Field notes

Clinical practice, in writing.

Start with the latest field note. The archive is organized for clinicians checking a specific question, not for browsing noise.

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Patient experience

Latest

Two minutes a day: the cognitive math behind a 14-day reflection arc

Daily mental-health check-ins fail when they ask for too much. Here is the cognitive-load budget behind the 14-day arc, why streaks were the wrong primitive, and how voice changes the math.

June 1, 20267 min read

Read by question.

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Compliance

HIPAA in-progress: an honest compliance posture for beta clinical software

Most healthcare software vendors back-date their HIPAA compliance language. Here is the version that admits what is shipped, what is in build, and what is on the roadmap, without inventing a badge.

May 31, 20267 min

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Architecture

The evidence map: why we built a graph instead of a chat

Clinical LLMs hallucinate when they reason against a transcript. They stop when they reason against a graph. Here is how the evidence map is structured and why every claim carries a receipt.

May 30, 20267 min

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Safety

Item-9 escalation: designing crisis detection without panic buttons

PHQ-9 item 9 asks about thoughts of self-harm. How an app responds the moment that item is non-zero is the difference between safety and theater. Here is how we built the surface.

May 29, 20267 min

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Clinical practice

The case for 14-day mood check-ins between therapy sessions

Between-visit drift is the quiet failure mode of outpatient behavioral health. Here is why a structured 14-day reflection arc closes the gap without becoming a second EHR.

May 22, 20266 min

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Clinical instruments

PHQ-9 and GAD-7: what clinicians actually watch for

PHQ-9 and GAD-7 are the two screens that show up in nearly every behavioral-health workflow. The thing nobody teaches outside of training: the score is the least interesting part. Here is what to read instead.

May 18, 20267 min