The archive
Writing on healthcare technology, systems, and incentives — some new, some republished from earlier work with its original date. Roughly one a month.
AI watermarks are shipping this month, and everyone is busy auditing the writing for an answer that was never there. You don't detect who wrote it like a fingerprint. It's an assertion made by the person willing to say, "I wrote this."
Read →We praise Toyota's culture because it lets us pretend the magic was mindset. It wasn't. Toyota engineered consequences, and the culture showed up as a byproduct.
Read →Every major tool in history lowered one threshold and raised another. AI is no different — it resets the floor and forces excellence upward.
Read →The Space Shuttle had 2,000 switches and stopped flying. The Soyuz had 63 and still flies. The most enduring systems keep only what is necessary.
Read →One in five claims gets denied on the first pass. A system that says no to a fifth of everything is not making mistakes. It is doing exactly what it was built to do.
Read →Clinicians spend more time clicking than caring, and everyone treats it as inevitable. It isn't. Good clinical UI is a design choice, not a law of nature.
Read →For too long, health IT vendors have replaced old technology with different outdated technology. Interoperability isn't impossible — some just profit from it staying broken.
Read →Care coordination depends on every provider seeing the whole patient record. Document-based exchange can't get us there. API-based exchange on FHIR can.
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