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Bills elevate two defensive backs for Week 4 vs. Patriots
DB Te'Cory Couch and CB Kani Walker elevated from practice squad for Week 4
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
GE HealthCare launches AI-driven operations system
GE HealthCare announced Tuesday the launch of a new artificial intelligence-enabled SaaS application to help healthcare organizations optimize resources and expand care access. | The application—dubbed CareIntellect for Operations—can forecast capacity constraints up to 72 hours in advance, the company says.
GE HealthCare Announces CareIntellect for Operations, Helping Health Systems Optimize Resources and Expand Access to Care
CHICAGO, September 15, 2026--GE HealthCare (Nasdaq: GEHC) today announced CareIntellect™ for Operations, a new AI-enabled Software-as-a-Service (SaaS) application designed to help health systems forecast capacity constraints up to 72 hours in advance, providing comprehensive unit-, department-, and enterprise-level views of emerging bottlenecks. By analyzing hundreds of patient- and operational-level data points—including bed availability, patient delays, staffing, wait times, and ancillary serv
Fake IT Calls Target Executives in Microsoft 365 Data Theft and Extortion Attacks
PREY-0058 uses help desk vishing and AitM token theft to steal data from Microsoft 365 and other SaaS services for extortion.
SAP bets on AI to recover from SaaSpocalypse downturn
SAP executive Jan Gilg discusses the SaaSpocalypse impact and its AI investments. It's been competing more with Palantir and other AI companies.
Your Business Doesn't Need More Software — It Needs Software That Adapts. Here's How AI Is Making That Possible.
SaaS solved one problem and created another. Here's how AI can help solve it.
Thryv Launches AI-Native Growth Platform for Small Businesses
DALLAS, August 04, 2026--Thryv's AI-native growth platform marks the most significant milestone in the company's SaaS transformation.
Synagie Unveils Geene 2.0 - BytePlus, SingData and FLY Entertainment Among 12 Founding Partners Building Trusted AI Commerce
Synagie, the flagship digital commerce and technology brand of Hong Kong-listed Synagistics Limited (HKEX: 2562), today unveiled Geene 2.0, a Trusted AI Commerce Intelligence Ecosystem (a SaaS platform) designed to help businesses move beyond isolated AI applications towards trusted, scalable business transformation.
New ClickLock macOS Stealer Kills Apps Every 210ms Until Victims Type Their Password
ClickLock Stealer kills macOS apps every 210 milliseconds until victims enter a password, then steals browser credentials, cookies, wallets, and Keych
Smart people: IBM's AI warning sparks new Saaspocalypse fears
IBM CEO Arvind Krishna wrote a letter to shareholders about a revenue miss. It's renewing months-old fears about a SaaSpocalypse.
'Godfather of SaaS' says you can't get truly rich working from home
SaaStr founder Jason Lemkin agrees with Flexport CEO Ryan Peterson's skepticism of remote work.
Enterprise AI spending grows, OpenAI leads, RBC reveals
RBC's latest CIO survey finds no AI token panic, no SaaSpocalypse, and surging enterprise AI spending, led by OpenAI.
How To Start A Profitable B2B Business—And 11 Ideas Worth Exploring
From consulting to SaaS, these profitable B2B business ideas can help you build recurring revenue and long-term growth.
Salesforce cuts jobs again as AI threat lingers
The SaaS giant has been hit by concern that AI could replace some traditional software services.
U.S. Embassy Supports Tunisian Business Delegation at 2026 SelectUSA Investment Summit - U.S. Embassy in Tunisia
U.S. EMBASSY SUPPORTS TUNISIAN BUSINESS DELEGATION AT 2026 SELECTUSA INVESTMENT SUMMIT The SelectUSA Investment Summit is the premier U.S. investment event, connecting thousands of investors, companies, economic development organizations, and industry experts to make deals happen. Media Note TUNIS, May 5, 2026 – U.S. Embassy Tunis is pleased to support a delegation of 11 Tunisian companies traveling to the United States to participate in the 2026 SelectUSA Investment Summit at National Harbor, Maryland, May 3-6, 2026. The Summit is an opportunity for these dynamic entrepreneurs to establish new connections and explore business and investment opportunities in the United States. This year, three Tunisian women entrepreneurs and members of the delegation representing Spiraw and Sotetel were accepted into the Select Global Women in Tech year-long mentoring program which will kick off at the summit. Since 2022, more than 50 Tunisian entrepreneurs in fields ranging from e-gaming, robotics, software engineering, coding, online fashion, and green tech have participated in SelectUSA Investment Summits, where they have taken their businesses to the next level. Hosted by the U.S. Department of Commerce, the SelectUSA Investment Summit is a one-stop shop for companies considering expanding to the United States and provides economic development organizations (EDOs) with the opportunity to meet directly with international companies to facilitate investment deals. Since inception, the SelectUSA Investment Summit has attracted tens of thousands of companies and economic development representatives, generating over $250 billion in new investment projects that support more than 125,000 jobs across the United States and its territories. The previous SelectUSA Investment Summit saw record-breaking numbers with more than 5,500 participants, including EDOs from 54 U.S. states and territories and over 2,700 business investors from 100+ countries, including Tunisia. The following Tunisian businesses will take part in this year’s SelectUSA delegation: AquaDeep – Revolutionizes aquaculture with AI-powered monitoring solutions, including a real-time larva counting system and a SaaS platform for environmental monitoring. The company is expanding operations across Tunisia, Europe, Africa, and the United States. Bouraoui Group – Specializes in event venues, hospitality experiences, innovative real estate development, and technology driven customer solutions. The business develops experience- focused and tech enabled lifestyle destinations that combine entertainment, culture, retail, and smart services, and is seeking international partners to co-develop hospitality, PropTech, smart retail, and experiential digital projects. Digital Cook – Builds HR and recruitment software solutions, including HRMS, ATS, and custom tools that streamline hiring, employee management, and talent development. It provides custom software, system integration, and scalable HR platforms for SMEs, large enterprises, and recruitment agencies seeking efficient, user-friendly ways to manage their workforce and improve recruitment. El Kanaouet – Provides high-quality and low-cost hydraulic infrastructure for the supply and distribution of drinking water. The company manufactures prestressed concrete structures based on current technological developments in the field and trends in integrated and digitalized management. El Kanaouet aims to enter the U.S. market with its production of centrifugal prestressed concrete pipes and other technical products and services. Fluoink Nanotechnologies – A deep‑tech startup developing next‑generation antimicrobial additives for paints, coatings, and industrial materials, enabling everyday surfaces to act as long‑lasting barriers against harmful bacteria and pathogens without changing their appearance or performance. Mare Custos – A subsea robotics company specializing in ROV-based underwater inspection services for offshore energy, ports, and marine infrastructure, using high-precision imaging, PAUT, and NDT to inspect structures in challenging conditions. SmartMed SA – A fast-growing digital health company operating in Tunisia, Algeria, and Morocco, offering an integrated ecosystem that helps patients book appointments (MedPro), enables clinics to digitize workflows and EMRs (MedLink), and supports targeted digital marketing for healthcare and pharma (MedAds). With millions of appointments and users, SmartMed has become a leading e-health platform in North Africa. Sototel – Builds telecommunications networks and services, including fixed, radio, and mobile networks. Sototel focuses on technological innovation and continuous improvement, providing high-value-added digital solutions. SOTUPRIN HGE – Specializes in manufacturing household electrical appliances under the brand HGE and OEM. Expanded from the local market to North Africa, Central Africa, the Middle East, and Europe. Spiraw by Food4Future – Designs and manufactures smart, AI-powered cultivation systems allowing individuals and businesses to grow fresh, highly nutritious food – starting with spirulina – directly at the point of consumption. Combining patented hardware, controlled-environment agriculture, and a connected app with an AI assistant, Spiraw aims to decentralize food production and create a new category at the intersection of agri-tech, consumer health, and smart home ecosystems. WaterSec (Istidama) – A climate-tech startup that uses IoT, AI, and smart sensors to help high consumption facilities (such as industries, hotels, and commercial buildings) monitor water use in real time, detect leaks, and optimize consumption. The company’s digital platform turns raw water data into alerts and actionable insights, making water management more transparent, proactive, and sustainable. Learn more about the SelectUSA Investment Summit at https://www.selectusasummit.us/. Follow live developments from the summit on X at https://x.com/SelectUSA.
Atlassian, Twilio, Five9 shares surge as AI boosts earnings
SaaS stocks have taken a hammering this year over fears AI will make some software obsolete, but earnings this week provided a more positive view.
The 3 forces quietly dismantling the business model that made enterprise software fabulously profitable
Roundtables with senior business leaders in San Francisco and New York revealed a consensus: AI isn't just threatening SaaS, but the entire industry.
Playtech opens worldwide sportsbook network to Inspired virtual games
Cloud-hosted integration gives Playtech operators access to Inspired’s licensed and U.S. sports content, widening distribution across regulated markets.
Inspired Entertainment Expands Global Reach Through SaaS Distribution Agreement for Virtual Sports with Playtech
NEW YORK, April 15, 2026 (GLOBE NEWSWIRE) -- Inspired Entertainment, Inc. (“Inspired” or the “Company”) (NASDAQ: INSE), a leading provider of B2B gaming content and systems, today announced a new SaaS distribution agreement with Playtech (LSE: PTEC), one of the world’s leading gambling technology companies. Under the agreement, Inspired’s Virtual Sports portfolio, including its market-leading licensed content and U.S. sports offerings, will be distributed via Playtech’s Sportsbook platform to op
Mystics reportedly fire GM Jamila Wideman after 1 season
Washington is making a major front office change on the first day of free agency.
Bringing SaaS to a wellness business
Wellhub CFO Bruno Annicq joined the company for the chance to make a big impact.
Wayfound.ai CEO transforms engineers into AI managers
Wayfound.ai, led by CEO Tatyana Mamut, uses AI agents to transform software development, challenging the traditional SaaS model.
Advancement of "Science as a Service (SaaS)" for NASA and Commercial Partners Request for Information
A new Science Mission Directorate (SMD) Request for Information (RFI) entitled “Advancement of “Science as a Service (SaaS) for NASA and Commercial Partners
The final four of Business Insider's business-focused bracket
The business-focused March Madness bracket narrows to four trends: SaaSpocalypse, tariffs, longevity, and robotics.
Vote in BI Today's trend-focused March Madness bracket
Business Insider kicks off its March Madness bracket, featuring eight top business trends, including SaaS, private credit, and robotics.
Intuit is betting its 40 years of small business data can outlast the SaaSpocalypse
Intuit lost 42% of its market cap as AI agents threaten to replace QuickBooks and TurboTax. Here's what the company says agents can't replicate.
Investors spill what they aren't looking for anymore in AI SaaS companies
TechCrunch spoke with VCs to learn what investors aren't looking for in AI SaaS startups anymore.
Jared Sleeper on Which Software Companies Will Survive the SaaSpocalypse
How the software business actually works.
The Di-SaaS-ter That Cost Billions in Market Value?
Business: The major market response to SaaS
“SaaS is dying as a business category”
As AI agents commoditize software, companies such as Wix, monday and Nice confront a forced reinvention of growth, pricing and value.
LastPass Brings Secure Access to Businesses and Individuals Alike With New Capabilities in 2025
BOSTON, December 10, 2025--LastPass, a leader in password and identity management trusted by over 100,000 businesses worldwide, announced a series of major advancements in 2025 designed to give users greater security, visibility, and control across work and life. Key updates include Passkeys, now available to all customers, and Business Max, a new SKU that introduces easy-to-use SaaS visibility and access control capabilities alongside other improvements that strengthen security and simplify use
Salesforce CEO Marc Benioff says he might rename the company 'Agentforce'
The SaaS pioneer recently learned in focus groups that customers want to talk about AI agents now