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This week's Touch Point is an encore. We are replaying TP470, "When AI Becomes the First Stop for Care." It aired in January, the same week OpenAI launched ChatGPT Health. Chris and Reed sat down with Brandon Scott of TenAdams and made a plain argument. For a growing number of patients, the health journey now starts inside an AI chat, before any health system enters the picture. Five months later the premise is no longer up for debate. By OpenAI's count, more than 230 million people ask health questions on ChatGPT every week, and roughly 40 million do it daily. The patient who shows up already holding an AI explanation of their lab results is now routine. What the original episode left open is the reason to replay it. TP470 asked how health systems would respond. The most visible answer so far is that they bought from the same company. OpenAI for Healthcare rolled out inside AdventHealth, Cedars-Sinai, HCA, Boston Children's, Stanford and other systems within a day of the consumer launch. In April, OpenAI put a free tool directly on clinicians' desks. The vendor that became the patient's first stop is now also the clinician's workspace and the enterprise platform. The front door, the exam room and the back office increasingly run through one synthesis layer. In this encore, Chris and Reed cover: Why AI became the first stop for care before most health systems had a strategy for it What ChatGPT Health actually does, and the line between "support" and "diagnosis" that OpenAI keeps drawing Where AI fills the gaps left by short appointments, fragmented records and limited access Why walled garden thinking is out of step with how patients now manage their health What changes when the tool patients trust and the tool clinicians use come from the same vendor If your digital strategy still treats the website as the first interaction, this episode was early to the problem and the problem only got bigger. Mentions from the Show: Original episode: TP470, When AI Becomes the First Stop for Care. https://touchpoint.health/podcast/tp470-when-ai-becomes-the-first-stop-for-care/ OpenAI, Introducing ChatGPT Health (Jan 7, 2026): https://openai.com/index/introducing-chatgpt-health/ OpenAI, Introducing OpenAI for Healthcare (Jan 8, 2026): https://openai.com/index/openai-for-healthcare/ Fierce Healthcare, OpenAI launches ChatGPT for Clinicians (Apr 30, 2026): https://www.fiercehealthcare.com/ai-and-machine-learning/openai-launches-chatgpt-clinicians-free-ai-tool-physicians-nps-and Advisory Board, Ty Aderhold on ChatGPT Health: https://www.advisory.com/daily-briefing/2026/01/12/chatgpt-health-ab-oi-ec TP476, Good Enough for People Is Not Good Enough for Machines: https://touchpoint.health/podcast/tp476-good-enough-for-people-is-not-good-enough-for-machines/ Brandon Scott on LinkedIn: https://www.linkedin.com/in/brandontascott/ TenAdams: http://tenadams.com Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

Chris Boyer and Reed Smith bring in two people who worked the problem from the inside. Chris Hemphill of Modular Feedback, who builds AI for a living, and Heather Nairn, a healthcare economist who reads this as an access problem first. The reflex across the industry is to point AI at the mess. Standardize the data, set some agents loose, let the model sort it out. Hemphill and Nairn tested that reflex against a plain deterministic workflow on exactly this job. The workflow won on accuracy, on speed and on cost. Their point is not that AI is useless here. It is that the most useful skill in this work is knowing when not to reach for it. The deeper problem is structural. Provider data is a commodity. Every payer and every health system chases the same handful of fields, guards its copy as proprietary, and rebuilds the same record in parallel. Every cycle spent on that is a cycle not spent on the access work that moves outcomes. Transportation, care coordination, the patient in crisis who just needs a number that connects. Mentions from the Show: U.S. Senate Finance Committee, Ghost Network Secret Shopper Study, May 2023: https://www.finance.senate.gov/imo/media/doc/050323%20Ghost%20Network%20Hearing%20-%20Secret%20Shopper%20Study%20Report.pdf HHS Office of Inspector General, behavioral health network issue brief, October 2025 (72% of listed clinicians non-participating) New York Attorney General, "Inaccurate and Inadequate: Health Plans' Mental Health Provider Directories" (EmblemHealth investigation) American Psychiatric Association class-action complaint against EmblemHealth, January 2026: https://psychiatryonline.org/doi/full/10.1176/appi.pn.2026.03.3.15 CMS Final Rule CMS-4208-F2, finalized September 2025 (MA directory data to Medicare Plan Finder by plan year 2027; 85% accuracy threshold) Ideon, CMS Provider Directory Requirements compliance guide, March 2026 (48.74% of MA provider locations carry at least one inaccuracy): https://ideonapi.com/resources/blog/cms-provider-directory-requirements-a-complete-compliance-guide-for-2026-2027/ JAMA, AI-assisted directory inconsistency study, University of Colorado researchers (81% of physicians show inconsistencies), via Healthcare Dive: https://www.healthcaredive.com/news/inconsistent-physician-directories-no-surprises-act/645307/ Modular Feedback (Chris Hemphill), deployment write-up: https://modularfeedback.com/blog Chris Hemphill on LinkedIn: https://www.linkedin.com/in/chrishemphill/ CONFIRM handle Heather Nairn on LinkedIn: CONFIRM URL Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

We have spent years pulling friction out of healthcare. That work is right and it should keep going. This week Reed Smith and Chris Boyer come at it from the other side and ask what the friction that remains is trying to tell us. The frame comes from Jon Acuff, who argues that the size of the inconvenience a person will tolerate points to what they actually value. Aim that at patients and the data gets more honest than any survey. A patient who drives forty minutes past three closer hospitals for a specific surgeon is showing you a commitment you could never manufacture. A patient who hits a wall of hold music and no-shows rather than fight through it is showing you something too. The first is loyalty. The second is a system breaking in a way the industry keeps logging as patient disengagement. One thing complicates the read. Tolerance only counts as a signal when the patient had a choice. The drive past closer options can be a referral lock, a narrow network, a single in-network plan or rural geography with no second door. Read that patient as loyal and you let an access failure pass as a win. Then Reed and Chris flip the lens onto the organization. The initiatives that survive a budget cycle or a leadership change tend to be the ones where someone absorbed real organizational pain on purpose. Most good ideas in healthcare don't fail because they were wrong. They stall because the inconvenience of doing them outran the conviction behind them. In this episode, Chris and Reed cover: Why a patient's tolerance for friction reads more honestly than a satisfaction score The line between the friction tax you impose and the friction patients accept on purpose When loyalty is really a captured patient with no alternative The four inconveniences that quietly kill good initiatives inside a health system How to score an initiative's inconvenience against the commitment behind it If purpose shows up in what you're willing to put up with, your roadmap already knows which bets you believe in. Mentions from the Show: Accenture, patient loyalty and provider selection research (access as a top factor when choosing a provider): https://www.accenture.com/us-en/insightsnew/health/difference-between-loyalty-leaving TP483, The Market That Competition Forgot: https://touchpoint.health/podcast/ CONFIRM slug TP485, Digital Equity Is Health Equity: https://touchpoint.health/podcast/ CONFIRM slug Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

Chris Boyer and Reed Smith run a forensic walk through five dated, citable moments where the future of healthcare consumerism was sitting in published research before the industry moved. The Pew health-seeker data in 2000. ePatient Dave's "Gimme My Damn Data" keynote in 2009, which took twelve years to reach the Information Blocking Rule. Mobile crossing into everyday health behavior by 2012. Apple, Amazon and Haven all declaring healthcare a priority inside twelve months in 2018 and 2019. Peer-reviewed AI matching dermatologists in 2017, three years before most people had heard of ChatGPT. The signals were never really about the technology. Each one was a permission a consumer gave themselves. Permission to research without asking. Permission to demand their data. Permission to expect everywhere and anytime. Permission to compare a hospital to Apple. Permission to skip the front door. Name the permission and you have found the signal. Five artifacts, each with a date and a source, and the same defensive industry response to all of them A six-marker test that tells you whether you are inside a signal while it is still a signal, not after Why the permission shift is the marker most teams miss, and the permission patients are taking right now The scoreboard for today: agentic AI as the new front door, the death of click-through, the restructuring of primary care, and voice The one current signal that breaks the pattern, and why ambient documentation moved fast when nothing else did The honest finding is uncomfortable. Three of today's four signals score 5 or 6 out of 6 on the same markers that flagged every past miss. The fourth, voice, scores about 3, and it shows what breaks the pattern. Ambient documentation moved quickly because it helps clinicians and patients in the same motion, so the internal politics line up instead of fighting. If you can name the permission your patients are taking right now, you have found the signal. The only question left is whether you act inside the window or wait for the deadline. Mentions from the Show: Pew Research Center, The Online Health Care Revolution, Rainie and Fox, November 2000: https://www.pewresearch.org/internet/2000/11/26/the-online-health-care-revolution/ Pew Research Center, Health Online 2013, Fox and Duggan, January 2013: https://www.pewresearch.org/internet/2013/01/15/health-online-2013-2/ deBronkart and Eysenbach, Gimme My Damn Data (and Let Patients Help!): The #GimmeMyDamnData Manifesto, JMIR, November 2019: https://www.jmir.org/2019/11/e17045/ Esteva et al., Dermatologist-level classification of skin cancer with deep neural networks, Nature, January 2017: https://www.nature.com/articles/nature21056 Tom Ferguson and the e-Patient Scholars Working Group, e-Patients: How They Can Help Us Heal Healthcare, Robert Wood Johnson Foundation, 2007: https://participatorymedicine.org/e-Patient_White_Paper_with_Afterword.pdf Tim Cook on CNBC's Mad Money, full transcript, January 8 2019: https://www.cnbc.com/2019/01/08/apple-ceo-tim-cook-interview-cnbc-jim-cramer-transcript.html Kyndryl, Healthcare Readiness Report, March 2026 (76% report more AI pilots than they can scale): https://www.kyndryl.com/in/en/about-us/news/2026/03/healthcare-readiness-report-findings Dave deBronkart, Meet e-Patient Dave, TED: https://www.ted.com/talks/dave_debronkart_meet_e_patient_dave Eric Topol, Deep Medicine, Basic Books, 2019: https://www.hachettebookgroup.com/titles/eric-topol/deep-medicine/9781541644649/ Eric Topol, The Patient Will See You Now, Basic Books, 2015 Clayton Christensen, Jerome Grossman, Jason Hwang, The Innovator's Prescription, McGraw-Hill, 2009 Dave deBronkart, Let Patients Help!, 2013 Society for Participatory Medicine: https://participatorymedicine.org/ TP483, The Market That Competition Forgot: https://touchpoint.health/podcast/tp483-the-market-that-competition-forgot/ TP478, The Journey Nobody Told Operations About: https://touchpoint.health/podcast/tp478-the-journey-nobody-told-operations-about/ TP457, The Patient Maze: Smarter Tools, Same Old Problems: https://touchpoint.health/podcast/tp457-the-patient-maze-smarter-tools-same-old-problems/ Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

Chris Boyer and Reed Smith walk through why the gap is structural rather than a marketing problem, then close with David Middendorf at Monigle on what Volume 9 actually says about where consumers are right now. Why engagement in health and engagement with healthcare have decoupled, and what the avoidance number among the most engaged segment actually means The structural reasons the operating model can't win this space, from P&L logic to service-line measurement to where wellness programs sit on the org chart The DTC and subscription brands that took categories that used to be referrals inside a health system, and built continuous relationships around them Why a majority of consumers now believe a technology company is more likely to revolutionize healthcare than a traditional system or provider Trust, local knowledge, the provider relationship, the clinical record, and what it would take to actually deploy those as competitive advantages David Middendorf on the "window not a wave" framing, AI as connective tissue for what Monigle calls a Living System of Experiences, and the three keys to the future: listening, personalization, wellness David Middendorf leads the Humanizing Brand Experience research at Monigle. Volume 9 is the ninth annual installment of the firm's flagship study of healthcare consumer behavior. He joins the show to walk through what the new data is saying and what health system brand and experience leaders should do about it. If your strategy deck still treats the space between sick visits as future state, the disruption has already happened and you missed it. Mentions from the Show: Monigle, Humanizing Brand Experience Vol. 9: Healthcare Edition, 2026: https://www.monigle.com/insights/humanizing-brand-experience-volume-9-healthcare-edition David Middendorf on LinkedIn: https://www.linkedin.com/in/dave-middendorf-195b924/ Monigle: https://www.monigle.com/ Global Wellness Institute, Global Wellness Economy Monitor 2025, November 2025: https://globalwellnessinstitute.org/industry-research/2025-global-wellness-economy-monitor/ Global Wellness Institute, US Wellness Economy Reaches $2 Trillion, March 2025: https://globalwellnessinstitute.org/press-room/press-releases/gow-us-econ-valued-at-2trillion/ Kaufman Hall, National Hospital Flash Report, December 2025 data, February 2026: https://www.kaufmanhall.com/insights/research-report/national-hospital-flash-report-december-2025-data HealthLeaders, Hospital Margins Stabilize as 'New Normal' Takes Hold, February 2026: https://www.healthleadersmedia.com/ceo/hospital-margins-stabilize-new-normal-takes-hold Hims & Hers Health, Q4 and Full Year 2025 Financial Results, February 2026: https://investors.hims.com/news/news-details/2026/Hims--Hers-Health-Inc--Reports-Fourth-Quarter-and-Full-Year-2025-Financial-Results/default.aspx TP481, Building the Schema App With Martha Van Berkel: https://touchpoint.health/podcast/tp481-building-the-schema-app-with-martha-van-berkel/ TP488, A Marketing-Led Approach to Patient Reactivation: https://touchpoint.health/podcast/tp488-a-marketing-led-approach-to-patient-reactivation/ Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

For twenty years, hearing the patient meant owning a Voice of Customer program. A survey, a tool, a dashboard you showed the board. On May 18, Qualtrics closed its 6.75 billion dollar acquisition of Press Ganey Forsta. The instrument the majority of U.S. hospitals use to hear their patients is now part of a cross-industry experience platform with its own roadmap. Chris Boyer and Reed Smith take that deal apart and ask who, inside the building, still works for the patient once the listening tool belongs to someone else. This is the third Touch Point in a row circling the same observation. TP485 argued digital equity is a clinical operations problem the health system can no longer outsource. TP487 argued the front door moved off the property. TP489 closes the pattern. The listening apparatus moved too. The episode argues marketing should stop being the collector of patient voice and become its advocate. Owning a program means making the signal presentable. Advocacy means being the named person accountable for the patient's voice surviving contact with a budget meeting. That role has a cost, and the episode names it plainly. If your health system would not fund a single internal advocate to carry the patient's voice into the room, you have already priced what that voice is worth to you. Mentions and links: Qualtrics, Qualtrics Acquires Healthcare Experience Leader Press Ganey Forsta for $6.75 Billion, PR Newswire, May 2026: https://www.prnewswire.com/news-releases/qualtrics-acquires-healthcare-experience-leader-press-ganey-forsta-for-6-75-billion-302774876.html Becker's Hospital Review, Qualtrics completes $6.75B deal for Press Ganey, May 2026: https://www.beckershospitalreview.com/digital-health/qualtrics-completes-6-75b-deal-for-press-ganey/ CMSWire, After Uncertainty, Qualtrics Closes Deal on $6.75B Press Ganey Forsta Acquisition, May 2026: https://www.cmswire.com/customer-experience/after-uncertainty-qualtrics-finalizes-6-75-billion-acquisition-of-press-ganey-forsta/ Healthcare IT News, Qualtrics eyes a data engine to predict the experiences patients want, May 2026: https://www.healthcareitnews.com/news/qualtrics-eyes-data-engine-predict-experiences-patients-want AHA Center for Health Innovation, What the Qualtrics Acquisition of Press Ganey Forsta Will Mean for Health Care, October 2025: https://www.aha.org/aha-center-health-innovation-market-scan/2025-10-14-what-qualtrics-acquisition-press-ganey-forsta-will-mean-health-care Qualtrics, Synthetic Data for Market Research FAQ, February 2026: https://www.qualtrics.com/articles/strategy-research/synthetic-data-market-research/ b2b International, AI in Market Research: The Limitations of Synthetic Data, August 2025: https://www.b2binternational.com/publications/ai-in-market-research-the-limitations-of-synthetic-data/ Customer Experience Dive, How synthetic data might shape consumer research, November 2024: https://www.customerexperiencedive.com/news/synthetic-data-consumer-research-customer-journey-qualtrics/732408/ Bain & Company, How Synthetic Customers Bring Companies Closer to the Real Ones, June 2025: https://www.bain.com/insights/how-synthetic-customers-bring-companies-closer-to-the-real-ones/ CMS, HCAHPS: Patients' Perspectives of Care Survey, 2025: https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/hcahps-patients-perspectives-care-survey Learn more about your ad choices. Visit megaphone.fm/adchoices

47% of health systems have no clear owner for patient activation. CMOs call it the biggest untapped growth opportunity in healthcare. Marketing has the strongest unclaimed toolkit for the work. Chris Boyer and Reed Smith on whether marketing claims the category, and what it accepts in return. This week's episode runs a thought experiment. What if marketing simply claimed the category. Not partial credit. Not co-ownership with clinical operations. The whole thing, identification through completed care. Chris Boyer and Reed Smith map the teams currently sharing the work, the asymmetric capability marketing brings to it, and the operational accountability marketing has to absorb to make the claim defensible. If the largest unclaimed growth category in healthcare is sitting on your desk and your function has the strongest unclaimed toolkit for it, the question isn't whether you want it. It's whether you're willing to be measured on completed care. Mentions from the Show: Forum for Healthcare Strategists / Digital Health Strategies, Health System Chief Marketing Officer Survey, May 2026 Patient Access Collaborative, Industry Insights 2025: The New Imperative for Patient Access Leadership, September 2025: https://www.patientaccesscollaborative.net/news/industry-insights-2025-the-new-imperative-for-patient-access-leadership Patient Access Collaborative Access Framework, BMC Health Services Research, 2025: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-025-12561-8 Linear Health, Referral Leakage Isn't an Out-of-Network Problem. It's a Follow-Up Problem, March 2026: https://linear.health/blog/referral-leakage-follow-up-problem Hospitalogy, The Health System Navigation Problem and Why You Should Fix Your Leaky Referral Pipeline, April 2025: https://hospitalogy.com/articles/2025-04-21/the-health-system-navigation-problem-and-why-you-should-fix-your-leaky-referral-pipeline/ US Tech Automations, Care Gap Outreach Is Failing: Why Manual Methods Can't Keep Up, April 2026: https://ustechautomations.com/resources/blog/healthcare-care-gap-outreach-pain-solution-2026 QuadMed, Closing Preventive Care Gaps Through Data-Driven Patient Outreach in MyChart, January 2026: https://quadmedical.com/outcomes/closing-preventive-care-gaps-through-data-driven-patient-outreach/ CipherHealth, Advocate Health case study on patient-centered outreach: https://cipherhealth.com/blog/advocate-health-patient-centered-outreach-close-care-gaps/ Health Catalyst / Upfront Healthcare, Scalable Strategies Increase Patient Activation and Close Care Gaps: https://www.healthcatalyst.com/learn/success-stories/closing-care-gaps Upfront Healthcare, Healthcare Psychographics and Segmentation: https://upfronthealthcare.com/psychographics/ Hibbard et al., Development of the Patient Activation Measure (PAM), Health Services Research, 2004: https://pmc.ncbi.nlm.nih.gov/articles/PMC1361049/ BMC Health Services Research, The role of patient navigators in ambulatory care: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07140-6 Artisan Strategies, Healthcare Patient Acquisition vs Retention Costs 2025: https://www.artisangrowthstrategies.com/blog/healthcare-patient-acquisition-retention-costs-statistics-trends MGMA Stat Poll, No-show fees in medical practices on the rise, January 2025: https://www.mgma.com/mgma-stat/no-show-fees-in-medical-practices-on-the-rise-to-balance-bumpy-attendance-rates Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

TP342 argued that patient access doesn't begin when someone calls for an appointment. It begins much earlier, in the digital layer, before the patient is sure they need care. That premise held. What changed is who owns the layer. Three years ago, the digital layer was something a health system could design, instrument and measure. Today, the patient's first contact happens in a synthesis interface no health system controls. Chris and Reed revisit TP342 this week with a brief intro that connects Reed's "AI and Access" thesis on LinkedIn to the original argument, an honest update on where the premise held, and a frame for listening back with three years of new context. In this encore conversation, Chris and Reed cover: Why patient access doesn't begin at the appointment, and what the real starting point actually is How digital is reshaping the front door of the health system Why "scheduling" is the wrong first metric for an access strategy Where the original argument still holds, and where the synthesis layer changes the picture If access begins in a layer you don't own, then every digital investment downstream of it is downstream of someone else's interface. Mentions from the Show: Original episode: TP342, When Does "Patient Access" Actually Begin? https://touchpoint.health/podcast/tp342-when-does-patient-access-actually-begin/ Reed Smith, "AI and Access in Healthcare" LinkedIn series: https://www.linkedin.com/in/reedtsmith/recent-activity/all/ TP471, Developing a "Route-First" Access Strategy: https://touchpoint.health/podcast/tp471-developing-a-route-first-access-strategy/ TP473, When Demand Outruns Supply: https://touchpoint.health/podcast/tp473-when-demand-outruns-supply/ TP476, Good Enough for People Is Not Good Enough for Machines: https://touchpoint.health/podcast/tp476-good-enough-for-people-is-not-good-enough-for-machines/ Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices

60% of healthcare marketing AI spend goes to writing copy. 6% goes to identifying patients who need care. Live from HMPS26 in Salt Lake City, Chris Boyer is joined by Craig Blake of Amsive Health, Jane Crosby of True North Custom and John Berndt of Valtech Health for a panel conversation on what the conference and the new Health System CMO Survey exposed about marketing's role inside health systems. The conversation opens with data and targeting and how the aging population is reshaping who marketers need to reach. It shifts to patient activation and the goldmine of existing patients sitting unactivated inside the system, then to loyalty and the structural problem of marketing's measurement gap. 72% of departments don't track campaigns through to completed care. 47% have no clear owner for activating existing patients. The panel takes a hard look at the simple prescription that "outside thinking will fix this," with Jane and John pushing back on the assumption that CMOs from other industries can move faster inside healthcare than the people already there. The conversation closes on AI: where it's actually being deployed in health systems, why most spend lands on content production rather than patient identification, and how LLM disruption is starting to show up at urgent care visits. Learn more about your ad choices. Visit megaphone.fm/adchoices

In 2025, U.S. digital health startups raised $14.2 billion. AI-enabled companies captured 54% of it. Every prediction in every roundup carries one quiet assumption underneath it. The patient on the receiving end can use what's being built. The Pew data from January says something different. Two trajectories. One looks like progress in aggregate. The other looks like the patients with the worst health outcomes being structurally locked out of the system that's being built. Chris Boyer and Reed Smith examine what happens when digital strategy and health equity stop being parallel tracks and become the same problem. Why the 2026 AI investment narrative quietly assumes a digitally capable patient, and what the population data actually shows The smartphone-dependent patient most health systems haven't internalized, and why portal UX fails them by design Why disparities in patient portal access are widening for low-income, less-educated and 65-plus populations, even as overall use rises What the 2025 cancellation of federal digital equity funding means for health systems whose patient panels actually need the work done Modality mix as the reframe: digital, phone, in-person and printed channels as a portfolio allocated by segment, not a hierarchy everyone migrates toward The University of Michigan study published in JAMA Network Open in October is the one to anchor on. Researchers looked at 511 hospitals in 51 counties in 17 states where census data showed at least 300,000 LEP residents. 29% of those hospitals offered the patient portal login in English only. 60% offered English plus Spanish. 11% offered three or more languages. In counties specifically chosen because they have hundreds of thousands of patients who don't speak English at home. If your most-invested-in digital experience reaches the patients who already had the most options, and barely touches the patients with the worst outcomes, what is your digital strategy actually optimizing for? Mentions from the Show: Pew Research Center, NPORS 2025, January 2026: https://www.pewresearch.org/short-reads/2026/01/08/internet-use-smartphone-ownership-digital-divides-in-u-s/ Pew Research Center, Internet/Broadband Fact Sheet, December 2025: https://www.pewresearch.org/internet/fact-sheet/internet-broadband/ Pew Research Center, Mobile Fact Sheet, December 2025: https://www.pewresearch.org/internet/fact-sheet/mobile/ OATS / Benton Institute, 19 Million Older Adults Lack Broadband, 2025: https://www.benton.org/blog/19-million-older-adults-lack-broadband Shah & Fiala, Disparities in Patient Portal Access and Utilization, Journal of General Internal Medicine, January 2025: https://link.springer.com/article/10.1007/s11606-025-09359-z Chen et al. (U-Michigan), Language Barriers and Access to Hospital Patient Portals in the US, JAMA Network Open, October 2025: https://ihpi.umich.edu/news-events/news/language-barriers-health-care-have-fallen-not-online-study-shows Healthcare Dive, Top healthcare AI trends in 2026 (Rock Health funding data), January 2026: https://www.healthcaredive.com/news/top-healthcare-ai-artificial-intelligence-trends-2026/809493/ HIT Consultant / CB Insights, Q1 2026 Digital Health Funding, April 2026: https://hitconsultant.net/2026/04/20/digital-health-funding-q1-2026-ai-ma-rebound/ Chief Healthcare Executive, AI in health care: 26 leaders offer predictions for 2026, January 2026: https://www.chiefhealthcareexecutive.com/view/ai-in-health-care-26-leaders-offer-predictions-for-2026 JMIR, Bridging Rural America's Digital Divide in Health Care, December 2025: https://www.jmir.org/2025/1/e88833 Johns Hopkins Bloomberg School, Bridging the Digital Divide in Health Care: A New Framework for Equity, January 2025: https://publichealth.jhu.edu/2025/bridging-the-digital-divide-in-health-care-a-new-framework-for-equity NPR, How ending the Digital Equity Act has disrupted programs to help people get online, November 2025: https://www.npr.org/2025/11/12/nx-s1-5594805/how-ending-the-digital-equity-act-has-disrupted-programs-to-help-people-get-online ScienceDirect narrative review, Addressing language barriers in U.S. healthcare, November 2025: https://www.sciencedirect.com/science/article/pii/S2772632025000418 Reed Smith on LinkedIn: https://www.linkedin.com/in/reedtsmith/ Chris Boyer on LinkedIn: https://www.linkedin.com/in/chrisboyer/ Chris Boyer website: http://www.christopherboyer.com/ Chris Boyer on BlueSky: https://bsky.app/profile/chrisboyer.bsky.social Reed Smith on BlueSky: https://bsky.app/profile/reedsmith.bsky.social Learn more about your ad choices. Visit megaphone.fm/adchoices