The techno-pragmatist: bridging clinical reality and product to design health technology that holds up inside large, matrixed systems—where the hard work is never the technology.
About
I am a practicing hospitalist and physician informaticist working within the leadership of a large, matrixed health system on the organizational and strategic challenges of deploying technology at scale. The distance between a sound idea and reliable adoption is rarely technical—and that gap is where I spend most of my time.
My vantage point is unusual: I am a shift worker, which means when I am on a clinical shift, I am fully a hospitalist—no split attention. When I step off the floor, I step into the work of making technology actually function inside the environments I just came from. That oscillation—between the bedside and the systems built around it—shapes everything about how I think.
My framework—the techno-pragmatist—is not a posture of skepticism. It is a commitment to rigor. I take new technology seriously when it demonstrably improves the experience of delivering care, not when it impresses a room. I am as conversant in enterprise implementation as I am in clinical evidence, which makes me a useful bridge between the institutions building health technology and the clinicians it is meant to serve.
"The hardest problems in health technology are not engineering problems. They are trust problems, workflow problems, and organizational problems."
Point of View
Clinician resistance to a new tool is data, not noise. Sometimes it points to poor design—the tool doesn't fit the workflow, or it adds steps instead of removing them. Sometimes it traces to distrust of the institution deploying it, in which case a rollout can only move as fast as that relationship allows. Either way, a failed launch doesn't reset to zero. It raises the bar for everything that follows.
Every alert, click, and screen transition carries a cognitive cost that nobody in the vendor meeting is accounting for. A clinical tool belongs in the workflow only when it surfaces the right information at the right moment, faster than the current way of working, without demanding anything extra in return. Anything less charges clinicians for the privilege of using it.
The era of curiosity and experimentation has given way to one that rewards discipline. There are now more AI tools than any health system can responsibly absorb. The most valuable skill in technology strategy is no longer the ability to evaluate a new tool—it is the willingness to decline one that does not align to strategy, and to hold that line under pressure.
The gap between what clinicians actually need and what builders ship is where most health technology fails. Closing it requires someone who has sat on both sides of the table—who understands what care actually looks like at 2 a.m. and what a product team needs to hear to build something that survives contact with it. That translation work is not a soft skill. It is the work.
Burnout is not a resilience problem. It is a design problem—the accumulated weight of systems that demand more than they give back. The health systems that will retain their clinicians are the ones that treat cognitive load as an organizational responsibility, not an individual one. Enabling people to do their best work, with less friction, is not a wellness initiative. It is a competitive advantage.
Media & Press
Podcasts & Video
Written Press
Writing
I write on clinical practice, health technology strategy, and organizational change—the terrain where most of the real work happens. New essays are published on Substack, covering everything from how clinicians actually adopt tools to what health systems get wrong about AI.
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"Most of what gets written about health technology is written by people who have never used it under pressure. The goal here is to write from inside the work—from the wards, the war rooms, and the vendor calls—and be honest about what it actually takes."
Affiliations & Credentials
Contact
I am available for speaking engagements, advisory work with health technology companies and startups, and press inquiries. Please use the form to get in touch.
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