The spine essay states the problem and the destination. Each piece after it goes deep on one part.
Healthcare pushes its coordination work onto patients and families because everything must pass through one narrow opening. Why that happens, what it costs, and what becomes possible when software can absorb the work instead of streamlining it.
The full model: identity, stability, action — and the learning layer underneath. How care changes when the system runs on all three instead of only the fastest one.
Demand rising, the clinical workforce retiring, and the family caregivers who absorb the overflow thinning out — all arriving at once. This is not a forecast. The people are already alive and their ages are known.
What changes technically when a system watches a person's expected path instead of a population cutoff.
Not a better portal. A different surface — and what building one for a blind user taught me about designing for everyone else.
Graduated engagement as equity design. Why a system should never charge attention as the price of good care.