Perspectives
Writing for practitioners, not for procurement.
Short essays on the architecture craft, the standards world, and the two-clock problem that every national digital-health programme sooner or later runs into. New pieces published irregularly.
What national digital-health programmes actually fail at
After four decades and dozens of national programmes on four continents, the failure modes are surprisingly consistent, and almost none of them are technical.
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A standard is a social artifact before it is a technical one
The most common mistake in standards work is treating the standard as a technical artefact that will succeed or fail on its technical merits. The most consequential decisions in a standard are almost always social.
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Why federated beats central for population-scale health data
The single biggest architectural mistake in national digital-health programmes is not a technology choice. It is the assumption that a central data warehouse is the natural end-state and that federation is a compromise.
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