, now branded Health in ChatGPT, where the privacy partition came out, the connectors thinned, and b.well disappeared in favor of first-party FHIR work against a smaller network Beyond a Shingle So what was announced now? Today, we’re introducing a new electronic health record integration that brings authorized patient context from Epic into ChatGPT for Healthcare, along with the Healthcare Public Data plugin for direct, structured access to official healthcare datasets like PubMed, DailyMed, and CMS Coverage. Together, these capabilities bring ChatGPT closer to the systems and sources healthcare teams trust, while supporting the controls and compliance healthcare work requires. The core portfolio is unchanged from prior announcements we delineated and discussed (aside from the relaunch of patient-facing). Since trade publications still seem to be confusing them by using the wrong names: Enterprise sales motion: ChatGPT for Healthcare Protecting their core product / PLG: ChatGPT for Clinicians Consumer/patient-facing product: Health in ChatGPT So really, this is a feature release (specifically for ChatGPT for Healthcare when it comes to EHR integration). What’s cool about it, though, is that we are moving beyond just putting out a shingle. Everything in the January enterprise launch was horizontalizable: Horizontal tech companies thus generally start verticalization with their “putting out a shingle phase”. Telling the world you’re open for business as a horizontal tech company reliably attracts early inbound interest from buyers who are already trying to force-fit horizontal tools into domain-specific workflows and are eager for any signal that the vendor intends to support their use case more directly. Nothing was really vertical specific, which is exactly what you'd expect from the ultimate hypergrowth horizontal company dipping their toes into specific industries. But eventually you have to stop changing the sign on the door and start changing the product. Can you guess where the horizontal product was going to run out of road? This is the core dilemma writ large: verticalization requires differentiation, while scale economics of consumer and horizontal push toward unification. I’ve buried the lede so deep here it will be painful to some readers, but what should be shocking to no one is that my perspective is that EHR integration is the only path that meaningfully resolves this tension for ChatGPT for Healthcare. Integration with Microsoft Sharepoint is fine, but it is categorically insufficient for any product that hopes to influence clinical decision-making. SMART Money Well here we are, eight months later! Real vertical investment has begun, which surprised a few people. One friend in the industry messaged me: “Absolutely no way Epic gave ChatGPT API access.” Looking forensically at the announcements, the integration is notably read-only across appointment notes, laboratory results, medications, and specialist documentation. So while I’m not a betting man, I'd wager the house this is a SMART on FHIR launch: That sounds a lot like USCDI! The recommended path for the workflow they outline would be SMART on FHIR Their Health AI lead’s post is evocative of both standalone and EHR launch SMART, which another termed “ChartGPT” and “EHR Plugin” The implementation burden for SMART on FHIR is the lowest of the available integrative paths This is the team who literally did patient-facing SMART on FHIR with Epic last month Most importantly, if you’re a horizontal company, you generally still haven’t taken the full plunge and thus (overly) value reusability. SMART on FHIR is the logical compromise: healthcare-specific enough to matter, but standardized enough to reuse. Nobody Asked Judy Another friend asked “I thought they had to go to each health system, or did they go direct to Epic and now health systems opt in?” Given the trust paradigms in healthcare, this functionally cannot be Epic hoovering up all the data for OpenAI and shoving ChatGPT in their customers’ faces (or they would revolt). However, I do believe the aforementioned terrible coverage by TechCrunch and other outlets is probably responsible for that question, given the 325 million reference. When using FHIR as a business associate to an Epic customer, there is no EHR gatekeeping to speak of, as that isn’t how fhir.epic.com works: You register an app You pick your APIs You test against the sandbox APIs You list as “Ready for Production” Hospitals pick your app You test and go live with them Bluntly, nobody had to say yes or no in Verona (nor were they given the chance). Vendor Services (their next developer tier up that I doubt OpenAI is using quite yet in this initial release) certainly has contractual paperwork that some resent, but even there, the twin pressures of mounting antitrust and information blocking make outright gatekeeping increasingly fraught. My friend’s sentiment is, to me, representative of a broader industry neurosis, perhaps a sort of scar tissue of prior eras: people assume the gate is still there and never actually try the door. There are certainly other ways Epic (and any EHR) can put its thumb on the scale, but they are not so dumb as to stand in front of a federally mandated API and play bouncer at this exact moment in time. So I think they can and probably should go deeper, as this release is at best parity and at worst behind vertical-specific competition. OpenEvidence did a basic SMART launch with Sutter Health in February, allowing for more convenient evidence search by providers. They then add patient-context (the equivalent SMART on FHIR flow to what we see here) when Cedars-Sinai went enterprise-wide in May. UpToDate has four distinct applications across deeper workflows like patient engagement listed in Epic Showroom and announced a partnership with Epic to power Art at UGM Abridge and other ambient scribes have invested deeply into the deepest bidirectional clinical copilot workflow with integrations well beyond SMART on FHIR. In that light, the “Who is OpenAI primarily targeting here?” is clear. This release brings them into striking distance of OpenEvidence, but not the others quite yet. They are the only one of the three you can reach without building something truly Epic-specific. When will they go further? Competition is a great motivator to overcome the horizontal demons and start building things that can’t be reused: not across industries, not across EHRs, maybe not past the customer you built them for. That’s the price of actually verticalizing. The question is if and when OpenAI will be willing to pay it. Month in Review Here is the monthly review. As a reminder, this is a regular round-up of the month’s posts and other content to surface things you may have missed across regulation, litigation, interoperability, and beyond. AI assistance is used in these bullet summaries so I can focus on articles. Articles Published: None this month Video Content: The Information Exchange: Standards-based Thruple Edition (Aug 14): Back to school for us too, with Brad reporting in from the CMS Health Tech Ecosystem’s one year anniversary in DC. We get into the January CMS-0057 deadline, the fall rulemaking reading list, and why enrollment still keeps most apps off FHIR. The Information Exchange: Epic Dúnadan Edition (Aug 25): A UGM roundup with Ryan Brickner joining for the first time to check our takes against what the building actually thinks. Rangers, Ergo sitting on top of EHI, and a down-market lineup that needs some cuts. Regulatory: Stacked Deck, Bad Hand (Aug 05): ONC’s website refresh took the entire HIT Policy Committee record with it, so I rebuilt the archive and went looking for the regulatory capture story everyone assumes is buried in there. Stacking the deck and winning the hand turn out to be very different things. The Sixth Generation of Patient Access (Aug 19): A quick catalog of the five generations of patient access we’ve layered on since HIPAA, and the two candidates now competing to be the sixth. One is planned. The other is the market routing around the plan entirely. Court cases: Three Cases Walk Into a Docket (Aug 06): Two surprise settlements cleared the board in a single week, and then Judge Maddox dropped ninety-four pages on Vyne v. Henry Schein. The sleeper is a DMCA holding that makes direct-to-database a considerably riskier business model. Epic v. Health Gorilla: Into the MDL (Aug 10): Nine class actions are headed to Miami, and the Panel signaled it wants to bring the case that spawned them along too. That would leave Epic arguing the requests were obviously fraudulent in one courtroom and unknowable in the other. Amazon v. Perplexity: Agents Are Legalized! (Aug 11): The Ninth Circuit vacated the injunction against Comet, holding that the user is the one accessing the servers rather than the company that built the agent. A real win for agentic access, and a much narrower one than the headline suggests. Veeva v. Epic: Come At Me, Bro (Aug 26): Epic’s response brief wants the dismissal affirmed and, unusually, wants the opinion published as precedent. Buried in it is Epic’s own description of what its non-competes actually prohibit, which current and former employees should read closely. EHRs: The Contract Epic Would Never Sign Today (Aug 04): A 1999 SEC exhibit catches Epic licensing nearly its entire product line, Tapestry included, to the company that became TriZetto. The marketing services menu attached to it is the part that will make you blink. Forecast from Verona (Aug 07): The Epic Almanac makes one argument six different ways: the AI is only as good as the networks behind it. Emmie headlines, Art’s context stack is the most ambitious part, and Penny finally gets an autonomous coding date on the calendar. Works With Epic MyChart (Aug 17): Epic’s first new Showroom category since the death of Workshop certifies hardware instead of software, badge on the box and all. Made for iPhone, but for blood pressure cuffs, and rough news for anyone selling the RPM stack sitting in between. UGM Hot Takes 2026 (Aug 20): Everyone else covered the AI announcements, so I went after Savvy deleting the payment gateway, Rangers as Boost with the timer removed, and a down-market lineup with too many entries. Plus the Health Grid tidbits I cannot help myself on. MyChart Central Grows Up (Aug 24): Device data and Emmie turn Epic’s identity hub into a full consumer platform, which is both a logical answer to ChatGPT and a bit of a mistake. It also happens to be the best scraping target Epic has ever shipped. Industry Analysis: The Wrong Yardstick (Aug 12): Vertical software keeps getting judged against Superhuman and Notion, which is the wrong bar entirely. Your user is comparing your product to a whiteboard and forty phone calls before lunch. Primitives vs. Abstractions (Aug 27): Developers want building blocks, systems of record prefer to hand out business logic, and both sides have a real case. There’s no test from the outside that separates the engineering reason from the competitive one, which is why this keeps ending up in court. Cross-industry Comparisons: The Two Kinds of Platform Power (Aug 18): Attention power and record power are different problems that keep getting handed the same regulatory toolkit. Congress’s latest swing at Big Tech shows both what’s possible and where it falls apart. The Dogs of (Platform) War (Aug 21): A CourtListener alert turned up a property management fight with healthcare’s exact shape and none of the Cures Act. Shell prospects, ghost accounts, a notetaker bot that came back to haunt someone, and a lawyer arguing both sides of the same theory in two states. Fractals All the Way Down (Aug 31): Yardi dominates property management right up until you zoom into one segment, where AppFolio owns it outright and Yardi doesn’t appear at all. Where you draw the line around a B2B software market is about to decide an awful lot of cases. Other News: If Judy Had the Courage (Aug 13): A short eulogy for the era when software was allowed to look insane: WinAMP, bold colors, and everything the grey chatbot era has taken from us. External Media: Portland Monthly Health Tech Meetup: Erin O’Brien channeled my own feelings - maybe it’s just because it’s August and beautiful, but the monthly edition of the PDX Health community meetup was a ripper. Make sure to reach out if interested to join for the next one. STAT’s Coverage of Epic This Month: Brittany Trang of STAT did a fantastic job of breaking the FTC investigation that’s been lurking, as well as UGM related coverage, so I had to give her her wish of a meme. Fall Conferences: I’m pumped to be kicking off my fall conference season in NYC at Nabla Accelerate next month, which Chrissy provided the link to apply for. Here’s the rest of my schedule in case you want to meet up: Commonwell (Redwood Shores, CA): Oct 13-14 Open@Epic (Madison, WI): Oct 21-22 eHealthExchange (Austin, TX): Oct 27 Sequoia Project (Austin, TX): Oct 28-29 HLTH (Vegas): Nov 15-18 RSNA (Chicago): Nov 29-Dec 3 Posts I Liked: HTI-6 Should Unbundle API Certification: Josh Mandel makes the case that HTI-6 should split (g)(10) into separate authorization and data certifications, so a PACS or a genomics platform can certify only the role it actually performs. Imaging is the urgent example, but the structure solves a much bigger problem. On implementing ePrior Auth with Epic: Scott Rossignol’s field notes from a live ePrior Auth build on Epic, including the two app registrations nobody warns you about and the CPT mapping problem waiting at the end. CMS-0057 implementations are going to be such a beast. Healthcare point solutions are starting to look a lot like streaming services: Spencer Dorn runs the cable-to-streaming arc against health IT and lands squarely on the bundling half of the cycle. Bundling can be good! It can also be bad! Life is nuanced. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
ASUS Republic of Gamers Announces ROG Flux Charger Dock
ASUS Republic of Gamers (ROG) today announced the ROG Flux Charger Dock, a premium all-in-one charging and connectivity hub for gamers and creators. With 260 watts of total power output, it easily turns a laptop into a full gaming setup with an external monitor, mouse, and keyboard. A built-in...
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Island Areas Pursue Policies That Advance Health Outcomes
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Nintendo maintenance schedule - June 14, 2026 - Wii and 3DS session incoming
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A university professor spent 100 days living in a 100-square-foot habitat 22 feet beneath a Key Largo lagoon — and when he finally surfaced, he measured half an inch shorter after spending the entire mission under elevated pressure
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News | Live Nation buys land in Dublin Docklands for live entertainment venue
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SDSU soccer match versus Idaho canceled
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Amazon is selling $249 Apple AirPods Pro 3 for just $169 (plus 10 more fab deals)
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Texas' business court boom: New venue outpaces expectations
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Bonus 236: A Term of Self-Inflicted Wounds
Within minutes of the Supreme Court handing down the birthright citizenship ruling on Tuesday and rising for its summer recess, its defenders were pointing to that decision (alongside the late-arriving mail-in ballots ruling on Monday and the tariffs ruling from February) as decisive proof that the Court really is “above politics,” and that criticisms of the justices for behaving more like politicians in robes than like judges are thus unfair. For a particularly thoughtful version of this claim, see Professor Will Baude’s opening response to the latest New York Times written roundtable about the Court with Baude, Professor Kate Shaw, and me. In that roundtable, I already offered one of the two major arguments against this thesis—that it’s an assessment of the numerator without regard to the denominator, and that a full account of the Court’s behavior throughout OT2025 suggests that the Court behaved even more politically during the current term than during even the previous (highly politicized) one. Just to take one of many data points, last term (OT2024), there were six rulings in argued cases in which all six Republican-appointed justices were in the majority and all three of the Democratic appointees were in dissent (along with a slew of such rulings on the emergency docket). This term, there were … 13. (Along with two 6-3 summary reversals and 10 rulings on the emergency docket from which the three Democratic appointees all dissented.) Today’s bonus issue addresses the flip side of that coin. In particular, below the fold, I identify four different moments in which the justices could have acted in ways to specifically defuse charges of political behavior—and opted instead to lean all the way in. As much as end-of-term narratives focus on what the Court did, and on the takeaways from individual rulings, consider today’s post an attempt to identify opportunities that the Court missed, as well. At least in the examples discussed below, by opting for the outcome that made the Court look more transparently political, the Court inflicted a series of (unnecessary) credibility wounds on itself. For those who aren’t paid subscribers, we’ll be back Monday with our regular coverage of the Court. For those who are, please read on.
Voyageur Canoe Outfitters navigates business impacts from BWCAW closures, wildfires
Summer days at the end of the Gunflint Trail usually begin with tow-boats idling at the dock, canoes entering the water, and the excited chatter of guests and outfitter guides before a Boundary Waters Canoe Area Wilderness (BWCAW) trip begins. This week, however, the atmosphere around Voyageur Canoe Outfitters and other outfitter businesses along the...
Nearly 10 months at sea. Families now count the hours until USS Lincoln docks
Sailors went months without setting foot in a port after the carrier got called to the Middle East to fight the war in Iran
Somerset campsite's £27k business rates rise 'catastrophic'
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Official: Manchester United confirm three players have signed new deals
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Monster Hunter Wilds will target 30fps on Switch 2 with two visual modes docked and one handheld
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SpaceX Dragon Docks with Science, Supplies, and Roll-Out Solar Arrays
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7 things to subtract from your real estate business
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Local businesses brace for gigantic cargo moves starting next week
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Vikings news: Minnesota revise starting CB's contract before Week 1
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2026 HFA European Congress Spotlights New Industry Research
Health & Fitness Association submitted comments to the Office of the US Trade Representative on two trade policy dockets that could have significant implications for exercise equipment manufacturers, suppliers, and fitness facility operators.
NFL Punishes Former Texans Starting O-Lineman, Chargers Defensive Back
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Wednesday, July 29th: Rock the Dock, Humane Society of Eastern Carolina, Entertainment Report, Be Our Guest: La Tovara
Eastern Lifestyle
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Today on Pinstripe Alley
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Is Citizens United to blame for everything?
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September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
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