Radically different
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WASHINGTON — Health secretary Robert F. Kennedy Jr. once said there are no vaccines that are safe and effective. On Wednesday, he seemed to have changed his tune.
Across two Senate hearings, Kennedy noted that as health secretary, he funded the development of new vaccines, green-lit new shots for patients, asserted flu vaccines are preventive care, and even urged “every child to get the MMR,” a shot he previously suggested wasn’t safe. Last week, he acknowledged the shot could have saved the life of a child who died of measles.
Kennedy’s agenda continues to make waves across American health care, as his department pursues a broad crackdown on alleged fraud and seeks to upend Americans’ relationship with ultra-processed foods, all after major cuts across health agencies and a reworking of vaccine policy. But the about-face expands to a number of core MAHA issues — chemicals in food and the government’s relationship with industry among them.
It comes as some leaders of the insurgent movement have grown skeptical of the administration they rallied to support, forcing the Trump administration to thread the needle between courting the MAHA base’s ongoing support and dropping MAHA priorities seen as impractical or politically unwise.
Washington state hospitals say their Medicare patients are waiting two to four times longer in some cases for procedures that are now subject to prior authorization under a new Medicare program.
The report from Sen. Maria Cantwell (D-Wash.) is among the first to document alleged patient harm stemming from the Centers for Medicare and Medicaid Services’ new Wasteful and Inappropriate Service Reduction, or WISeR, Model. Cantwell is one of several Democratic members of Congress who have been urging CMS to scrap the program, which launched Jan. 1.
Cantwell aired her concerns about WISeR to Health and Human Services Secretary Robert F. Kennedy Jr. at a Senate Committee on Finance hearing Wednesday. She said CMS is using artificial intelligence as a “denial device” and that patients are waiting weeks to get sign off for services that previously didn’t require approval.
A former tobacco industry executive has been appointed to senior leadership at the Centers for Disease Control and Prevention, alarming public health advocates and critics of industry influence on government.
Stephen Sayle, named in March as the CDC’s deputy director for legislative affairs, previously worked at Fontem Ventures, a subsidiary of the British multinational tobacco corporation Imperial Brands. Between 2017 and 2018, he was U.S. vice president of corporate affairs at Fontem, which is focused on non-combustible tobacco products like the e-cigarette brand blu and the oral nicotine pouch brand Zone.
Background: Telemedicine has become central to digital health strategies, yet the regulatory environment that shapes ethical safeguards and equitable access remains uneven and incompletely assessed across countries. Legal and normative instruments matter because they define requirements for privacy, consent, accountability, professional readiness, and barrier reduction. Objective: This study aimed to map the current global landscape of normative instruments related to telemedicine and identify which ethical and social safeguards are explicitly addressed, with particular attention to equity. Methods: We conducted a document analysis guided by the READ (ready the materials, extract data, analyze data, and distill findings) framework. From February 2024 to February 2026, we conducted a structured web-based search across all World Health Organization (WHO) member states with no language restrictions, using official government sources, statutory professional regulators, and institutional publication channels. Retrieval combined internal site searches, direct navigation, external search engine queries, and targeted snowball sampling to identify currently in-force instruments. Two researchers independently extracted and coded data using a predefined codebook. We operationalized 10 binary items covering regulatory presence and scope (questions 1 and 2), safeguards for data protection (question 3), consent and disclosure (questions 4 and 5), prior in-person prerequisites (question 6), monitoring (question 7), training requirements (question 8), and equity (questions 9 and 10). We summarized frequencies overall and stratified by WHO region and World Bank income group and conducted a qualitative thematic analysis of included normative instruments. Results: Of the 194 WHO member states, 81 (41.8%) had at least one current normative instrument related to telemedicine in force. Among these, 72.8% (59/81) defined telemedicine or telehealth. Data protection provisions were most common (73/81, 90.1%), followed by mandatory informed consent (n=71, 87.7%) and monitoring mechanisms (n=65, 80.2%). Fewer countries required disclosure of telemedicine limitations (n=36, 44.4%) or mandated telemedicine-specific training (n=26, 32.1%). Prior in-person consultation requirements were uncommon (n=8, 9.9%). Equity-related safeguards were uneven: 51.9% (n=42) referenced justice, equity, or nondiscrimination, whereas 30.9% (n=25) included concrete barrier reduction provisions (eg, digital inclusion or accommodations for people with disabilities and minors). Conclusions: Telemedicine regulation is becoming more common, but both coverage and safeguarding content remain uneven. While privacy, consent, and monitoring are frequently addressed where regulation exists, disclosure, physician competency, and operational equity measures are less consistently specified. Strengthening telemedicine governance will require translating ethical commitments into enforceable standards that address digital determinants of access and protect groups at risk of exclusion.
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Formative evaluation is widely used in implementation science to anticipate barriers and facilitators prior to the deployment of health technologies, typically relying on stakeholders’ reported beliefs collected before real-world exposure. This approach has proven informative for many digital health tools; however, its application to immersive and embodied technologies such as extended reality (XR) warrants closer scrutiny. Most XR interventions in health care are delivered through head-mounted displays, which depend on spatial perception and sensorimotor engagement. Several implementation-relevant properties, including comfort, perceived intrusiveness, safety, and workflow disruption, often become apparent only through direct interaction. At the same time, large segments of the health care workforce remain XR-naive, such that preuse judgments are frequently shaped by anticipation rather than experience. Drawing on concepts from implementation science, grounded cognition, and human-computer interaction, this Viewpoint examines a plausible interpretive problem in XR adoption and argues that perception-based formative evaluation, when applied through frameworks developed for screen-based technologies, may misclassify barriers and facilitators. Rather than questioning formative evaluation as a methodological approach, we identify a boundary condition for its interpretability in experience-dependent technologies and propose a pragmatic refinement: incorporating brief experiential familiarization before eliciting stakeholder perceptions to strengthen early-stage assessment and improve alignment with real-world implementation decisions.
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Background: Mobile health (mHealth), and specifically smartphone apps, have grown exponentially in both functionality and accessibility and are becoming an important component of health care. Research exploring the use of mHealth for managing or treating chronic diseases, such as cancer, has shown promising effects. Yet, comparatively little work has examined how such technologies can enhance exercise interventions for young people with cancer. To optimize the effectiveness of mHealth in these contexts, it is essential to build a stronger evidence base on user experience. Objective: This study aimed to investigate how healthy children and young people engaged with an augmented reality (AR) app developed specifically for children and young people undergoing cancer treatment, and to identify design features that may support engagement and behavior change in the intended clinical population. Methods: School and university students, aged 8‐21 years, were eligible to participate in the study. Practical workshops allowed participants to engage with the AR exercise app before taking part in focus groups to explore user experiences. Data were analyzed using qualitative content analysis, which also involved a critical friend approach using 2 researchers (HM and KS). Suggested improvements were mapped against the motivational affordances’ taxonomy. Results: A total of 39 participants aged 8‐21 years took part in the focus group study. Participants found the demonstrations and varied exercises useful but expressed some concerns regarding data safety and functionality of the novel AR avatar. It was proposed that additional educational components, challenges, and rewards, as well as a customizable avatar, social support features, and audio instructions for a more inclusive design would be desirable and could enhance user experience. When mapped against the motivational affordances taxonomy, the suggested improvements aligned primarily with mechanisms of user education, challenges, feedback, cooperation, and comparison. Conclusions: This study provides an understanding of how apps that prescribe exercise can be optimized to enhance motivation and user experience. By assessing feedback and suggestions for improvements, the findings highlight key design features that may support engagement. While this initial work focused on healthy, age-matched participants, further evidence specifically in children and young people with a childhood cancer diagnosis is needed. International Registered Report Identifier (IRRID): RR2-10.1177/14604582241288784
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