Twitxy Saved

Josh Mandel, MD

Verified account This account is verified. Learn more

@JoshCMandel

physician, programmer, and would-be pâtissier/poet. Chief Scientist at @AledadeACO and Architect for @SMARTHealthIT.

Bsky: josh.mandel.md
Madison joshuamandel.com Joined June 2012
624 Following 3.4K Followers 1.5K Posts

Latest posts 5

Josh Mandel, MD Verified account @JoshCMandel
"Maybe model intelligence improvement outstrips my feature appetite such that it's fine" -- for small scale hobby projects, this is exactly how I'm experiencing things
Patrick Collison Verified account @patrickc Oct 31
I'm now building an "improvements" feature into all of my personal vibecoded applications: a freeform text input that's hooked up to an agent that yolo implements whatever is submitted.

It's an interesting experience -- the activation energy barrier to sanding any rough edge or implementing any new feature becomes extremely low. Someone else who uses one of the applications I created has already implemented 150 improvements over the course of a few days. This pattern feels like a new kind of tool -- liquid software? -- and every application that doesn't have this feature now has a slightly rigid and anachronistic flavor. Why can't I just tell it how I want it to be different?

Now, it's not obvious to me how this pattern can or should scale. Does it become unmaintainable after a while? (Maybe model intelligence improvement outstrips my feature appetite such that it's fine?) How does collaborative software work in this model? Can software designed this way be secure and reliable?

Whatever the larger questions about broader deployment, it definitely works great in a personal context. It reminds me a little of the visions of Lisp/Lisp machines, Smalltalk, and HyperCard -- systems that the user can take control of and modify. Those visions never quite worked, though: the vast majority of software today is not end-user modifiable in any useful way. So, while this "liquid" affordance is a very small touch, the way it changes one's relation to the software feels a bit transgressive and empowering in a Lickliderian and Engelbartian way.
View quoted post on X
Josh Mandel, MD Verified account @JoshCMandel
On the theme of appetite for software being much larger than historical supply... Sometimes I wake up in the middle of the night and can just tell that I won't be able to fall back asleep. At times like these I reach for a podcast (played through headphones), but fumbling with my phone and selecting it and hitting play and adjusting the volume are all little unnecessary movements (and light!) that can disturb my wife. Last night I had Claude build a replacement for the default Android screensaver -- it only activates when my phone is plugged in on its charging stand at night, and when it is active it notices if I turn on my Bluetooth headphones and automatically selects the next unplayed episode of my mindless-content-for-when-I-can't-sleep podcast and plays it after setting the volume to a quiet default. The phone screen, while still black, turns into an interface I can tap once to toggle pause/play, and horizontally drag to adjust volume within a constrained range (0-20% level). This setup supports zero-touch default case, and any manual parts are "wide targets" that I can actuate silently -- and with my eyes closed. I built the whole thing using Claude code on my phone, remoted in to my desktop on the home Wi-Fi which can connect back to my phone over ADB to install, test, and run software on the phone. 15min project!
1 replies 0 reposts 12 likes 645 views View on X
Josh Mandel, MD Verified account @JoshCMandel
This is an exciting integration pattern, but very asymmetric: patients don't get their choice of agents. (Emmie can access MyChart capabilities that other agents can't.) See "Who Gets to be the Agent?" at x.com/JoshCMandel/st…
Epic @HeyEpic Oct 21
Introducing Connectors: a new way for apps to communicate with Epic.

Developers can soon build Connectors that bring information from other apps into Epic, like pulling arrival time from an ambulance app so the ED can prepare without switching between apps.
View quoted post on X