Josh Mandel, MD

Josh Mandel, MD

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Chief Architect SMART Health IT; FHIR/clinical apps

Prune Idle Session History to Cut Resume Costs
SocialApr 23, 2026

Prune Idle Session History to Cut Resume Costs

Hmm @AnthropicAI or knowledgeable users, does "full" here mean "including pre-resumption"? >The design should have been simple: if a session has been idle for more than an hour, we could reduce users’ cost of resuming that session by clearing old thinking...

By Josh Mandel, MD
When Comfort Slogans Blur Between Flights and Funerals
SocialApr 18, 2026

When Comfort Slogans Blur Between Flights and Funerals

Airline platitude or undertaker platitude? "It is our honor to care for you on your journey."

By Josh Mandel, MD
Claude Opus 4.7 Autonomously Validates COVID‑19 Drug Claims
SocialApr 18, 2026

Claude Opus 4.7 Autonomously Validates COVID‑19 Drug Claims

This seemed like a fun task for Claude Opus 4.7! https://t.co/Z5qJwBNYwi has an example run on the claim "Hydroxychloroquine improves clinical outcomes in patients with COVID-19." https://t.co/kn0aWevNVv describes the pipeline. I spent 3-4h on this with Claude Code managing 10...

By Josh Mandel, MD
SMART Permission Tickets Enable Seamless Patient and Proxy Access
SocialApr 14, 2026

SMART Permission Tickets Enable Seamless Patient and Proxy Access

How might SMART Permission Tickets help with patient self-access, proxy access, public health, and more? Overview / explainer / live demo here: https://t.co/AHJ8s5oBuA

By Josh Mandel, MD
97 Submissions Analyzed: Imaging Interop RFI Findings
SocialMar 19, 2026

97 Submissions Analyzed: Imaging Interop RFI Findings

My Regulations dot gov comment analysis of 97 submissions on the Imaging Interop RFI is up and ready at https://t.co/fsO7u7hidD Quick summary article here...

By Josh Mandel, MD
Health IT Licensing Must Shift From Seats to Token Usage
SocialMar 8, 2026

Health IT Licensing Must Shift From Seats to Token Usage

Direct implications for Health IT licensing -- as HTI-5 proposes AI/RPA as a first-class means of "access"/"use" of health information.

By Josh Mandel, MD
Most Health Systems Stall Patients' HIPAA Record Rights
SocialFeb 20, 2026

Most Health Systems Stall Patients' HIPAA Record Rights

HIPAA guarantees patients a right to their own medical records. In practice, most health systems require patients to fill out a release-of-information form designed for a different legal purpose; justify why they want their own data; and wait. I sampled...

By Josh Mandel, MD
Deregulation Must Preserve Interoperability, AI Access, and Bulk FHIR Metrics
SocialFeb 19, 2026

Deregulation Must Preserve Interoperability, AI Access, and Bulk FHIR Metrics

SMART Health IT team submitted formal comments on HTI-5. Feel free to read and borrow language. Briefly: Deregulation should not mean losing sight of whether interoperability is actually working. (HTI-5 risks eliminating the instrumentation ASTP/ONC needs to steer a successful...

By Josh Mandel, MD
AI Skill Automates Faxing Healthcare Requests in 2026
SocialFeb 18, 2026

AI Skill Automates Faxing Healthcare Requests in 2026

It's 2026, so... I just wrote a Claude Skill that faxes a request form to my healthcare provider.

By Josh Mandel, MD
EHR Export Docs Reviewed: Gaps, Wins, and Fixes
SocialFeb 17, 2026

EHR Export Docs Reviewed: Gaps, Wins, and Fixes

I analyzed the mandatory "EHI Export" documentation for essentially every certified EHR on the market. Read on for the full picture; examples of the good, the bad, and the ugly; and recommendations for ONC, vendors, and patients to improve access...

By Josh Mandel, MD
HTML Comments Reveal Vendor’s Intentional Export Method Distinction
SocialFeb 17, 2026

HTML Comments Reveal Vendor’s Intentional Export Method Distinction

Your human users might only read the visible content in your page, but bots read the HTML comments :-) I appreciated this nugget from my EHI Export analysis, and I have to say that I agree with "kendra/sli", they had...

By Josh Mandel, MD
Josh Mandel, MD | Pulse