I have spent more than twenty years in healthcare technology, first as a consultant at EY, Accenture and Capgemini and then on the operating side, where I am now Chief Digital and Information Officer at Smile America Partners. Before any of that I studied economics at UCLA, and later took my MBA at UCLA Anderson. These essays sit where those two halves meet: how systems work, what they cost, and why intelligent people keep misjudging them.
What this is
Paper and Ink is a collection of point-of-view essays. Each one takes a question people argue about (whether to normalize a database, how to budget for technology, what a market shock means) and tries to replace the argument with an explanation. Most disputes, I have found, are not disagreements about facts. They are confusions between two kinds of thing that look alike: a purchase and a commitment, a jolt and a fracture, a record and a question.
The essays fall into three subjects: technology leadership, systems and data, and markets and economics. Some are pegged to the week's news and carry their date, so you can judge them against what happened next. Others are meant to read the same in ten years.
How they are made
These essays are mine: the questions they pursue, the arguments they develop, and the conclusions they reach. I shape each piece’s structure, evidence, intended reader, and final language through writing, revision, and editorial judgment.
I use Claude, Anthropic’s AI model, to support that work: researching sources, testing arguments, and developing drafts under my direction. Its suggestions are material to examine, challenge, rewrite, or discard. I decide what belongs, what holds up, and what ultimately gets published.
Every factual claim carries a citation, and figures based on models rather than measured data are identified in their captions. The arguments, opinions, and responsibility for the finished work are mine. So are the mistakes.
A good essay should leave you able to reason about the next case without me.
Why it looks like this
Every illustration is a physical paper object resting on the page: a thermal receipt, an index card, a sheet of graph paper held down with masking tape, all drawn in ink, pencil and rubber stamps. Color appears only to mark the two ideas an essay pulls apart, gold for one and blue for the other. Both come from the blue and gold of my alma mater. The aim is the feel of a good printed essay: quiet, unhurried, and meant to be read to the end.
House rules
- Start with something you can hold. A toaster, a change-of-address card, a nutrition label. If an idea cannot be shown with an everyday object, I probably do not understand it yet.
- Sort the kind before judging the case. Ask what kind of thing happened before asking whether it was good or bad.
- Cite the facts, label the models. Sources sit at the foot of every essay, and illustrative figures say they are illustrative.
- Write at the level of the industry. These are my own views. They do not speak for Smile America Partners or anyone else I work with, and they do not discuss any employer's systems, vendors or patients.