The American health system is built to bill — not to remember, not to care, not to answer to anyone. I’m building the layer that does: human, attested, and owned — across the whole journey, from the surgeon’s code to the family’s receipt.
Every piece I build stands on those four. Only those.
I didn’t have to argue this one. In a single recent stretch, Firely, the ATA’s new AI-policy body, Primary Venture Partners, John Bass at Hashed Health, the RCM establishment, and the open-source clinical-AI project Kartha each said a version of it: the model is a commodity; the accountable signature is the product. Eighteen states have written it into law; the FDA permits clinical AI as safe decision support only when a licensed clinician independently reviews it; the AMA calls it augmented intelligence — never an autonomous decision-maker.
When everyone converges on your thesis, the thesis stops being the moat. What’s left is the two things nobody combines: who signs, and who owns.
The shared spine: AI drafts, a named licensed physician signs, and the signature becomes a hash-anchored, FHIR-mapped record that compounds. That ledger is the moat, and it’s the same organ everywhere.
Solace owns navigation. Homecare Homebase owns the EHR. Welby owns remote monitoring. The RCM giants own claims at scale. None of them owns the attested, human-signed, owned record across the whole journey — the one asset that gets more valuable the more surfaces touch it, and the one thing AI makes possible and can’t commoditize. That connective tissue is SolvingHealth.
The medical record bills. Ours remembers — and answers to someone.
Blaine Warkentine, MD · SolvingHealth · Boulder, CO · orthoblaino@gmail.com