Posts on health system strategy as technology shifts capabilities and demand beyond hospitals and clinics.
Every published post with this tag.
Advocate Health saw patient connections between MyChart and ChatGPT rise more than 7,000% in one month. Hospitals must pay to deliver the records while ChatGPT increasingly competes with them to interpret those records for patients.
Forty-five of 49 telehealth sites prescribed a GLP-1 to a fake patient based on a web form and an upper-body photo. The prescription requirement doesn’t exist in practice. Given a benign 20-year safety record and a new FDA pathway for OTC drugs that need screening, it may be time to stop pretending otherwise.
It’s commonly asserted that America has a looming shortage of doctors. But Boston has more doctors per capita than any state in America — and it also has the longest appointment wait in the country. What the doctor-shortage debate measures, and what it doesn’t.
Everyone I know in healthcare says long appointment waits are the result of a doctor shortage. I plotted wait times against physician supply across 15 metros and found no correlation — in fact, the biggest metro in the state with the most doctors per capita (Mass) has the longest waits.
The front door to healthcare is a funnel: it directs patients to higher-level care, where the money is. Oura and Whoop are rebuilding that front door on a consumer subscription — and the demand it absorbs never shows up in the claims data.
I speak with at least 100 healthcare leaders each year. They track everything — length of stay, readmissions, OR utilization, revenue cycle velocity. The one thing they're not tracking at all? The demand leaving the system entirely. And a Harvard finding that should have set off alarms six years ago has gone almost completely unnoticed.
OpenAI and Anthropic both launched enterprise healthcare AI offerings last month. OpenAI's is more complete — a ready-to-use product for clinicians plus an API for developers. Anthropic's is developer-focused, with connectors to healthcare databases like CMS and ICD-10. Both will eventually offer the full stack. The question is what you need now.
In the first week of January 2026, Utah, and OpenAI each drew a different line around health AI — and liability. Utah’s Doctronic pilot treats AI like a clinician, with malpractice coverage and preserved remedies. OpenAI adds medical-record syncing under unchanged disclaimers and a $100 cap.
Blue Cross Blue Shield of Massachusetts just posted a $400 million loss — the worst in their history. The culprit? GLP-1 medications that could eventually save insurers billions. The costs hit today, the savings arrive years later, and health systems are caught in the middle.
GLP-1 medications may do far more than treat diabetes or reduce weight. If they substantially cut obesity and metabolic disease, they could trigger the first large-scale decline in healthcare demand seen in the modern era. This piece explores how earlier demand shocks reshaped medicine, why GLP-1s pose a similar challenge for chronic-disease–based service lines, and what hospitals must do now to prepare for a world with fewer cardiometabolic patients.
The New York Times built one of the best digital products in media — yet its real revenue and profit have fallen by more than half. That’s what disruption actually looks like: the work moves elsewhere while the industry shrinks. Healthcare is now entering the same pattern, driven by consumer tech, GLP-1s, and safer mobility. We’re heading toward better health — and a smaller healthcare system.
Lawmakers are moving to ban AI-only insurance denials, requiring human sign-off for every case. It sounds compassionate, but it locks us into the same slow, opaque, costly system. The smarter move is AI with guardrails — transparency, audits, and contestable rationales — for faster, clearer, more accountable decisions.
From telemedicine to wearables, fewer clinic visits mean fewer emissions. And as new products like low-carbon inhalers and self-administered HIV therapies move toward over-the-counter access, the environmental benefits of consumerization become even clearer.
Most doctors, nurses, PAs, techs, and others in healthcare aren’t familiar with the term “disruption” and are unaware of how technological trends have already begun disrupting their current business models. This post is the first of three that will provide a basic understanding of the term, and the phenomenon.