4th person dies after a Legionnaires' disease outbreak sickens dozens in New York City
The outbreak in Central Harlem has sickened dozens since it began in late July. Seventeen people were hospitalized as of Thursday, according to the health department.
The bacteria that causes Legionnaires' disease had been discovered in 12 cooling towers on 10 buildings, including a city-run hospital and sexual health clinic, health officials said. Remediation efforts have been completed on 11 of the cooling towers, with the final tower's remediation required to be completed Friday.
Legionnaires' disease is a type of pneumonia that is caused by Legionella bacteria, which grow in warm water and spread through building water systems. The city's outbreak has been linked to cooling towers, which use water and a fan to cool buildings.
People usually develop symptoms — a cough, fever, headaches, muscle aches and shortness of breath — between two days to two weeks after exposure to the bacteria, according to the U.S. Centers for Disease Control and Prevention.
Dr. Michelle Morse, the city's acting health commissioner, said new cases in the Central Harlem outbreak have begun to decline 'which indicates that the sources of the bacteria have been contained.' She urged people who live or work in the area to contact a health care provider if they develop flu-like symptoms.
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Associated Press
an hour ago
- Associated Press
Epic UGM 2025 Survival Guide: Insider Tips for Vendors, Storytellers, and Market Watchers
Black Book Research Marks Its 12th Year on the Ground in Verona with Independent, Vendor-Agnostic Insights for Navigating Epic's Provider-First Culture MADISON, WI / ACCESS Newswire / August 16, 2025 / Every August, Verona becomes the gathering place for thousands of Epic users, providers, and partners. UGM isn't a typical trade show , it's more like a community meet-up where leaders come to hear Epic's roadmap, share ideas, and compare notes. For vendors, PR teams, and media, it's a chance to understand where the conversation is heading and how to connect without disrupting the flow. For vendors and the PR, content, and marketing teams that support them, UGM plays by different rules. This isn't where you show off. It's where you learn, listen, and figure out how not to step on Epic's toes. Black Book has been at UGM for twelve consecutive years, and this year we're sharing candid insights on what's worth your time, what to avoid, and what's not always what it looks like. Why Epic Matters More Than Ever Epic just collected several top honors in Black Book's 2025 surveys: #1 Large Hospital & Academic EHR - Epic topped the list for hospitals over 500 beds and AMCs. #1 Ambulatory EHR - EpicCare Ambulatory led for multi-specialty groups. #1 in Patient Accounting - Epic Resolute ranked first for large-hospital billing and financial integration. Global Expansion - Epic is one of the few EHRs truly deployable in 100+ countries. These recognitions reflect more than market share, they underscore Epic's influence on enterprise IT strategy, revenue cycle performance, and global deployment models. For vendors, PR firms, and marketing teams, aligning messaging with Epic's trajectory isn't optional; it's essential. Understanding how Epic is shaping provider priorities allows you to position solutions in complementary spaces, identify integration opportunities, and craft narratives that resonate with the executives and clinicians driving adoption. What's Worth Your Time Tuesday Keynote & 'Cool Stuff Ahead' The keynote sets the tone for the year, and in 2025 the themes are clear: AI, automation, and patient experience. Expect Epic to highlight not just new features, but how they're embedding intelligence into daily workflows from ambient documentation to predictive scheduling. In past UGMs, these announcements have reshaped priorities quickly. (When Epic previewed ambient clinical documentation in 2022, it accelerated demand for vendors that could prove seamless alignment with Epic's approach.) Vendors should listen less for the marketing spin and more for the clues on what providers will be asking about in the next RFP cycle. Cool Stuff Breakouts These sessions separate the polished keynote vision from what's truly ready for adoption. Some breakouts have had massive staying power (Epic's 2019 telehealth toolkit quietly laid the foundation for COVID-era virtual care) while others have faded away. The smart vendors look for white space: where Epic signals the need, but the solution is partial. Historically, gaps have shown up around population health analytics, precision medicine workflows, or specialty-specific modules. Those are opportunities for vendors to step in and create complementary value. Peer-to-Peer Tracks Although designed for providers, these sessions are often the most candid window into Epic customer sentiment. Providers use them to air frustrations and swap workarounds, whether it's revenue cycle complexities, interoperability gaps, or challenges embedding telehealth into everyday workflows. Black Book has seen these unfiltered pain points surface here months before they make it into survey data or RFP requirements. For vendors, PR firms, and marketing teams, this is where you learn the language that resonates because it's the language providers use with each other, not with sales reps. 2025 Watchlist: Where Vendors Should Pay Attention Ambient AI in Clinical Workflows - Epic is moving fast here; vendors should consider whether they're complementing or competing. Patient Engagement Beyond MyChart - Expect new features, but plenty of room for third-party innovation in remote monitoring, digital front door tools, and specialty-focused engagement. Cross-Border Data Exchange - Epic's global deployments mean more pressure on vendors to solve for multi-country compliance, translation, and regional integration. Specialty Care Extensions - Epic continues to strengthen core modules, but specialty workflows (oncology, behavioral health, rehab) often lag. These remain high-value entry points for partners. Revenue Cycle Automation - Resolute's strong ranking doesn't end the story; providers still struggle with denial management, AI-assisted coding, and payer integration. What to Skip Hard Selling UGM is built on relationships, not transactions. Cornering a CIO at lunch with your pitch isn't just ineffective: it's a reputation-killer. Provider leaders talk to each other, and word spreads quickly if a vendor is pushy or tone-deaf. In past years, we've seen companies shut out of follow-up meetings simply because they treated UGM like a hunting ground. If you want traction, focus on listening to what providers care about and save the pitch for after Verona. Provider Councils These forums, leadership councils, specialty groups, advisory tracks , are designed for providers to speak freely with each other and with Epic. They're not press briefings or lead-gen opportunities. Crashing them, taking notes with an agenda, or inserting your company's perspective will backfire. Providers value these spaces because they're candid and protected. Respecting those boundaries shows that you understand Epic's culture, and ignoring them can get you labeled as untrustworthy. Trade Show Thinking If you show up expecting HIMSS or HLTH, you'll be frustrated. There are no booths to draw people in, no badge scanners, no post-event lead lists. UGM is intentionally structured to keep the focus on providers and Epic's roadmap, not on vendor marketing. The companies that struggle here are the ones who measure success in swipes and scans. The companies that win are the ones who leave with insight and positioning instead of 'leads.' What's Not Always What It Looks Like 'Cool Stuff' Announcements Every UGM brings a wave of new features, AI pilots, and product teasers. Some of these turn into genuine market-shifters (Epic's 2019 telehealth expansion became foundational during COVID), while others fade quietly or never scale beyond a few early adopters. The trap for vendors is over-reacting. Don't build your next quarter's strategy on a single keynote demo. Instead, pay attention to which features providers buzz about in the hallways and which ones make it onto the Epic Roadmap with timelines and support commitments. That's where you'll know adoption is real. Cosmos & Data Partnerships Epic presents Cosmos, its massive data aggregation and research network, as a partnership opportunity. In reality, many vendors discover it functions more like a data contribution pipeline than a co-development platform. Providers contribute; Epic aggregates; insights flow back on Epic's terms. This doesn't mean there's no value, but vendors need to walk in with clear eyes: contributing data doesn't automatically translate into a strategic seat at the table. Successful vendors position themselves around what Cosmos doesn't provide, for example, advanced analytics, specialty-specific research, or integration with external datasets. Beyond the Walls Sessions These sessions are marketed as open forums to discuss collaboration across the healthcare ecosystem: payers, public health, life sciences, and more. They are valuable for networking and understanding where Epic is signaling interest. But it's important to remember: Epic always positions itself as the central hub in any collaboration. Vendors who attend expecting co-equal partnerships often come away disappointed. The real takeaway is exposure and visibility to providers and Epic staff, a chance to signal alignment but not necessarily immediate business upside. Think of it as strategic reconnaissance rather than a direct sales opportunity. PR, Media, and Marketing: Your Verona Playbook UGM isn't an easy place to run PR or marketing plays. Epic controls its narrative tightly, and there's no 'expo buzz' to ride on. But there's still plenty of value if you approach it right. Don't push for scoops. Use UGM to understand what stories providers are telling each other, then build campaigns that echo that language. The gold is in the corners of conversations. Capture the tone of what frustrates providers that's what will resonate in post-UGM blogs, case studies, and thought leadership. How to Access Pre-UGM, UGM, and Post-UGM Insights Black Book's polling around Epic UGM captures provider, payer, and vendor sentiment before, during, and after Verona. Vendors, providers, and payers can request specific polling data by contacting [email protected]. Free resource data reports are available for download at About Black Book Research Black Book Research is an independent healthcare benchmarking and satisfaction survey firm, trusted worldwide for unbiased insights into healthcare technology, outsourcing, and managed services. Known for its rigorous methodologies and vendor-agnostic approach, Black Book collects feedback from providers, payers, and healthcare professionals to deliver the industry's most actionable performance data. Black Book has no financial interests, advisory relationships, or vendor subscriptions, ensuring research findings remain transparent, credible, and aligned with real-world user experience. Contact InformationPress Office 8008637590 SOURCE: Black Book Research press release
Forbes
2 hours ago
- Forbes
Psychologists And Mental Health Experts Spurred To Use Custom Instructions And Make AI Into A Therapist Adjunct
In today's column, I first examine the new ChatGPT Study Mode that has gotten big-time headline news and then delve into whether the crafting of this generative AI capability could be similarly undertaken in the mental health realm. The idea is this. The ChatGPT Study Mode was put together by crafting custom instructions for ChatGPT. It isn't an overhaul or feature creation. It seems to be nothing new per se, other than specifying a set of detailed instructions, as dreamed up by various educational specialists, telling the AI what it is to undertake in an educational context. That's considered 'new' in the sense that it is an inspiring use of custom instructions and a commendable accomplishment that will be of benefit to students and eager learners. Perhaps by gathering psychologists and mental health specialists, an AI-based Therapy Mode could similarly be ingenuously developed. Mindful readers asked me about this. Let's talk about it. This analysis of AI breakthroughs is part of my ongoing Forbes column coverage on the latest in AI, including identifying and explaining various impactful AI complexities (see the link here). AI And Mental Health Therapy As a quick background, I've been extensively covering and analyzing a myriad of facets regarding the advent of modern-era AI that produces mental health advice and performs AI-driven therapy. This rising use of AI has principally been spurred by the evolving advances and widespread adoption of generative AI. For a quick summary of some of my posted columns on this evolving topic, see the link here, which briefly recaps about forty of the over one hundred column postings that I've made on the subject. There is little doubt that this is a rapidly developing field and that there are tremendous upsides to be had, but at the same time, regrettably, hidden risks and outright gotchas come into these endeavors too. I frequently speak up about these pressing matters, including in an appearance last year on an episode of CBS's 60 Minutes, see the link here. If you are new to the topic of AI for mental health, you might want to consider reading my recent analysis of the field, which also recounts a highly innovative initiative at the Stanford University Department of Psychiatry and Behavioral Sciences called AI4MH; see the link here. ChatGPT Study Mode Introduced A recent announcement by OpenAI went relatively far and wide. They cheerfully introduced ChatGPT Study Mode, as articulated in their blog posting 'Introducing Study Mode' on July 29, 2025, and identified these salient points (excerpts): As far as can be discerned from the outside, this capability didn't involve revising the underpinnings of the AI, nor did it seem to require bolting on additional functionality. It seems that the mainstay was done using custom instructions (note, if they did make any special core upgrades, they seem to have remained quiet on the matter since it isn't touted in their announcements). Custom Instructions Are Powerful Assuming that they only or mainly used custom instructions to bring forth this useful result, it gives great hope and spurs avid attention to the amazing power of custom instructions. You can do a lot with custom instructions. But I would wager that few know about custom instructions and even fewer have done anything substantive with them. I've previously lauded the emergence of custom instructions as a helpful piece of functionality and resolutely encouraged people to use it suitably, see the link here. Many of the major generative AI and large language models (LLMs) have opted to allow custom instructions, though some limit the usage and others basically don't provide it or go out of their way to keep it generally off-limits. Allow me a brief moment to bring everyone up to speed on the topic. Suppose you want to tell AI to act a certain way. You want the AI to do this across all subsequent conversations. This usually only applies to your instance. I'll explain in a moment how to do so across instances and allow other people to tap into your use of custom instructions. I might want my AI to always give me its responses in a poetic manner. You see, perhaps I relish poems. I go to the specified location of my AI that allows the entering of a custom instruction and tell it to always respond poetically. After saving this, I will then find that any conversation will always be answered with poetic replies by the AI. In this case, my custom instruction was short and sweet. I merely told the AI to compose answers poetically. If I had something more complex in mind, I could devise a quite lengthy custom instruction. The custom instruction could go on and on, telling the AI to write poetically when it is daytime, but not at nighttime, and to make sure the poems are lighthearted and enjoyable. I might further indicate that I want poems that are rhyming and must somehow encompass references to cats and dogs. And so on. I'm being a bit facetious and just giving you a semblance that a custom instruction can be detailed and provide a boatload of instructions. Custom Instructions Mixed Bag The beauty of custom instructions is that they serve as an overarching form of guidance to the generative AI. They are considered to have a global scope for your instance. All conversations that you have will be subject to whatever the custom instruction says should take place. With such power comes some downsides. Imagine that I am using the AI and have a serious question that should not be framed in a poem. Lo and behold, I ask the solemn question and get a poetic answer. The AI is following what the custom instruction indicated. Period, end of story. The good news is that you can tell the AI that you want it to disregard the custom instructions. When I enter a question, I could mention in the prompt that the AI is not to abide by the custom instructions. Voila, the AI will provide a straightforward answer. Afterward, the custom instructions will continue to apply. The malleability is usually extensive. For example, I might tell the AI that for the next three prompts, do not abide by the custom instructions. Or I could tell the AI that the custom instructions are never to be obeyed unless I say in a prompt that they should be obeyed. I think you can see that this is a generally malleable aspect. Goofed Up Custom Instructions The most disconcerting downside of custom instructions is that you might inadvertently say something in the instructions that is to your detriment. Maybe you won't even realize what you've done. Consider my poetic-demanding custom instruction. I could include a line that insists that no matter what any of my prompts say, never allow me to override the custom instruction. Perhaps I thought that was a smart move. The problem will be that later, I might forget that I had included that line. When I try to turn off the custom instruction via a prompt, the AI might refuse. Usually, the AI will inform you of such a conflict, but there's no guarantee that it will. Worse still is a potential misinterpretation of something in your custom instructions. I might have said that the AI should never mention ugly animals in any of its responses. What in the world is an ugly animal? The sky is the limit. Unfortunately, the AI will potentially opt not to mention all kinds of animals that were not what I had in my mind. Would I realize what is happening? Possibly not. The AI responses would perchance mention some animals and not mention others. It might not be obvious which animals aren't being described. My custom instruction is haunting me because the AI interprets what I said, though the interpretation differs from what I meant. AI Mental Health Advice Shifting gears, let's aim to use custom instructions for the betterment of humanity, rather than the act of simply producing poetic responses. The ChatGPT Study Mode pushes the AI to perform Socratic dialogues with the user and gives guidance rather than spitting out answers. The custom instructions get this to occur. Likewise, the AI attempts to assess the level of proficiency of the user and adjusts to their skill level. Personalized feedback is given. The AI tracks your progress. It's nifty. All due to custom instructions. What other context might custom instructions tackle? I'll focus on the context of mental health. Here's the deal. We get together a bunch of psychologists, psychiatrists, therapists, mental health professionals, and the like. They work fervently on composing a set of custom instructions telling the AI how to perform therapy. This includes diagnosing mental health conditions. It includes generating personal recommendations on aiding your mental health. We could turn the generic generative AI that saunters around in the mental health context and turn it into something more bona fide and admirable. Boom, drop the mic. The World Is Never Easy If you are excited about the prospects of these kinds of focused custom instructions, such as for therapy, I am going to ask you to sit down and pour yourself a glass of fine wine. The reason I say this is that there have indeed been such efforts in the mental health realm. And, by and large, the result is not as standout as you might have hoped for. First, the topic of mental health is immense and involves risks to people when inappropriate therapy is employed. Trying to devise a set of custom instructions that can fully and sufficiently provide bona fide therapy is not only unlikely but also inevitably misleading. I say this because some have tried this route and made outlandish claims of what the AI can do as a result of the loaded custom instructions. Watch out for unfulfilled claims. See my extensive coverage at the link here. Second, any large set of custom instructions on performing therapy is bound to be incomplete, contain misinterpretable indications, and otherwise be subject to the downsides that I've noted above. The nature of using custom instructions as an all-in-one solution in this arena is like trying to use a hammer on everything, even though you ought to be using a screwdriver on screws, and so on. Third, some argue that using custom instructions for therapy is better than not having any custom instructions at all. The notion is that if you are using a generic generative AI that is working without mental health custom instructions, you are certainly better off by using one that at least has custom instructions. The answer there is that it depends on the nature of the custom instructions. There is a solid chance that the custom instructions might worsen what the AI is going to say. You can just as easily boost the AI as you can undercut the AI. Don't fall into the trap that custom instructions mean things are necessarily for the better. Accessing Custom GPTs I had earlier alluded to the aspect that there is a means of allowing other users to employ your set of custom instructions. Many of the popular LLMs tend to allow you to generate an AI applet of sorts, containing tailored custom instructions that can be used by others. Sometimes the AI maker establishes a library into which these applets reside and are publicly available. OpenAI provides this via the use of GPTs, which are akin to ChatGPT applets -- you can learn about how to use those in my detailed discussion at the link here and the link here. Unfortunately, as with all new toys, some have undermined these types of AI applets. There are AI applets that contain custom instructions written by licensed therapists who genuinely did their best to craft therapy-related custom instructions. That seems encouraging. But I'm hoping you now realize that even the best of intentions might not come out suitably. Good intentions don't guarantee suitable results. Those custom instructions could have trouble brewing within them. There are also AI applets that brashly claim to be for mental health, yet they are utterly shallow and devised by someone who has zero expertise in mental health. Don't let your guard down by flashy claims. The more egregious ones are AI applets that are marketed as though they are about mental health, when the reality is that it is a scam. The custom instructions have nothing to do with therapy. Instead, the custom instructions attempt to take over your AI, grab your personal info, and generally be a pest and make life miserable for you. Wolves in sheep's clothing. The Full Meal Deal Where do we go from here? The use of custom instructions for therapy when aiming to bring forth an AI-based Therapy Mode in a generic generative AI is not generally a good move. Even if you assemble a worthy collection of the best psychologists and mental health experts, you are trying to put fifty pounds into a five-pound bag. It just isn't a proper fit. The better path is being pursued. I am a big advocate and doing research on generative AI and LLMs that are built from the ground up for mental health advisement, see my framework layout at the link here. The approach consists of starting from the beginning when devising an LLM to make it into a suitable therapy-oriented mechanism. This is in stark contrast to trying to take an already completed generic generative AI and reshape it into a mental health context. I believe it is wiser to take a fresh uplift instead. Bottom Line Answered For readers who contacted me and asked whether the ChatGPT Study Mode foretells that the same impressive results of education-oriented custom instructions can be had in other domains, yes, for sure, there are other domains that this can readily apply to. Is mental health one of those suitable domains? I vote no. Mental health advisement deserves more. A final thought for now. Voltaire astutely observed: 'No problem can withstand the assault of sustained thinking.' We need to put on our thinking caps and aim for the right solution rather than those quick-fix options that might seem viable but contain unsavory gotchas and injurious hiccups. Sustained thinking is worth its weight in gold.
Yahoo
2 hours ago
- Yahoo
Rabbits With 'Tentacles' & Horns Spotted in Colorado Amid Virus Fears. See Photos
It sounds like something out of a horror movie: Rabbits spotted with "tentacles" or horns growing out of their heads. But it's really happened in Colorado. "There are really rabbits with what look like tentacles growing out of them," USA Today reported. What gives? Why do the rabbits have horns? Photos of the horned rabbits have emerged online. Colorado Parks and Wildlife confirms that rabbits can have "black nodules on the skin, usually the head," noting that "growths can sometimes become elongated, taking on a horn‐like appearance." Rabbits With 'Tentacles' Were Seen in Fort Collins, CO The rabbits caused a stir when they were spotted in Fort Collins, CO, according to the Coloradan. They've been dubbed "Frankenstein rabbits" by USA Today. "Cottontail rabbits with horn-like growths on their heads have appeared in Fort Collins in recent weeks," the site wrote on Aug. 13. The Colorado Parks and Wildlife discusses the virus on its website section about cottontail rabbits. "Rabbit papillomas are growths on the skin caused by the cottontail rabbit papillomavirus. The growths have no significant effects on wild rabbits unless they interfere with eating/drinking," it reads. The news freaked some people out online. The Rabbit Virus Isn't Harmful to Humans, Officials Say "Most infected cottontails can survive the viral infection, after which the growths will go away. For this reason, CPW does not recommend euthanizing rabbits with papillomas unless they are interfering with the rabbit's ability to eat and drink." Colorado Parks and Wildlife says the rabbit virus isn't harmful to humans. "Like other papillomaviruses, this virus is specific to rabbits and does not cause disease in other species," the agency wrote. "There is a risk of transmission to domestic rabbits, especially if rabbits are housed outdoors where they may contact wild rabbits or biting insects. In domestic rabbits, the disease is more severe than in wild rabbits and should be treated by a veterinarian." Rabbits With 'Tentacles' & Horns Spotted in Colorado Amid Virus Fears. See Photos first appeared on Men's Journal on Aug 13, 2025 Solve the daily Crossword
