Brandt Welker https://brandtwelker.com Essays on healthcare technology, systems, and incentives. en-us Stop Auditing the Phrases https://brandtwelker.com/essays/stop-auditing-the-sentences https://brandtwelker.com/essays/stop-auditing-the-sentences Sun, 30 Aug 2026 00:00:00 GMT 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." Culture Doesn't Shape Behavior. Incentives Do. https://brandtwelker.com/essays/culture-and-incentives https://brandtwelker.com/essays/culture-and-incentives Thu, 18 Dec 2025 00:00:00 GMT 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. Raising the Bar: Why AI Doesn't Erode Rigor, It Redefines It https://brandtwelker.com/essays/raising-the-bar https://brandtwelker.com/essays/raising-the-bar Fri, 22 Aug 2025 00:00:00 GMT Every major tool in history lowered one threshold and raised another. AI is no different — it resets the floor and forces excellence upward. The Power of Simplification: Lessons from Spacecraft Design https://brandtwelker.com/essays/power-of-simplification https://brandtwelker.com/essays/power-of-simplification Wed, 02 Apr 2025 00:00:00 GMT 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. The Denial Machine https://brandtwelker.com/essays/denial-machine https://brandtwelker.com/essays/denial-machine Sat, 22 Mar 2025 00:00:00 GMT 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. Are You in an Abusive Relationship with Your EHR? https://brandtwelker.com/essays/abusive-relationship-with-your-ehr https://brandtwelker.com/essays/abusive-relationship-with-your-ehr Fri, 26 Feb 2016 00:00:00 GMT 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. Don't Let Health IT Go Extinct https://brandtwelker.com/essays/dont-let-health-it-go-extinct https://brandtwelker.com/essays/dont-let-health-it-go-extinct Tue, 23 Feb 2016 00:00:00 GMT For too long, health IT vendors have replaced old technology with different outdated technology.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. Care Coordination on FHIR: The Case for API-Based Exchange https://brandtwelker.com/essays/care-coordination-on-fhir https://brandtwelker.com/essays/care-coordination-on-fhir Thu, 18 Feb 2016 00:00:00 GMT 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.