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VISN 8 continues to lead the way in health care innovation within the Veterans Health Administration.

After the successful completion of the 2024 Veterans Health Venture Studio program, which saw 7 teams create working prototypes, the 2025 cohort kicked off with the Hackathon this past August. Of the 51 concepts developed at the Hackathon, 17 teams were selected to join the Make-a-thon (December 2025 – March 2026), where teams will advance their concepts into technical designs ready to prototype. A subset of these teams will advance to the Accelerator, where they will collaborate with technical experts to create working prototypes prepared for pilot testing within VA.

Dr. Sandal describes the vision of VHVS as “simple yet powerful: to create technology by the people who will use it, alongside those people.” The Studio aims to develop five or more technologies each year, created by clinicians and Veterans, that can be rolled out across the entire VA system—delivering solutions that Veterans can proudly say they helped create.

Representing James A. Haley Veterans’ Hospital, Orlando VAMC, San Juan VAMC, Malcolm Randall VAMC, C.W. Bill Young VAMC , Thomas H. Corey VAMC, and VA facilities from across Florida, Puerto Rico, and the Caribbean, these innovators are prepared to tackle some of the most pressing challenges facing Veteran care. Their participation reflects VISN 8’s commitment to fostering collaboration and breakthrough solutions that improve outcomes for Veterans across the region and beyond.

David Dunning, Interim Director of Veterans Integrated Service Network 8 (VISN 8), The Sunshine Network, shares the personal motivation behind this innovation effort:

“It’s very personal for me. I get my care here, my spouse is a Veteran, my dad was a Veteran, her dad was a Veteran. So, seeing how we can get better at what we’re doing—it’s about tearing it down and building it back up into something transformational.”

Veterans Health Venture Studio: Founded and Led by VISN 8 Innovation Leader

The Veterans Health Venture Studio (VHVS), founded and led by Dr. Indra Sandal, Chief of Innovation at James A. Haley Veterans’ Hospital, fuels innovation by providing a structured pipeline that supports projects from initial ideation to pilot and scale phases. Focused on People Development, Technology Development, and Community Development, VHVS cultivates innovation capacity, launches new technologies, and builds partnerships to enhance health care delivery.

The VHVS program includes a Hackathon, Make-a-thon, and Accelerator in Year 1, followed by piloting and scaling in Year 2. This structure ensures VISN 8 projects receive the mentorship, resources, and support needed to evolve from concepts into practical, deployable solutions.

Highlights from the 2025 Veterans Health Hackathon

The 2025 Hackathon energized VISN 8 with over 350 participants collaborating across 17 VISNs and more than 100 VA and community organizations. Teams competed across three critical tracks:

• Timely Access to Care
• Optimizing Enterprise-wide Costs and Operational Efficiency
• Improving Community Care Coordination

Judged by 17 experts, nine winning teams emerged, showcasing innovative solutions ranging from appointment scheduling portals to AI-powered referral management tools. VISN 8 proudly claims several winners and finalists from its regional facilities, reflecting a strong culture of innovation dedicated to Veteran-centered care.

VISN 8 Teams Advancing to the Make-a-thon

Seventeen teams—comprising the nine Hackathon winners and eight additional rigorously selected projects—will advance to the Make-a-thon. These teams represent a powerful cross-section of VISN 8 expertise, including:

Timely Access to Care

• Bravo Zulu Health – Streamlines appointment and test scheduling into a single portal to reduce missed care and cancellations.
  • Antonio Romero, C.W. Bill Young VAMC
  • Onelis Cardona Lorenzo, Malcolm Randall VAMC
• SPEED Access Care – Uses AI to screen high-risk symptoms, preventing delayed diagnoses and guiding provider routing.
  • Claudia Legaspi, C.W. Bill Young VAMC
  • Alysa Werkheiser-Quillen, James A. Haley VAMC
  • Sylvia Santiago-Rodriguez, James A. Haley VAMC
  • Dana Glenn, James A. Haley VAMC
  • Yolanda Showers, James A. Haley VAMC

     

• CareBridge – Empowers Veterans and providers with real-time access to care plans, discharge summaries, and chatbot support.
• Referral IQ – Enhances consult completeness through AI pre-validation against service line rules.
  • Pedro Diaz-Rosario, San Juan VAMC
  • Jorge Montanez, San Juan VAMC
  • Grace Cruz-Lamboy, San Juan VAMC

     

• PIVOT – Reduces no-shows and boosts engagement via an AI hub enabling appointment rescheduling across preferred channels.
  • Richard Paul, Orlando VAMC
  • Erin Bohannon-Chenault, James A. Haley VAMC

 

Optimizing Costs and Efficiency

• VA Resource Allocation Mapping (VA R.A.M.) – Tracks medical supply inventories using AI to limit waste from surpluses and expirations.
  • Farrah Noronha, Orlando VAMC
  • Robert Eaton, Malcolm Randall VAMC

     

• autoVAte – Streamlines ePAS workflows with AI-driven assessment, triaging, and auto-approval.
  • Ashley Rush, Orlando VAMC
  • Candace McNulty, Orlando VAMC
  • Catherine Javellana, Malcolm Randall VAMC

     

• CareNav – Reduces misdiagnosis by suggesting CPT/ICD codes from clinical notes using AI.
  • Nitza Robles Sanchez, James A. Haley VAMC
  • Hayley Stevenson, James A. Haley VAMC
• Exit Strategy – Improves discharge planning and clinical capacity through a real-time dashboard.
  • Alexandra Kennedy, James A. Haley VAMC
  • Hope Hunter, James A. Haley VAMC

     

• Improving Outcomes – Uses a digital CHF tool to promote adherence and monitor patient weight, reducing readmissions.
  • David Beck, James A. Haley VAMC
  • Mohamad Anas Sukkari, Malcolm Randall VAMC
  • Caitlyn Morley, Thomas H. Corey VAMC

 

Enhancing Community Care Coordination

• Mission Fax Impossible – Automates community care records management to reduce treatment delays.
  • Edward Martin, Malcolm Randall VAMC

     

• Laser Focus – Increases referral transparency through AI-powered document scanning and validation.
  • Jessica DelleChiaie, James A. Haley VAMC
  • Gilberto Balderas, Orlando VAMC
  • Carlos Gonzalez-Rodriguez, San Juan VAMC
  • Rafael Giraud Carcano, San Juan VAMC
  • Mia Lind Correa, San Juan VAMC

     

• Care Continuity – Provides Veteran-focused tracking with real-time views, AI alerts, and secure messaging.
  • Karen Cionci, James A. Haley VAMC

     

• Care Ninjas  – Integrates a scalable mobile and MyHealtheVet referral tracker to build Veteran trust.
  • Tiffany Anthony, James A. Haley VAMC
  • Angela Rozar, James A. Haley VAMC
  • Catherine Clark Martin, James A. Haley VAMC
  • Sandra Dompkosky, Thomas H. Corey VAMC
  • Michele Laney, James A. Haley VAMC

     

• Care Connect – Streamlines prescribing with pharmacist-led, standardized intake and secure messaging.
  • Michael Pitter, Orlando VAMC
  • Charmaine Leighton‑Stewart, James A. Haley VAMC

     

• Shadow PACT – Preserves care continuity by scanning provider notes with AI for clinical triggers and auto-generating information packets.

The Path Forward: Make-a-thon and Beyond

The Make-a-thon will begin with an immersive bootcamp, providing teams with training, mentorship, and strategic support to refine their solutions into functional prototypes ready for pilot testing across VISN 8 and the broader VA system. This phase is designed to align leadership, cultivate innovation, and prepare high-potential projects for sustainable impact.

VISN 8’s innovators have already benefited from nearly 5,000 person-hours of training, demonstrating their readiness to deliver transformative solutions that enhance Veteran care and operational efficiency.

Collaboration Powering VISN 8 Innovation

The Make-a-thon thrives on collaboration among VA leadership, the Office of Healthcare Innovation and Learning, The American Legion, and Microsoft. Microsoft plays a pivotal role by providing comprehensive training, and mentorship, empowering teams to accelerate their innovations.

These partners serve as Advisory Council members and expert faculty, guiding VHVS’s strategic vision and working closely with teams throughout the Make-a-thon to refine and validate solutions. This collective expertise ensures VISN 8’s innovations are positioned for meaningful, scalable impact throughout the VA.

NEW YORK (AP) — It was a scary good year for investors.

It was scary because the U.S. stock market plunged to several historic drops on worries about everything from President Donald Trump’s tariffs to interest rates to a possible bubble in artificial-intelligence technology. In the end, though, it was a great year for anyone with the stomach to stick through the swings.

S&P 500 index funds, which sit at the heart of many savers’ 401(k) accounts, returned more than 18% in 2025 through Dec. 11 and set a record high that day. It’s their third straight year of big returns.

Here’s a look at some of the surprises that shaped financial markets along the way:

Tariff tremors

Trump dropped the biggest surprise on “Liberation Day” in April, when he announced a sweeping set of tariffs that were more severe than investors expected.

It immediately triggered worries about a possible recession and spiking inflation. The S&P 500 plunged nearly 5% on April 3 for its worst day since the 2020 COVID crash. The very next day, it dropped 6% after China’s response raised fears of a tit-for-tat trade war.

The tariffs’ impact went beyond the stock market. The value of the U.S. dollar fell, and fear even shook the U.S. Treasury market, which is seen as perhaps the safest in existence.

Trump eventually put his tariffs on pause on April 9 after seeing the U.S. bond market get “queasy,” as he put it, which sent relief through Wall Street. Since then, Trump has negotiated agreements with countries to lower his proposed tariff rates on their imports, helping calm investors’ nerves.

Wall Street motored higher through a remarkably calm summer thanks to euphoria around artificial-intelligence technology and strong profit reports from companies. The market also got a boost from three cuts to interest rates by the Federal Reserve.

READ MORE: AI darlings prop up Wall Street as most other stocks fall

Trade worries can still cause havoc in markets, and Trump sent stocks spiraling as recently as October with threats of higher tariffs on China.

Trump and the Fed

Another surprise was how hard, and how personally, Trump lobbied to get the Federal Reserve to lower interest rates.

The Fed has traditionally operated separately from the rest of Washington, making its decisions on interest rates without having to bend to political whims. Such independence, the thinking goes, gives it freedom to make unpopular moves that are necessary for the economy’s long-term health.

Keeping interest rates high, for example, could slow the economy and frustrate politicians looking to please voters. But it could also be the medicine needed to get high inflation under control.

As inflation stubbornly remained above the Fed’s 2% target, the central bank kept rates steady through August. This drew Trump’s ire – even though it was his own trade policies that were driving fears about inflation higher.

Trump continuously picked on Fed Chair Jerome Powell, even giving him the nickname “Too Late.” Their tense relationship reached a head in July when Trump, in front of cameras, accused Powell of mismanaging the costs of a renovation of the Fed’s headquarters. Powell, in turn, shook his head.

Even though Wall Street loves lower rates, the personal attacks caused some queasiness in financial markets because of the possibility of a less independent Fed. Powell’s turn as Fed chair is set to expire in May, and the wide expectation is that Trump will choose a replacement more likely to cut rates.

Good but not first

“America first” didn’t extend to global markets. Even as U.S. stocks soared to another double-digit gain, many foreign markets fared even better.

The technology frenzy that helped fuel gains for the S&P 500 and the Nasdaq composite drove Korea’s KOSPI higher in 2025, enjoying its biggest gain in more than two decades. South Korea is a technology hub and companies including Samsung and SK Hynix surged amid the focus on artificial intelligence investments and advancements.

Japan’s Nikkei 225 had a double-digit gain for a third straight year. Besides the focus on AI and the technology sector, the gains were boosted in October and November following national elections and plans for a $135 billion stimulus package.

European markets also had a strong year. Germany’s DAX got a boost as the government announced plans to ramp up spending on infrastructure and defense, which could fuel economic growth in Europe’s largest economy.

The European Central Bank spent the first half of the year cutting interest rates, which helped give financial markets across Europe a boost. France’s CAC 40 was a laggard, up 10% as of Monday.

Crypto’s ups and downs

Even with a reputation for volatility, cryptocurrencies still managed to surprise market watchers.

Bitcoin dropped along with most other assets early in the year as Trump’s trade policies scared investors away from riskier investments.

The most widely used cryptocurrency roared back as the White House and Congress threw their support behind digital assets and the Trump family launched a number of crypto ventures. Retail investors joined in by pouring money into bitcoin ETFs, stock-like investments that allowed them to benefit from the run-up in price without having to actually store bitcoin in digital wallets. Some companies, notably Strategy Inc., made buying and holding crypto the crux of their business and their stocks jumped.

READ MORE: How a Trump business deal with a crypto firm exposes potential conflicts of interest

Bitcoin and hit a high around $125,000 in early October. But, almost as quickly, digital assets tanked as investors worried the prices for shining stars such as tech stocks and crypto had jumped too high. As of Monday afternoon, bitcoin traded around $89,400, down roughly 28% from the peak and 4% below where it started the year.

What’s ahead?

Many professional investors think more gains could be ahead in 2026.

That’s because most expect the economy to plod ahead and avoid a recession. That should help U.S. companies grow their profits, which stock prices tend to track over the long term. For companies in the S&P 500, analysts are expecting earnings per share to rise 14.5% in 2026, according to FactSet. That would be an acceleration from the 12.1% growth estimated for 2025.

But some of this year’s concerns will linger. Chief among them is the worry that all the investment in artificial-intelligence technology may not produce enough profits and productivity to make it worth it. That could keep the pressure on AI stocks like Nvidia and Broadcom, which were responsible for so much of the market’s gains this year.

And it’s not just AI stocks that critics say are too pricey. Stocks across the market still look expensive after their prices climbed faster than profits.

That has strategists at Vanguard estimating U.S. stocks may return only about 3.5% to 5.5% in annualized returns over the next 10 years. Only twice in the last 10 years has the S&P 500 failed to meet that bar, assuming this year ends without another sell-off.

At Bank of America, strategist Savita Subramanian says the S& P 500 could rise by less than half as much as profits do in 2026. She said that could be a result of companies reducing stock buybacks, as well as global central banks implementing fewer rate cuts.

Reporter Damian Troise contributed.

AI has moved from the margins to the mainstream of asset management. Firms are deploying AI to accelerate research, modernize operations, sharpen risk surveillance, and enhance client service. A significant percentage of managers are either already using or planning to use AI to inform asset class research and portfolio decisions.¹ A Mercer survey found that 91 percent of managers are engaged with AI – 54 percent  are currently using it, while 37 percent  plan to incorporate it into their investment strategies or asset class research.² An EY survey of 100 firms found that 95 percent  have scaled GenAI adoption across multiple use cases, with 78 percent  already exploring agentic AI for deeper strategic benefits.³

At the same time, regulators have made clear that longstanding rules governing supervision, marketing, recordkeeping, and fiduciary duty apply equally to AI-enabled activity. The result is one of significant promise, but also heightened scrutiny, where managers who balance innovation with strong governance are most likely to gain a competitive advantage.

Where AI adds the most value

Across the investment and operating lifecycle, AI is already proving useful as a companion rather than an autonomous decision-maker. On the investment side, managers are using AI to synthesize large unstructured data sets, summarize earnings calls and filings, compare investment guidelines to portfolio rules, and prioritize signals for human review. These tools can significantly shorten research and quality-control cycles, enabling professionals to focus on strategic decision-making.

In risk and compliance, AI-powered surveillance assists with scale and consistency. Email and communications review, trade surveillance, and behavioral analytics can be triaged by models that flag outliers for escalation, supporting timely detection of potential issues. In marketing and client service, AI can pre-screen communications, including social content and performance claims, to help identify statements that may be unfair, unbalanced, or unsubstantiated. In legal and operations, AI expedites document review, contract clause extraction, privilege tagging, and e-discovery tasks – areas where speed and accuracy can translate into meaningful cost savings.

These use cases share two common traits. First, AI is most effective when constrained to tasks with clear objectives and well-understood boundaries. Second, the strongest results come when human experts remain firmly “in the loop”, supervising inputs and validating outputs.

The regulatory landscape: Old rules, new tools

While there are few prescriptive AI-specific rules for US asset managers today, existing frameworks apply with full force. The Investment Advisers Act prohibits investment advisers from making false or misleading statements about a firm’s capabilities, including claims about AI use. The SEC’s Marketing Rule requires fair, balanced presentation and substantiation of performance claims. That extends to AI-generated materials and to representations about AI-driven forecasts. The Financial Industry Regulatory Authority’s communications communications standards similarly apply to AI-enabled content and chatbots; guidance emphasizes pre-deployment evaluation, explainability, and ongoing supervision.

Recent enforcement actions underscore two themes. First, “AI washing” – overstating or fabricating the role of AI in investment processes, will attract antifraud scrutiny. Second, hypothetical or AI-enhanced performance claims, if unsubstantiated or improperly presented to the public, can violate the Marketing Rule.

Regulators are also modernizing their own toolkits. Units focused on cyber and emerging technologies have highlighted AI-related risks and are using analytics to detect market abuse. Their posture remains technology-neutral: innovative tools are permitted, but fiduciary duty, supervision, and recordkeeping expectations remain unchanged. Managers must still be able to explain the “why” behind decisions and the “how” behind models sufficient to satisfy oversight inquiries. 

Key risks to manage

Even as AI accelerates workflows, it introduces distinct risks that require active management. Model risk, including errors, bias, or weak explainability, can undermine outcomes and erode trust. Hallucinations and overconfident summaries can produce inaccurate or misleading outputs, especially when models are applied outside their training domain. Over-reliance on AI for nuanced judgment can miss context that experienced professionals would catch. 

Data governance is equally central. Using public or consumer-grade tools for sensitive inputs can jeopardize confidentiality or privilege; in some configurations, user prompts and documents may be retained and used to train third-party models. Discovery and recordkeeping obligations also extend to AI-generated content and prompt histories in many contexts; if AI is used within a decision process subject to books-and-records rules, the inputs and outputs should be captured. 

Finally, integration risk is real. Poorly specified implementations, weak vendor diligence, or unclear user policies can result in inconsistent practices across business lines. The result can be a perception of disorder, even when the firm’s actual risk controls are sound.

A practical playbook for responsible adoption

A pragmatic governance approach can unlock AI’s benefits while mitigating downside risk. The most effective programs begin with an inventory of use cases: what tools are in use across research, trading, client service, compliance, legal, and operations; what data they touch; and where human review sits in the workflow. Clear scoping helps identify high-impact, low-risk opportunities and highlights areas requiring tighter controls. 

From there, firms should align policies and procedures to existing obligations rather than reinvent the rulebook. Communications generated or screened with AI must meet the same standards as traditional content. Where AI informs investment decisions, contemporaneous documentation should describe data inputs, key prompts or parameters, backtesting or validation steps where applicable, and the human rationale for the final decision.

Tool selection and configuration matter. Enterprise-grade solutions that offer tenant isolation, data control options, and audit logs are generally preferable to public tools for sensitive workflows. Contracting and vendor diligence should evaluate retention settings, model training practices, security controls, export and logging capabilities, and support for prompt/output capture. Where feasible, enable features that preserve an audit trail of inputs and outputs. 

Human oversight remains the foundation. Users should be trained to craft precise prompts, anticipate common failure modes, and sanity-check answers against known facts or source documents. For critical outputs such as marketing claims, investor communications, and legal conclusions, AI should augment, not replace, professional review. Periodic testing of models against known benchmarks, plus spot checks for bias or drift, helps sustain confidence over time. Firms should also maintain thorough records of all testing activities, including methodologies, results, and any remedial actions taken, to support oversight and demonstrate compliance. 

Finally, governance should be right-sized and iterative. Some firms convene cross-functional committees; others designate an accountable owner within compliance or risk with input from technology and the business. What matters is that someone is paying attention, policies are consistent across disclosures and channels, and the program can evolve as tools and use cases mature.

The bottom line

AI is rapidly becoming an essential component of asset management. Used thoughtfully, it enhances speed, consistency, and insight across the enterprise. Deployed carelessly, it can amplify old risks and create new ones, from misleading claims to data leakage and inadequate documentation. Success lies in pairing ambition with accountability: candid, accurate disclosures about how AI is used; enterprise-grade tooling with appropriate data controls; robust human oversight and recordkeeping; and a governance framework that is practical today and adaptable tomorrow. Managers who strike that balance will be best placed to capture AI’s upside while staying on the right side of evolving regulatory expectations.