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The Information Exchange: The O-PIMP Episode

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The Information Exchange: The O-PIMP Episode

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We're back after a few weeks off, and we came in hot:* OpenEvidence landed its first B2B deal at Mount Sinai! So we talk about what happens when a PLG darling tries to grow enterprise muscles, the competitive landscape as they do so, and whether the real moat is product or sales. * Then we pivot to MEDVi and the New York Times piece that has everyone talking: can you really vibe code a billion-dollar telehealth business for $20K? (And should you?) * We wrap with some wonkery — the ONC is the ONC again, the O-PIMP is born, and I walk us through why the Henry Schein v. Vyne case might redraw the line on what counts as a health information network in America.And yeah, you’ll have to listen to understand why this exists (and why it goes so hard):Relevant Articles* OpenEvidence Announcements* Mount Sinai to integrate OpenEvidence AI enterprise-wide* OpenEvidence and Tandem Partner to Streamline Evidence-Based Prescribing and Prior Authorizations* OpenEvidence launches Coding Intelligence* Abridge and clinical decision support* OpenEvidence’s Gambits: Some analysis of where OpenEvidence might go after PLG from last summer, including the enterprise motion* From Alert Fatigue to Approval Fatigue: An oldie showing how it was always logical ambient scribes would infuse CDS, another attempt beyond the pop-up* When Horizontal Meets Healthcare: A piece about OpenAI and how their healthcare business model differs and threatens different players* One Copilot to Rule Them All: The copilot convergence, which OpenEvidence is now rapidly joining* Abundance and Agent: A discussion of how AI-powered software development’s marginal costs mean players sprinting to build it all* The PLG Trap: The OpenEvidence v Doximity cases shows how the sword of openness (PLG) cuts both ways, as we discussed on the show* How A.I. Helped One Man (and His Brother) Build a $1.8 Billion Company: The NY Times article on MEDVi* Healthcare at Internet Scale: An article from last summer about the OpenLoop lawsuit that mentions MEDVi* Rik Renard’s MEDVi post* Death to ASTP, Long Live ONC* The Battle for the Soul of HIE (or at Least the Definition)Chapters* OpenEvidence’s Enterprise Pivot (00:00) - OpenEvidence lands its first B2B sale with an enterprise-wide deployment at Mount Sinai, embedded directly into Epic. The crew unpacks the tension between product-led growth and enterprise sales in healthcare (BAAs, PHI access, institutional sign-off) and how this move finally brings OpenEvidence into UpToDate/Wolters Kluwer’s competitive set for real.* The Great Convergence: Scribes, CDS, and RCM Collide (04:28) - Abridge partnering with Availity and UpToDate, back-office co-pilots moving upstream, front-office co-pilots moving downstream. Brad flags clinical trials enrollment as the next obvious adjacency, and the group debates who wins the “wedge into the chart” race.* PLG in Healthcare and the BAA Problem (08:21) - Why product-led growth has historically been almost impossible in healthcare because of PHI and HIPAA. OpenEvidence may be the closest thing to a Figma for healthcare, but the harder, more valuable use cases require enterprise contracts — and that’s a different muscle entirely.* Vibe Coding the Roadmap: OpenEvidence’s Shipping Velocity (13:03) - OpenEvidence is announcing something major every month. The group attributes this to LLM-assisted development and frames it as a wake-up call: if you’re not adopting Claude Code or Codex-type tools, you’re behind. But speed cuts both ways — if anyone can build an LLM wrapper on the same corpus, is velocity a moat or a vulnerability?* MEDVi, OpenLoop, and the GLP-1 Gold Rush (18:40) - A deep dive into MEDVi, a telehealth front-end on OpenLoop’s white-label MSO infrastructure reportedly generating $1.8B in revenue. Brendan connects it to an older lawsuit alleging fraudulent oral tirzepatide marketing. The real question: when website creation, content generation, and national distribution all approach zero marginal cost, harm scales faster than regulation can respond.* AI Doctors and the Guardrail Question (25:51) - If the provider layer also becomes marginal cost — AI doctors on top of white-label infrastructure — the need for guardrails becomes existential. The group draws parallels to Cerebral, opioids, and the recurring pattern of technology outpacing oversight.* ONC Is Back: ASTP Reverts to Its Original Name (28:25) - The ASTP is reverting to the Office of the National Coordinator. The mission doesn’t change, and the pattern is familiar — Democrats expand, Republicans slim down. Pryce mourns the logo, reveals the internal Office of Policy is now the Office of Programs and Implementation (”the O Pimp”), and the group riffs on missed merch opportunities.* What Is an HIE/HIN? Vyne Dental v. Henry Schein One (34:50) - The episode’s deepest policy cut. Henry Schein withdrew from ONC certification, arguably to dodge information blocking. Vyne is trying to ...

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