Be Curious, Not Judgmental

Ruminations and musings about healthcare AI, technology, and strategy

Category: Healthcare

  • Dear Tim

    Dear Tim

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    Tim Cook steps down as Apple’s CEO on September 1, 2026, and John Ternus takes over. Many of the recaps of the Cook era will lead with the iPhone, services, and the trillions of dollars of market cap. Far fewer will take seriously the claim he made to Jim Cramer in January 2019: “I believe, if you zoom out into the future, and you look back, and you ask the… Read more

  • The Patient Will See You Now

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    For two decades, technology has expanded patient agency over information. Search put medical knowledge in the browser. Wearables put physiology on the wrist. LLMs put explanation on demand. All of that mattered, but none of it changed where medicine begins. Patients became better informed participants in institutional care. They could read more, track more, and ask better questions. But the choreography around the patient stayed the same. The system initiated.… Read more

  • AI Jevons Paradox: Why AI May Create More Work, Not Less

    AI Jevons Paradox: Why AI May Create More Work, Not Less

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    The prevailing narrative about AI and white-collar work is a displacement story: AI learns a cognitive task, the humans who perform that task lose their jobs, and the only question is how fast it happens. Software engineers are the canary. Lawyers and accountants are next. Eventually, the thinking goes, most knowledge work gets automated away. There’s a problem with this narrative. It mistakes the death of a role for the… Read more

  • LumiHealth: What Building a National Health Game Taught Me About Behavior Change

    LumiHealth: What Building a National Health Game Taught Me About Behavior Change

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    A toast to the program I built at Apple with Singapore — and a case for why wellness is infrastructure, not a nice-to-have. Tim Cook once said, “If you zoom out into the future, and you look back, and you ask the question, ‘What was Apple’s greatest contribution to mankind?’ It will be about health.” I used to think about that line often when I worked at Apple. And it… Read more

  • The Humbling Math of Health AI: Why ChatGPT Can’t Grade Your Heart Yet

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    During my time at Apple, I developed deep respect for the engineers and data scientists working on algorithms for the Apple Watch. Watching them develop features like irregular rhythm detection for atrial fibrillation gave me an appreciation for just how hard this work is. The Apple Watch generates continuous, high-frequency data streams: heart rate sampled throughout the day, HRV measured during sleep, motion data at sub-second intervals. The sheer volume… Read more

  • When You Upload Your Medical Records to AI, Who’s Actually Protecting Them?

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    Forty million people ask ChatGPT health questions every day. This week, OpenAI and Anthropic made it official: connect your medical records, sync your Apple Health data, let the AI see your full health picture. The product pitches emphasize encryption, privacy (as I explored in health privacy in the AI era) controls, and promises not to train on your conversations. Here’s what they don’t mention: your conversations with ChatGPT or Claude… Read more

  • The New Computer in the Clinic

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    Andrej Karpathy describes the current moment as the rise of a new computing paradigm that he calls Software 3.0. as large language models emerge not just as clever chatbots but as a “new kind of computer” (“LLM OS”). In this model, the LLM is the processor, its context window is the RAM, and a suite of integrated tools are the peripherals. We program this new machine not with rigid code,… Read more

  • AI and the Prepared Mind: Engineering Luck in Drug Discovery

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    We are at a fascinating, paradoxical moment in the history of medicine. We stand in awe of a new AI-powered “Logic Engine” for drug discovery—a computational marvel like AlphaFold, which treats biology as an information system to be engineered. It promises a future of rational discovery. And yet, when we look at our most important medical breakthroughs, so many were not rationally designed. They were the result of messy, unpredictable,… Read more

  • How AI Gets Paid Is How It Scales

    How AI Gets Paid Is How It Scales

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    Almost ten years ago at Apple, we had a vision of how care delivery would evolve: face‑to‑face visits would not disappear, virtual visits would grow, and a new layer of machine-based care would rise underneath. Credit goes to Yoky Matsuoka for sketching this picture. Ten years later, I believe AI will materialize this vision because of its impact on the unit economics of healthcare.  Labor is the scarcest input in… Read more

  • When AI Meets Aggregation Theory in Healthcare

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    Epic calls itself a platform. And with the show of force at UGM last week, that’s exactly how the company now describes itself: inviting vendors to “network with others working on the Epic platform,” marketing a “cloud‑powered platform” for healthcare intelligence, and selling a “Payer Platform” to connect plans and providers. Even customer stories celebrate moving to “a single Epic platform.” But is Epic really a platform? The TL/DR is… Read more