A small collection of essays on AI, healthcare automation, and the working life of a medical practice. Written slowly, published when we have something worth saying.
11 min read
Since January 1, payer decision windows have tightened to 72 hours expedited and 7 days standard — and by 2027, every impacted payer must expose a FHIR Prior Authorization API. The bottleneck is moving from the payer to the practice. A field guide for the groups preparing now.
12 min read
The ambient scribe was the gateway. Agentic systems — tool-using, multi-step, workflow-native — are what comes next. A four-tier autonomy model for thinking clearly about trust, oversight, and where AI should (and shouldn't) act.
10 min read
Consolidation fatigue is real, the operating-layer cost curve is compressing per-physician admin cost, and the regulatory direction now favors interoperable small practices. The conditions for staying independent are shifting — this time in the practice's favor.
9 min read
Global word-error rate has stopped being the useful number. The accuracy ceiling now lives in five clusters: specialty vocabulary, multi-speaker/accent scenes, quiet dictation, numerical data, and negation. An engineering-first read on what's actually hard.
12 min read
The medical coding market is projected to grow from $2.98B to $9.16B by 2034. Inside the practices already pushing automation past 94% with 99% accuracy — and what it means for the next decade of revenue cycle.
10 min read
The first HIPAA Security Rule update in 20 years is reshaping how AI vendors must handle PHI. A working reference for covered entities and business associates.
9 min read
2024 data puts burnout at 48.2% of physicians, with 62% citing administrative tasks as the primary driver. A look at the mechanics, the cost, and the interventions that actually move the curve.
8 min read
Recent OECD and WEF research shows augmenting clinicians with AI delivers 30–50% productivity gains without the safety trade-offs of full replacement. The argument for a copilot, not an autopilot.
Vol. III is open with the buyer’s guide and the revenue-cycle essay. The next set: a longer look at the first twelve months of running a real medical practice on the Sarthi operating layer — measurement, where the trust curve bends, and what we got wrong. Subscribe below and we’ll send the next one when it’s bound.
New essays, reading lists, and occasional dispatches from the practices we work with. No product announcements, no lifecycle drip — just the writing.