A mourner prays as people gather at a makeshift memorial in the area where Alex Pretti was shot dead a day earlier by federal immigration agents in Minneapolis, Minnesota, on January 25, 2026. On January 24, federal agents shot dead US citizen Alex Pretti, a 37-year-old ICU nurse, while scuffling with him on an icy roadway, less than three weeks after an immigration officer shot and killed Renee Good, also 37, in her car. His killing sparked new protests and impassioned demands by local leaders for the Trump administration to end its operation in the city. (Photo by ROBERTO SCHMIDT / AFP via Getty Images)

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Alexis Kayser

By Alexis Kayser

Healthcare Editor

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This is a preview of the January 29 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursday mornings.

My thoughts have been with the family, friends and colleagues of Alex Pretti, the VA intensive care unit nurse who was killed by a border patrol agent during a federal immigration operation in Minneapolis over the weekend. Two U.S. Customs and Border Protection (CBP) agents fired at least 10 shots at Pretti in less than five seconds, according to forensic analyses of the video and audio footage (autopsy details have not been released to the public). He was 37 years old.

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This event has marked a turning point for many health care workers, leaders and organizations. My LinkedIn feed has been a sea of grief since Pretti’s occupation was released to the public. The American Nurses Association, National Nurses United and multiple state-level nursing coalitions have issued statements condemning ICE agents’ use of violence—speaking not just to Pretti’s case, but to immigration officials’ actions throughout the course of the Trump administration. Save HHS, a coalition of former and current HHS staffers, declared ICE’s and CBP’s presence in American cities a public health emergency.

“We believe ICE and CBP are a greater threat to the health of our nation than the lapse of HHS services,” the staffers wrote in a January 26 statement.

And they aren’t the only—or the first—health care professionals to make such a claim. Providers made similar remarks to Axios reporters this week. Data validates their concerns: 40 percent of immigrant adults and nearly 8 in 10 immigrant adults who are likely undocumented have experienced negative health impacts from immigration-related concerns since President Donald Trump took office, according to a fall survey from KFF and The New York Times. Nearly 30 percent said they’ve skipped or postponed care since January 2025.

Multiple organizations have assembled guides for hospital leaders and staff, outlining best practices for if an ICE agent enters your facility (many of these resources were developed last year, when federal deportation initiatives began ramping up). These guides from the ACLU, the Oregon Nurses Association, the National Immigration Law Center, the American College of Emergency Physicians and law firm Arnold & Porter are a good place to start.

A few clear takeaways for hospital and clinic executives:

While preparation can certainly help in times of crisis, it’s worth examining the emotions here, too—why the health care community had such a profound response to Pretti’s murder.

To summarize the statements posted online and the conversations I’ve had with physicians since the incident, many clinicians say they see themselves in Pretti. He was a nurse who spent his career serving the underserved at a government hospital. Sworn eyewitnesses say that he was killed while attempting to help a woman who was pushed to the ground by a federal agent. Stephen Miller, Trump’s deputy chief of staff, called him a “domestic terrorist.”

This is a familiar whiplash to medical professionals, former Surgeons General, CDC staff members, NIH scientists. Do what you are trained to do—and you might be branded a threat by the state.

This Newsweek article compiles tributes from Pretti’s friends, colleagues and community members, remembering him for who they knew him to be.

You can email your thoughts to a.kayser@newsweek.com. Take care this week.

A mourner prays as people gather at a makeshift memorial in the area where Alex Pretti was shot dead a day earlier by federal immigration agents in Minneapolis, Minnesota, on January 25, 2026. On January 24, federal agents shot dead US citizen Alex Pretti, a 37-year-old ICU nurse, while scuffling with him on an icy roadway, less than three weeks after an immigration officer shot and killed Renee Good, also 37, in her car.His killing sparked new protests and impassioned demands by local leaders for the Trump administration to end its operation in the city. (Photo by ROBERTO SCHMIDT / AFP via Getty Images)

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Pulse Check

Executive perspectives on key industry issues

Parkview Health is the only health system in the country to reach Epic’s 7-diamond status, an honor reserved for the highest level of MyChart utilization and digital engagement with patients.

Three-quarters of patients at the Fort Wayne, Indiana-based health system are active MyChart users, and that connectivity has led to enterprise-wide improvements, according to data that Epic shared with me. Since Parkview doubled down on its MyChart engagement, screening compliance has risen by 38 percent, and the system’s STARS rating increased by 2.6 percent.

I recently connected with Dr. Mark Mabus, senior vice president and CMIO at Parkview Health, and Laura Dubay, its director of digital health, to learn how they did it—and how your organization might be able to mimic their success in digital engagement, regardless of your EHR provider.

Editor’s Note: Responses have been lightly edited for length and clarity.

Tell me a bit more about this “7-diamond status.” What exactly does it take for a health system to achieve that?

Mabus: Epic has this program called MyChart Diamonds. It is a strategic adoption program for patient engagement, and these diamonds look at different areas to [assess the health system on a 10-point scale]. There are things like benchmarks for patient activation, self-service, scheduling, digital financial tools, virtual care and a lot of different criteria that Epic has come up with as “best in class” practices for health systems to adopt.

As a health system, we have to enable [these features] on our side. But we're also graded on how well patients utilize this stuff. So it's not just, “oh, build it and you get a diamond.” A lot of this is heavily dependent on having your patients use these features.

When we achieved MyChart Diamond Seven this summer [2025], we were the first Epic organization in the world to hit that high of a level from their benchmarks. And it reflects on us, but it also reflects on our community. Our patients have engaged with the features that we have turned on.

There are still 10 [possible diamonds], so we’re not done. We’re making our way there.

How did you use community feedback to determine which features were worth the effort and investment?

Dubay: We developed a digital feedback platform that we named Viewpoints. Essentially, we added a question to the end of our traditional [patient] survey that said, “Would you be willing to provide feedback outside of your care?” The survey was sent to all patients that received care, not just MyChart patients.

Our goal was to get 10,000 [willing participants] within a week. Our first week, we had over 1,700 patients that [agreed to] provide feedback. And [now], we actually have well surpassed our 10,000 voice journey.

But we put together [another] survey, and it started out as simple as, “Have you heard of MyChart?” We got this overwhelming response that like 99 percent of the patients that responded had heard of MyChart, and like 95 percent of the patients responding had used it. But then we asked, out of all the features we have enabled, did you know they were enabled? How easy are they to use for you? What is missing?

That provided the feedback we needed to continue to tailor our messaging, education and marketing materials to highlight those features [that people weren’t aware of or didn’t know how to use] and give more step-by-step guides on the purpose behind them.

What surprised you from that survey? Were there any features that patients weren’t interacting with that you expected them to, given your investments on the backend?

Dubay: Some of the lower usage was around E-Visits and the 24/7 care we have available. Many patients see my chart as a way to message their provider, schedule their appointment, look at test results. But we also have put a lot of care options [into MyChart].

E-Visits is an asynchronous questionnaire, so if you've got a sore throat, you can fill it out, and it goes to a provider who will then respond back to you. That feature and our symptom checker are what [patients] use Dr. Google for, right?

But if you’re out there googling things, we want you to get that information from us, from providers that actually do this day in and day out. We're highlighting those features [so patients know they] don't need to use Dr. Google. Go to MyChart and get those details from a provider.

Mabus: There are other functionalities that patients discover on their own and utilize to the max. We enable things like self-scheduling for imaging, and mammograms are a big one. Patients wanted to be able to schedule those online by themselves, without having to call anybody.

We turned on the functionality. Didn't have to educate on it. People just started using it. That's the digital age that we live in.

Why do you think that self-scheduling was getting more use than the e-visit?

Mabus: I think it's actually driven by other areas of industry, too. We're used to booking our car service online or quickly ordering something from a retail giant. We don’t want to talk to people anymore, and we want to be able to [make appointments] on the weekends.

That's what the health system wants, too—to improve access, to save revenue. It’s cheaper for a patient to self-schedule than it is to have them [interact with a call-center employee.] So we are definitely looking at those things where it's a win-win for patients and operations.

How have you reframed the app to patients, ensuring they’re aware of these features and encouraging use?

Dubay: It starts with our providers. They touch on that when [patients are] here [for a visit], that MyChart is a core piece of your care journey with us.

From more of a consumer lens, we have MyChart Mondays that we publish out on several social media channels where we highlight features and functionality. We take feedback from Viewpoints [surveys]. We look at usage, where we see that increase or decrease, or where we want to increase usage. And then we tailor our messaging through a lot of our marketing site pieces as well. We have a MyChart newsletter that goes out on a quarterly basis that takes all of those features that we want to highlight more, as well as new things that we're doing to improve. On our [health system] website, we've got a full page dedicated to answering questions about MyChart.

Mabus: We also try to encourage our coworkers to share their own experiences with MyChart and what they utilize in it as they are helping patients along in the journey, whether it's one of our cancer navigators, a nurse on the floor or registration staff at a clinic. They have those experiences and are able to help patients know what to use MyChart for and when, and we definitely encourage them to share that with the patients they touch.

What’s the purpose of all of this time and effort? How is the health system benefiting from increased MyChart utilization?

Mabus: MyChart enables us to communicate with patients on their own terms, whether it's through logging into the portal or turning on the app or through text messaging [features]. We're able to contact patients and get some things done that maybe there wasn't time for in that visit where you just had that sore throat.

We [also benefit from] outreach for preventative screenings. For example, we were using a manual process for colorectal cancer outreach screenings. People were picking up the phone and calling patients and trying to get them to do a colorectal cancer screening. When we automated that through MyChart messaging, our compliance rates jumped from 20 percent to 58 percent. That’s a huge impact in preventative screenings, which are quality measures for payers as well.

Then there are tools that enable simple things, like a patient can pay their bill through MyChart which enables quicker financial returns for the health system. And Fast Pass is a functionality on MyChart that if somebody cancels an appointment, that spot opens up in the provider schedule and can be offered to someone else—we'll send a text out to the first five people on the waitlist to see who wants to take that appointment. It [allows us to] fill our schedules faster, so there's not lost revenue from an open spot, but it's a patient satisfier too. They get in sooner if they were on the wait list.

Dubay: Dr. Mabus summed it up well. There's that easier access, improved transparency, convenience. [It communicates to the patient that] you are the reason we're here, and we want to keep you in the circle and engaged. And from a health system perspective, it shows our partnership. It creates loyalty and stickiness.

Mabus: I still see patients. And when my patients get a MyChart message from me, I think they feel more connected to their care than if they didn't have MyChart and they got a phone call from a nurse who may not have been involved in that appointment or be as familiar with their case.

It sounds funny. We've been talking about all this automation and all these efficiency gains through technology, but it still comes down to people and connections, and that's what helps empower our patients along their health care journey, too.

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Dr. David Battinelli is physician-in-chief at Northwell Health and dean of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, both based in New York. (Northwell Health)

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Last Thursday, I hosted a panel of executives from Northwell Health, WHOOP and Withings for a conversation about wearable use in health systems. The discussion produced a number of great insights on health, wellness and the ways that we monitor it—you can view the session in full here.

One thing that stood out to me: all of the speakers agreed that they’d rather have too much data than too little, whether for themselves, their loved ones or their patients/clients. At the same time, research shows that “information overload” can negatively impact both patient outcomes and clinician wellbeing.

Health systems, wearables developers and even the FDA are still working out regulatory and data-surfacing processes that benefit patients without paralyzing providers. But in the meantime, I'd like to share something that Dr. David Battinelli, physician-in-chief at Northwell Health and dean of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, said at Thursday’s virtual event—something that might make you feel a bit more hopeful as you traverse the unknowns of new technology.

To summarize Battinelli’s points: don’t let the potential pitfalls cloud your vision of the possibilities. And write your wish lists in pencil, keeping an open mind for the advancements you didn’t know you needed.

Editor’s Note: Responses have been lightly edited for length and clarity.

If you missed last week’s event, you can still register for our February 3 webinar, “Preventing Chronic Disease Patients From Falling Through the Cracks.” I’ll be moderating the conversation with leaders from Cleveland Clinic, Sutter Health, Endeavor Health and Oura. Click here to sign up for free.

This is a preview of the January 29 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursday mornings.

Editor's Note: This article was updated on January 29 at 7:40 p.m. ET to include new information from WhidbeyHealth.

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