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#Change Healthcare
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Dinkclump Linkdump
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I'm on tour with my new novel The Bezzle! Catch me TONIGHT in LA (Saturday night, with Adam Conover), Seattle (Monday, with Neal Stephenson), then Portland, Phoenix and more!
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Some Saturday mornings, I look at the week's blogging and realize I have a lot more links saved up than I managed to write about this week, and then I do a linkdump. There've been 14 of these, and this is number 15:
https://pluralistic.net/tag/linkdump/
Attentive readers will note that this isn't Saturday. You're right. But I'm on a book tour and every day is shatterday, because damn, it's grueling and I'm not the spry manchild who took Little Brother on the road in 2008 – I'm a 52 year old with two artificial hips. Hence: an out-of-cycle linkdump. Come see me on tour and marvel at my verticality!
https://pluralistic.net/2024/02/16/narrative-capitalism/#bezzle-tour
Best thing I read this week, hands down, was Ryan Broderick's Garbage Day piece, "AI search is a doomsday cult":
https://www.garbageday.email/p/ai-search-doomsday-cult
Broderick makes so many excellent points in this piece. First among them: AI search sucks, but that's OK, because no one is asking for AI search. This only got more true later in the week when everyone's favorite spicy autocomplete accidentally loaded the James Joyce module:
https://arstechnica.com/information-technology/2024/02/chatgpt-alarms-users-by-spitting-out-shakespearean-nonsense-and-rambling/
(As Matt Webb noted, Chatbots have slid rapidly from Star Trek (computers give you useful information in a timely fashion) to Douglas Adams (computers spout hostile, impenetrable nonsense at you):
https://interconnected.org/home/2024/02/21/adams
But beyond the unsuitability of AI for search results and beyond the public's yawning indifference to AI-infused search, Broderick makes a more important point: AI search is about summarizing web results so you don't have to click links and read the pages yourself.
If that's the future of the web, who the fuck is going to write those pages that the summarizer summarizes? What is the incentive, the business-model, the rational explanation for predicting a world in which millions of us go on writing web-pages, when the gatekeepers to the web have promised to rig the game so that no one will ever visit those pages, or read what we've written there, or even know it was us who wrote the underlying material the summarizer just summarized?
If we stop writing the web, AIs will have to summarize each other, forming an inhuman centipede of botshit-ingestion. This is bad news, because there's pretty solid mathematical evidence that training a bot on botshit makes it absolutely useless. Or, as the authors of the paper – including the eminent cryptographer Ross Anderson – put it, "using model-generated content in training causes irreversible defects":
https://arxiv.org/abs/2305.17493
This is the mathematical evidence for Jathan Sadowski's "Hapsburg AI," or, as the mathematicians call it, "The Curse of Recursion" (new band-name just dropped).
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But if you really have your heart set on living in a ruined dystopia dominated by hostile artificial life-forms, have no fear. As Hamilton Nolan writes in "Radical Capital," a rogues gallery of worker-maiming corporations have asked a court to rule that the NLRB can't punish them for violating labor law:
https://www.hamiltonnolan.com/p/radical-capital
Trader Joe’s, Amazon, Starbucks and SpaceX have all made this argument to various courts. If they prevail, then there will be no one in charge of enforcing federal labor law. Yes, this will let these companies go on ruining their workers' lives, but more importantly, it will give carte blanche to every other employer in the land. At one end of this process is a boss who doesn't want to recognize a union – and at the other end are farmers dying of heat-stroke.
The right wing coalition that has put this demand before the court has all sorts of demands, from forced birth to (I kid you not), the end of recreational sex:
https://www.lawyersgunsmoneyblog.com/2024/02/getting-rid-of-birth-control-is-a-key-gop-agenda-item-for-the-second-trump-term
That coalition is backed by ultra-rich monopolists who want wreck the nation that their rank-and-file useful idiots want to wreck your body. These are the monopoly cheerleaders who gave us the abomination that is the Pharmacy Benefit Manager – a useless intermediary that gets to screw patients and pharmacists – and then let PBMs consolidate and merge with pharmacy monopolists.
One such inbred colossus is Change Healthcare, a giant PBM that is, in turn, a mere tendril of United Healthcare, which merged the company with Optum. The resulting system – held together with spit and wishful thinking – has access to the health records of a third of Americans and processes 15 billion prescriptions per day.
Or rather, it did process that amount – until the all-your-eggs-in-one-badly-maintained basket strategy failed on Wednesday, and Change's systems went down due to an unspecified "cybersecurity incident." In the short term, this meant that tens of millions of Americans who tried to refill their prescriptions were told to either pay cash or come back later (if you don't die first). That was the first shoe dropping. The second shoe is the medical records of a third of the country.
Don't worry, I'm sure those records are fine. After all, nothing says security like "merging several disparate legacy IT systems together while simultaneously laying off half your IT staff as surplus to requirements and an impediment to extracting a special dividend for the private equity owners who are, of course, widely recognized as the world's greatest information security practitioners."
Look, not everything is terrible. Some computers are actually getting better. Framework's user-serviceable, super-rugged, easy-to-repair, powerful laptops are the most exciting computers I've ever owned – or broken:
https://pluralistic.net/2022/11/13/graceful-failure/#frame
Now you can get one for $500!
https://frame.work/blog/first-framework-laptop-16-shipments-and-a-499-framework
And the next generation is turning our surprisingly well, despite all our worst efforts. My kid – now 16! – and I just launched our latest joint project, "The Sushi Chronicles," a small website recording our idiosyncratic scores for nearly every sushi restaurant in Burbank, Glendale, Studio City and North Hollywood:
https://sushichronicles.org/
This is the record of two years' worth of Daughter-Daddy sushi nights that started as a way to get my picky eater to try new things and has turned into the highlight of my week. If you're in the area and looking for a nice piece of fish, give it a spin (also, we belatedly realized that we've never reviewed our favorite place, Kuru Kuru in the CVS Plaza on North Hollywood Way – we'll be rectifying that soon).
And yes, we have a lavishly corrupt Supreme Court, but at least now everyone knows it. Glenn Haumann's even set up a Gofundme to raise money to bribe Clarence Thomas (now deleted, alas):
https://www.gofundme.com/f/pzhj4q-the-clarence-thomas-signing-bonus-fund-give-now
The funds are intended as a "signing bonus" in the event that Thomas takes up John Oliver on his offer of a $2.4m luxury RV and $1m/year for life if he'll resign from the court:
https://www.youtube.com/watch?v=GE-VJrdHMug
This is truly one of Oliver's greatest bits, showcasing his mastery over the increasingly vital art of turning abstruse technical issues into entertainment that negates the performative complexity used by today's greatest villains to hide their misdeeds behind a Shield of Boringness (h/t Dana Clare).
The Bezzle is my contribution to turning abstruse scams into a high-impact technothriller that pierces that Shield of Boringness. The key to this is to master exposition, ignoring the (vastly overrated) rule that one must "show, not tell." Good exposition is hard to do, but when it works, it's amazing (as anyone who's read Neal Stephenson's 1,600-word explanation of how to eat Cap'n Crunch cereal in Cryptonomicon can attest). I wrote about this for Mary Robinette Kowal's "My Favorite Bit" this week:
https://maryrobinettekowal.com/journal/my-favorite-bit/my-favorite-bit-cory-doctorow-talks-about-the-bezzle/
Of course, an undisputed master of this form is Adam Conover, whose Adam Ruins Everything show helped invent it. Adam is joining me on stage in LA tomorrow night at Vroman's at 5:30PM, to host me in a book-tour event for my novel The Bezzle:
https://www.vromansbookstore.com/Cory-Doctorow-discusses-The-Bezzle
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If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:
https://pluralistic.net/2024/02/23/gazeteer/#out-of-cycle
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Image: Peter Craven (modified) https://commons.wikimedia.org/wiki/File:Aggregate_output_%287637833962%29.jpg
CC BY 2.0 https://creativecommons.org/licenses/by/2.0/deed.en
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trumanjo · 28 days
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Crazy that I haven't seen anywhere talking about this. Over a week now and my pharmacy haven't been able to bill straight state medicaid or manufacture coupons. This is a nationwide outage!
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kafiranablogs · 5 hours
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UnitedHealth Group paid over $3.3 bln to care providers hit by cyberattacks, ET HealthWorld
London: U.S. insurer UnitedHealth Group on Wednesday said it has advanced more than $3.3 billion so far to care providers impacted by a cyberattack last month on insurance claims system Change Healthcare. UnitedHealth said it has paid more than 40 per cent of that total to so-called safety net hospitals and federally qualified health centers serving high-risk patients and communities. Change…
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hislop3 · 3 days
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Sign of the Times: Petersen Health Care Files for Bankruptcy
Mid last week, Petersen Health Care, a Peoria, IL based nursing home operator filed for bankruptcy in Delaware. SC Healthcare Holdings LLC, which operates as Petersen Health Care, in federal court filings last Wednesday said it is seeking Chapter 11 bankruptcy protection because of ongoing financial problems partly due to an October ransomware attack and disruptions in payments from payers…
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innonurse · 20 days
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Cybersecurity: UnitedHealth aiming to restore Change Healthcare systems by mid-March
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- By InnoNurse Staff -
Services provided by UnitedHealth Group Inc. are beginning to be reinstated over two weeks following a cyberattack on its Change Healthcare subsidiary that disrupted the US health system.
Read more at CNBC
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mysharona1987 · 3 months
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balkanradfem · 1 month
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I've managed to curate my small misogyny-free space both online and in real life, and now I'm no longer used to misogyny, it's no longer normal to me. So when I accidentally glimpse it, I'm not desensitized to it, I'm always shocked and unbelieving.
If I notice a m*n talking about a woman like she's 'just some ***' I'm immediately aware that this is in fact a demonic creature who needs to be burned. If I see anyone using a slur against women or pretending women are at fault for any of the world's issues, the hair on my neck stands up at the unbelievable amount of hatred.
Anyone implying that women should be in any way controlled, punished, forced to do anything against their will or dedicate their lives to anyone but themselves, is preposterous and villainous to me, I'm at loss that someone could even think that way about a half of the human population who are creators and administrators of life.
I know I am in a bubble, but it feels different knowing deeply in your heart that all of this is not normal, that casual or normalized hatred against women is absolutely insane, that it's sharp and painful and dehumanizing at every turn. It's insane to realize that women just have to live like this, believing all of that is normal, that I once lived like this, wondering what was wrong with me and why I couldn't just be what everyone was expecting me to.
I think still, if I can make a small space without this hate present in it, without anyone or anything implying we should be anything but free, anything but full complete human beings with absolute control over our lives, then we can strengthen and grow these spaces, and get more women in, have more women experience what life is like when hatred is removed. There is hope for women.
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the-greatest-fool · 14 days
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I basically only post and read posts in my bubble aside from occasionally scrolling through Real Tumblr, but people’s takes about US politics on this website are fucking unbelievable. They talk about our government as if it didn’t save us from a pandemic-induced financial collapse, pump trillions of dollars into public works, not to mention substantially invest and rein in pharmaceuticals, and is instead some sort of ultra-neoliberal-corporate kitty shooting machine.
Like let’s be for real. Do they…know what the government does? How it works? Do you know what a conservative is? Do you know what an authoritarian is?
Because a system of government whose citizens are all lucky it has had continuous peaceful transfer of power for centuries could very well have its greatest norm violated—that those who reject its legitimacy must be rejected—and we don’t blink an eye.
Because the first major investment against climate change, coupled with life saving investments into healthcare, cancer research, and drug costs could be shredded by indiscriminate fiscal conservatives who don’t care if we die in forest fires, cancer from pollution, lose insurance because we’re jobless, or, apparently, all die in a fricking plague.
Because a foreign policy establishment that had finally reversed two decades of foreign intervention in favor of a normalization strategy aimed at reducing American foot presence, drone strikes, and indiscriminate killings is about to be replaced by the whims of a man who dropped the “mother of all bombs” on the Middle East, gave American soldiers up to Russian bounty hunters, extorted a foreign leader for political favors and arguably indirectedly resulted in that country being BRUTALLY INVADED BY AN IMPERIAL NEIGHBOR, is in the pockets of CCP-funded billionaires, and WANTS TO “FINISH THE JOB” IN GAZA.
Because a President who is against family separations and promotes a path for DREAMERs and more legal immigration and rights for unodcumented people could be replaced by a man who wants to separate families, PUT UNDOCUMENTED PEOPLE IN CONCENTRATION CAMPS, RESTRICT EVEN LEGAL IMMIGRATION, ESPECIALLY THAT OF MUSLIMS, AND SHOOT MIGRANTS.
Because a President who stopped a repeat of the Great Recession and the painful decade that followed it with strong fiscal stimulus which CUT CHILD POVERTY IN HALF BEFORE CONSERVATIVES MADE IT EXPIRE, then managed to cut deficits and presided over a decline in inflation, resulting in record high real wages (aka taking into account inflation) for workers is going to be replaced by a President who wants to TARIFF ALL FOREIGN GOODS by 15%, CUT TAXES FOR THE FILTHY RICH AND THE TAX ENFORCEMENT TO STOP THEM, INCREASE CHILD POVERTY AND UNINSUREDNESS by cutting gov’t programs, and HURT UNIONS which by every measure will lead to lower wages, higher prices, and more poverty and starvation.
Because a President who has pledged to sign a bill codifying Roe v. Wade (which has yet to be possible in recent memory, whatever these kids say), who enshrined the right to marry someone of the same sex or different race, who supports the Equality Act which would enshrine LGBTQ protections into the law, could be replaced by THE MAN WHO REMOVED AMERICA’S RIGHT TO ABORTION, whose Christian nationalist supporters want to END SEXUAL FREEDOM as we know it including TARGETING IVF AND BIRTH CONTROL, who wants to reverse LGBTQ discrimination law in favor of Christian bigots who hate queer and trans people, and who demonizes that community to win political support.
Ask yourself if you really think there’s no difference between the two. Ask yourself if a reasonable person given these facts would choose the latter. Ask yourself why you see so much propagandizing against the reasonable choice. Ask yourself why so many people seem to have opinions on this when they “don’t even go here”.
Maybe I’m just preaching to the choir here. Maybe people who say this inane stuff wouldn’t vote anyways. Maybe somehow we’re screwed anyways. Maybe people will stupidly vote third party and we’re fucked. Maybe this will get me attacked.
I don’t care anymore. If I have to see one more fucking post acting like we live under the fucking Evil Empire while a SELF PROCLAIMED DICTATOR is about to end the best streak of decent governance I’ve ever seen in a while, I just can’t anymore.
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penwrythe · 5 months
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What's stopping the possibility of a ceasefire is pretty simple. Hamas is holding 239 Israeli civilians hostage including children and the elderly. What's happening in Palestine is a travesty and horrendous. But Israel can't initiate a ceasefire from the position they're in, so we need to be agitating for Hamas to release the hostages and call for a ceasefire instead.
NO GENOCIDE IS JUSTIFIABLE
HOW DOES THE KILLING OF INNOCENT PEOPLE ON THIS EXTREME LEVEL FORCE HAMAS TO RETURN HOSTAGES??
ISRAEL'S BOMBARDMENT AND INDISCRIMINATE SHOOTING IN GAZA THREATEN EVERYONE THERE INCLUDING DOCTORS JOURNALISTS CHILDREN ENTIRE FAMILIES AND THE HOSTAGES
EVERYONE IS TARGETED
YOU HAVE HOSPITALS BOMBED HOW ANY OF THIS IS JUSTIFIED
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@sarroora @fairuzfan @palipunk @wearenotjustnumbers2
You know more about this than I do.
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luanna801 · 1 year
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I feel like a thing we don’t talk about enough in the context that Jack LIVES in the asylum is: If Lucy had accepted his proposal, was he going to bring her back to live there with him???
Like, I grant you it’s fully possible he was planning to buy a perfectly normal house with a proverbial white picket fence, but this is Jack “brought a lancet to propose” Seward, and I think it’s just as likely that he either hadn’t thought this through, or else thinks it’s Perfectly Normal Behavior to bring your brand new wife, a sheltered society girl, back to your asylum to share your Brooding Goth Asylum Lifestyle.
Would their kids have been raised there?? Not just in any asylum, but the asylum with security fiascos second only to Arkham? The asylum where one of his patients successfully ran into his study with a knife and stabbed him???
Obsessed with the idea of Renfield escaping for the 159603th time and Jack having a mild heart attack when he finds him in the kid’s room, but Renfield is just holding Baby Seward very gently and singing “The Itsy Bitsy Spider” (or as it was known back then, I kid you not, “The Blooming Bloody Spider”) while the two of them play with an actual spider.
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awkward-teabag · 3 months
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Love (cannot emphasis how much sarcasm there is in that word) that an official Canadian government response to high cellphone rates is to switch carriers.
Switch it to what? We basically have three companies since one was allowed to eat the forth (with the government saying it wasn't anti-competition and the company eating the other pinky promising they wouldn't jack rates up). Even the smaller companies have to rent infrastructure from the Big Three so there's only so much they can do if that rent costs an arm and a leg.
And that's not touching on how many "small companies" are actually just subsidiaries of the Big Three. You may save $5 but you're still with Telus/Rogers/Bell.
Or that the actual small companies tend to have shit coverage because they don't have the infrastructure available to them and are prevented from getting it. Or their traffic is throttled in favour of the Big Three's customers. Or both.
Or that they're extremely regional thus aren't an option for a huge chunk of Canada's population.
We have no true options and the government has shown time and again that they're fine with monopolies, in multiple industries, and don't care when said monopolies jack up prices to make shareholders and the c-suite more money at the expense of everyone else. At most there will be a verbal slap on the wrist and a giftcard for $25 that people have to register for, for a decade and a half of price gouging.
It's not talked a whole lot about outside the country from what I've seen and heard but Canada is a country of monopolies. A handful of companies own nearly everything, every province has a family or two that owns a hell of a lot (Nova Scotia is basically owned by one family at this point), and our government ignores it. Even the branch that is supposed to be against monopolies is fine with mergers and takeovers in most cases.
Because, you know, the company said it totally wouldn't use consumers' lack of options to increase prices.
#canada#so much of our infrastructure and critical construction such as housing#has been pawned off for decades to private companies#and i forgot to mention one (1) family owns the bridge that is a major international corridor between canada and the us#which is apparently fine even though they fought tooth and nail to stop a bridge they don't own from being built#like our housing crisis can be traced back to the government deciding to stop building public housing in the 90s#because they figured private developers would pick up the slack#affordable apartments don't bring in much money so we got decades of cheap-ass 'luxury condos' instead#and once airbnb became a thing we got entire buildings with units <300sqft#and of course when the party in charge rotates between conservatives and neolibs nothing changes and that can gets kicked down the road#and keeps getting kicked until something collapses and they see the chance to fully privatize an industry#something similar is happening to our healthcare system too#it has been left to languish for years/decades with funding freezes and cuts#and private companies are quick to jump in and get the government stamp of approval to do [thing] that the public system clearly can't do#when [thing] would absolutely be possible if it was actually funded and/or staffed#so many communities were cut off when greyhound closed up shop because there's no government inter-city transportation#we lost internet/banking/cell service/etc nation-wide because one of the big three decided to push an update to live without redundancies#and it bugged and took the entire company's network down#even the government agency that demands major companies have a backup on a different network was taken down because they ignored that#and they got a deal if they kept their backup with rogers while their main network was also rogers#so they couldn't even make an emergency statement or anything about it#half my province also lost all digital infrastructure because it's a private company and making a redundancy line would mean smaller bonuse#it's just so bad#joke all you want about how canada is nice and friendly#but you are wrong and it's hell if you actually live here#the only reason canada is seen as nice is because it's hard to not seem like the better option when the us is your neighbour#and because of decades of pr work to make canada seem friendly and nice and not at all problematic#in some countries you actually have to try to hide you're canadian because of how much we colonize and the damage we do to other countries#yes these tags have derailed from the post but ugh#i take major issue with people who insist canada is nice and has never done anything wrong
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odd-god · 4 months
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We need a new civilization.
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uncanny-tranny · 9 months
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Even if you don't agree with incarcerated people having access to education, monetary compensation for work, or whatever, I really hope you acknowledge that so long as you provide the state incentive to imprison people (free labour or whatever it may be), the state will continuously imprison people - especially for non-violent crime.
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bloodpen-to-paper · 1 month
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I'm realizing now how reasonable the economics and paywall system might seem from the Koreans' perspective in comparison to our older members. Acau and Jungryeok from what I know play a lot of vanilla, where something like the warpstone system isn't even available. The fact that it exists here is already a huge buff, so having to work for it doesn't take away from that. The members who had it for free before feel cheated, but the new members see a reasonable opportunity they haven't had before
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logorrhea5mip · 9 months
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Anyone remember that one MrBeast video where he got 1000 people cured of blindness? Me neither. Anyways.
My grandpa recently had that same procedure done and thanks to our government subsidized healthcare, he paid 13$ for it.
The interesting and terrifying consequence of that relates to the 10s of thousands of people who can't have that surgery in the (~7 times richer than Serbia) United States. They aren't blind because of disease, they are blind because of capitalism.
And you don't get better proof of the evil of a system than "Many people are blind for no fucking reason besides the unlimited greed of the privileged few."
Whenever anyone complains of "violent" protests or "extreme" activists or whatever, remember how violent and extreme it is do deprive people of sight for no other reason than the cardinal sin of being poor.
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innonurse · 1 month
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Abridge secures $150 million to develop generative AI for medical documentation
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- By InnoNurse Staff -
According to CEO Shivdev Rao, M.D., the Pittsburgh-based startup secured a $150 million series C fundraising round to fund additional R&D to create solid foundation models that would fuel both enhancements to the business's current technologies and new products.
Read more at Fierce Healthcare
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Other recent news and insights
While US pharmacy disruptions continue, UnitedHealth claims that Change Healthcare was hacked by a nation-state (TechCrunch)
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