15 Years of Learnings and Failures Building Tech in Healthcare, in 1 Post
The "messy middle" of building tech in healthcare, and being human.
I’ve been writing about my “health tech” experience for more than a decade, mostly for myself — to process what I was learning building healthcare products, leading teams, and figuring out who I wanted to be. Below all of it, and new writing coming here :)
TL;DR:
About healthcare: it’s the incentives, stupid! AI finally makes it possible to align who delivers care with who pays for it
About building products: build less, ship more, learn faster — aka common sense beats frameworks
About life: the hardest problems aren’t technical — they’re about who you want to be while solving them. Keep trying, be kind.
🏥 About Healthcare: It’s the Incentives, Stupid!
It’s the incentives, stupid. The US spends $4.5 trillion a year on healthcare — more than any country on earth — and gets worse outcomes than countries spending half as much. The reason isn’t a lack of technology or talent. It’s that the entire system rewards volume, not value. AI is the first technology powerful enough to actually rewire who gets paid for what.
The key to quality, accessible healthcare: tech-first, asset-efficient care delivery (Jan 2024) — The thesis: virtual, tech-first care delivery beats building hospitals.
The new Operating System the US Healthcare needs (Oct 2022) — Health plans must evolve from aggregators to platforms.
The dawn of Virtual Care (Feb 2021) — Virtual care defined and mapped — written just as COVID proved the model.
Better health at lower costs? Invest in the welfare state (SDOH) (Jan 2021) — Social determinants of health as the real cost lever.
Why & how I will share my health data (Feb 2020) — Data ownership and portability — more relevant than ever.
Primary Care is dead… no wait, it works! (Dec 2019) — The paradox of primary care in the US.
Disrupting US Healthcare (Part 2): modularization & integration (Dec 2019) — Clayton Christensen’s framework applied to healthcare.
US Healthcare: mainframes, “free market”, and the prisoner’s dilemma (Nov 2019) — Why coordination failure is the root cause.
🛠️ About Building Products: Build Less, Ship More, Learn Faster
Common sense is the most undervalued skill in product development. Not frameworks. Not methodologies. The ability to look at a problem, make a call, and ship something that teaches you whether you were right. The best product teams don’t have better process — they have faster feedback loops between idea and evidence.
“Business-led” companies & the role of product development (Aug 2023) — Why “product-led” vs. “sales-led” is the wrong framing.
Software Roadmaps = Living Statements of Intent (Feb 2021) — Stop treating roadmaps as promises. They’re hypotheses.
Product Managers = Change Managers (Jan 2020) — Common sense as the most undervalued PM skill.
Agile = don’t be an asshole (Jan 2020) — 20 years of agile distilled into one sentence.
Reflections on Product Management (Sep 2019) — Three years of thinking compressed into one post.
Scaling product-centric organizations (Mar 2016) — What happens when you’re not in the garage anymore.
🧭 About Life: The Hardest Problems Aren’t Technical
Pull the bandaid. Be kind. Keep trying. Most of what I’ve learned about leadership and life comes down to some version of those three things. These are the pieces that don’t fit neatly into product or healthcare — the personal essays, the philosophical rants, the attempts to reconcile ambition with integrity.
How to work with me (Sep 2023, updated 2026) — My operating manual for remote collaboration.
Is Excellence Enough or Is Enough Excellence? (Sep 2022) — Perfectionism is the enemy of judgment.
2020: crisis and turning point (Dec 2020) — A year that changed everything.
Yes, it’s still hard. Be kind. (Feb 2020) — The sequel to pulling the bandaid.
Who is NOT going to get us? (Jan 2020) — Big tech embedding into every corner of our lives. Written in 2020, feels even more true now.
My authenticity journey (Nov 2019) — The lifelong process of becoming who you actually are.
The harder thing is the right thing (Nov 2019) — Pull the bandaid. Always.
Entrepreneurs = change agents (Oct 2019) — Business as a vehicle for the change you want to be.
Doing well & doing good (Oct 2019) — The tension between capitalism and humanity.
Trying to reconcile humanity & capitalism (Oct 2019) — I’m still trying.
Take your time (Oct 2019) — It started as a rant about espresso to-go.
Inspiring career advices (Feb 2016) — Advice I got during my 2014 job search. Still holds.
Eastern wisdom — How mindfulness and awareness are changing my life (Jan 2016) — Where it all started.
All views are my own.