clinicians.dev

A community of clinical experts super-powered with skills in agentic engineering. Our roots are in coding and clinical medicine. We know how to create and supervise LLMs writing Python, SQL, R, JS, HTML. We love startups, regs, policy, UI/UX, data viz, project management, informatics. We want to create the medicine of the next 100 years.

✉ Email for Slack invite → Slack → Substack ↓ Next event

today · the wire

The Wire

What you'll be asked today — and what to say back. A couple that caught my eye this morning; the rest are on the wire.

Duke built its own chart-summarizing AI because no vendor had one

Becker's Hospital Review · Jul 2026

Duke's in-house tool, Scout, reads a patient's full chart inside Epic and hands back a summary in one to three minutes with links to every source document — it went enterprise-wide this month after Duke's own team concluded no vendor sold anything comparable. The preprint RCT: about 40% faster task completion, 40–50% lower cognitive workload. The more interesting number is the ten years Duke spent building the underlying data-access layer before the model was ever the hard part.

BuilderYour competition for the summarization layer isn't another startup — it's the customer's own informatics team with full chart access and no procurement cycle. What they can't easily replicate is cross-site generalization and maintenance at scale. Sell that, not the demo.

The email that cost a children's hospital $5.3 million came from a furniture vendor

Becker's Hospital Review · Jul 2026

Three stories broke this week and they share one lesson. AnMed closed dozens of clinics and imaging sites after a malware disruption. Children's Healthcare of Atlanta lost $5.3 million to a business email compromise that came through a hacked furniture vendor's account. And a single practice-management vendor's breach exposed 442,000 patients across unrelated provider organizations. None of it started inside a hospital firewall — it started with vendors and email.

The White House just gave HHS and NIH a 90-day AI deadline

Becker's Hospital Review · Jul 23

A White House memo directs every federal agency with $3B+ in R&D authority — HHS and NIH included — to realign FY2028 budgets around nine priorities led by AI, and to file implementation plans within 90 days. For health data specifically, it elevates NIH's Genesis Mission — longitudinal cohort data plus supercomputing — to a budget priority, which health IT watchers are already reading as validation for EHR data strategies like Epic's Cosmos. Budgets are strategy — when FY2028 dollars re-rank around AI, every grant-funded partner you have re-ranks with them.

Is Epic's noncompete employer list about to get struck down on appeal?

Becker's Hospital Review / Brendan Keeler · Jul 27

Veeva has appealed the dismissal of its suit over Epic's restrictive employment covenants, after Epic added Veeva to its internal prohibited-employer list and a job candidate withdrew from Veeva's hiring process over noncompete risk. The trial court dismissed on standing but did it with prejudice — that distinction is now the core of the appeal, and Brendan Keeler, who called the original dismissal correctly, thinks Veeva ultimately wins.

HatersEpic doesn't need to win this case for the list to work. The chilling effect on candidates already did its job — appeals take years, and by the time a court rules, the hiring cycles that mattered are over.

86% of physicians read your wearable data. It shows up in the chart 6% of the time.

Radio Advisory · Jul 28

Rock Health's Megan Zweig lays out the gap and three ways it's closing: health systems building their own monitoring ecosystems, integration layers piping wearable data into clinical workflow, and wearable makers standing up their own care delivery — Mayo Clinic just chose to invest in Whoop's $575M round rather than sit downstream of it. Demand was never the problem here.

80/2086% of physicians already look at the data and 6% have it in workflow. Demand is solved — the integration layer is the whole game.

Read the full wire ↗

learn by doing

Interactives

Companion experiences for the newsletter — don't just read about it, try it.

Cleared Before Measured

July 29, 2026 · Source: Chalouhi et al., npj Digital Medicine — multireader fetal ultrasound study (Jul 28, 2026) · MIMI Labs · FDA 510(k) release, imaging-AI product codes, decisions through Jul 17, 2026

Every FDA 510(k) clearance in the imaging-AI product codes — 369 dots, 184 companies, 2016 to July 2026 — plotted against review time and colored by what the device is allowed to claim. Only 20% sit in a detection/diagnosis code; more than half just segment and measure. Raise "min clearances per company" to 5 and the median review drops 140 → 123 days; filter to first submissions only and it climbs to 172. Critical lens: nothing in the 510(k) record says whether anyone ever ran the unassisted arm.

The Unassisted Arm

July 29, 2026 · Source: Chalouhi et al., npj Digital Medicine, published Jul 28, 2026 · device: Sonio Suspect, FDA K243614 · study funded by Sonio, a Samsung company

All 750 fetal ultrasound stills from yesterday's multireader study on one field — 250 abnormal, 500 normal — with the AI switching on and off. Unassisted, 13 U.S. physicians caught 136 of 250 abnormalities and agreed with each other 26% of the time. Then the stress test the study didn't run: drag prevalence from the enriched 33.3% down to a real 3% anomaly screen and PPV falls from 78.5% to 18.4%.

Browse all interactives →

from the substack

Builder's Briefing

The newsletter — what shipped this week, what it means, and what to build next. A couple of recent issues.

Duke built its own chart reader 🔦, ~80 AnMed sites go dark 🕳️, Being safe vs feeling safe 🤔

⚡ Around the Wards

Read on Substack →

VA signs a $1.6B agent license 🏛️, Hopkins won't scale one yet 🧪, Evals are the new PRDs 📋

⚡ Around the Wards

Read on Substack →

What the Vibe

Saturday, May 30, 2026 · 12p–2p ET

Vibe coding changed everything. The barrier to building just disappeared. So what's the vibe? Is clinicians.dev dead? Does knowing how to code still matter when anyone can build? Four clinician-builders. Twelve minutes each. Show us what you made — vibe-coded, hand-coded, or somewhere in between.

Tentative speakers

Joe Izzo

First, Do No Harm — Especially With Your MVP: A CMIO's Advice in the Clinician-Builder Era

Patrick Damaso

Trajectories, Not Targets: Catching Reward-Hacked Diagnostic Reasoning One ICD Branch at a Time

Sam Wang

Silent Denials, Loud Insights: Visibility into the Payors Who Won't Show Their Work

Matt Segar

From Bedside to Buyout: An EP Fellow Path to Acquisition

4 talks (12 min each)
1:1 breakouts after each
Group discussion
Open community talk: "What the Vibe?"

RSVP on Luma →

01 · Learn

AI & agentic engineering

The foundational reads, the tools clinicians-who-code are actually using, and the loop that ships.

Context engineering — the foundation

Effective Context Engineering for AI Agents

Anthropic's foundational guide.

Building Effective Agents

When to use workflows vs. agents, and how to structure both.

2026 Agentic Coding Trends Report

How teams are actually shipping with agents.

Learn `CLAUDE.md` / `AGENTS.md`

The spec files that make agentic coding repeatable.

🔁 The Ralph Wiggum Pattern — the loop that ships. Tight spec → agent implements → you verify → adjust spec → repeat. Just keep going.

Tools of the trade

Tool	Best for	Notes
Claude Code	Complex multi-file work, architecture	Terminal-native, large context. The power tool. Good for non-code tasks too.
Cursor	Daily coding with autocomplete + inline edits	AI IDE, huge user base.
Windsurf	Budget entry, Cascade collaboration	AI-native editor.
Copilot / Codex CLI	Repo-native GitHub workflows	Tight GitHub integration.

Agentic frameworks & orchestration

CrewAI— multi-agent orchestration, clinical workflow pipelines
LangGraph— graph-based agent workflows with state
AutoGen— Microsoft's multi-agent conversation framework
MS Agent Framework 1.0— production .NET + Python
DSPy— programmatic LLM pipelines, good for clinical NLP

02 · Communities

Communities, courses, substacks

Where clinician innovators and clinician builders are hanging out.

EHRs, FHIR, fake patients

The pipes you'll need when you're actually building.

EHRs & FHIR

🔑 SMART-on-FHIR / OAuth flow — fhir.epic.com/Documentation?docId=oauth2

Clinical datasets worth knowing

From CXRs to genomes to ICU waveforms. Filter by name, modality, or license.

Name	Relevance	License
ReXGradient-160K	160k multi-site CXR + reports — vision-language radiology sandbox.	Harvard DUA, non-commercial
CheXpert Plus	Large paired CXR–report set; benchmarked in many papers.	Stanford DUA, free research
Endoscapes 2023	Open laparoscopic chole frames — segmentation / CVS detection.	CC BY-NC-SA 4.0
Surg-3M	3M surgical frames powering "SurgFM" foundation model.	TBA, expect research-only
AFRICAI Repository	Imaging sets from African centres — fairness & domain shift.	Mixed open licenses
OpenOximetry	Waveforms + skin-tone data for pulse-ox bias work.	PhysioNet credentialed
DeepLesion	32k CT slices with bounding-box lesions; detection / tracking.	NIH DUA, research-only
BioASQ Synergy 2024	Biomedical Q-A pairs — LLM eval set.	CC BY 2.5
CliniFact	Clinical-trial fact-checking corpus — fine-tune retrieval / RAG.	MIT
Hallucination Annotations	Doctor- & LLM-written discharge summaries with token-level labels.	PhysioNet credentialed
Clinical-Trial Eligibility QA	QA pairs linking MIMIC-IV to apixaban RCT criteria.	PhysioNet credentialed
PIFIR	Wearable PPG/ECG for arrhythmia-free interval prediction.	PhysioNet restricted
GREGoR R02	Rare-disease genomic + phenotypic harmonised data.	dbGaP controlled
Synthetic Rare-Disease EHRs	Benchmark synthetic EHRs for low-prevalence conditions.	CC BY
Korea4K	4k Korean genomes — ancestry diversity for variant calling.	EGA controlled
OpenNeuro	20k+ public neuro-imaging sessions; BIDS-ready.	CC0 / CC BY-SA
Bridge2AI-Voice	Multimodal speech (voice, vitals) for health AI.	PhysioNet restricted
PMDB Pain Monitoring	Wearable IMU + self-report pain diary.	CC BY 4.0
DREAMT Wearable Sleep	Apple Watch PSG pairs for sleep-staging models.	PhysioNet restricted
MC-MED	Multi-condition medical dialogue (GPT / human).	PhysioNet credentialed
Wearable Stress Dataset	Smartwatch vitals + stress labels — mental health ML.	PhysioNet restricted
MIMIC-IV v3.1	Flagship 380k-patient de-id EHR; ED + ICU tables.	PhysioNet credentialed + CITI
MIETIC	Italian clinical-notes corpus with entity spans.	PhysioNet credentialed
ODD (Opioid Behavior)	Annotated notes for opioid-related behaviour NLP.	PhysioNet credentialed
UK Biobank	500k UK adult cohort — EHR, surveys, genetics.	Controlled access
All of Us (NIH)	1M-goal US cohort — EHR, surveys, genomics, wearables.	Registered + Controlled tiers
TCGA	~11k patients across 33 cancer types — multi-omics + clinical.	Partially open
AmsterdamUMCdb	First open European ICU DB — 23k admissions.	DUA required
ADNI	Longitudinal Alzheimer's — serial MRI/PET, clinical, biomarkers.	Free non-commercial
ABCD Study	10k youths — neuroimaging, cognitive, mental health, genetic.	NIMH controlled access
NHANES (CDC)	US national survey — health, nutrition, lab data.	Public domain
CheXpert (original)	224k chest X-rays, 65k patients — labeled findings.	Free non-commercial
EchoNet-Dynamic	10k+ cardiac ultrasound videos with EF + ventricle volumes.	Non-commercial
Synthea	Realistic synthetic patient records — full EHR.	MIT
1000 Genomes	WGS from ~2,500 diverse individuals — human variation reference.	Open access
DementiaBank (Pitt)	Speech recordings + transcripts from Alzheimer's patients + controls.	Consortium access
VitalDB	6,300+ surgeries with continuous high-freq vital sign waveforms.	Open, registration + DUA
Medical Segmentation Decathlon	10 open datasets for 3D medical image segmentation.	CC BY-SA 4.0
PANDA	10k+ prostate biopsy WSIs with Gleason grades.	CC BY 4.0

05 · Conferences

AI & health conferences

Borrowed from Raihan Faroqui's healthcare AI resource guide. Filter to find your tribe.

06 · Jobs

Job boards that don't suck (as much)

What they are. Not endorsements — just the lay of the land.

jobs.heyhealthtech.com
Rock Health Capital
MDisrupt
PharmDs in IT
AMIA
General Catalyst— surprisingly good for startups
Matchday Health
Wellfound
Look for Zebras
Fractional Jobs
HealthTech Nerds Jobs

07 · Startup

So you want to build a startup

But don't know anything about tech/stack, marketing/sales, finances, management.

Life hacking / survival

Because clinician-builders need to not burn out.

09 · Experiments

LLM matrix tests (alpha)

Testing out LLMs with fake patient scenarios generated by GPTs.

Past events

Where we've been.

Fall 2025 Conference

Time	Speaker	Talk
1:00p	TBD	Welcome
1:10–1:22p	Josh Mandel, MD	Conversational Interoperability for Prior Auth and Beyond — MCP, A2A, and the Unreasonable Effectiveness of Making Data Accessible
1:35–1:47p	Jung Hoon Son, MD	Data CPR: How LLMs Revive Buried Clinical Insights
2:00–2:12p	Jason Theobald, MD	Contain Multitudes: A Docker Intro
2:25–2:37p	Calvin Johnston, MD	Software Design and Family Medicine: Overlapping skill sets
2:50p	TBD	Wrap-up

Summer 2025 Conference

Time	Speaker	Talk
1:00p	Kevin Maloy, MD	Welcome
1:10–1:22p	Vishnu Ravi, MD	Digital Health that Ships: An Open Framework You Can Use Today
1:35–1:47p	Alex Dummet, MD	Topic TBD
2:00–2:12p	Pawan Jindal, MD	Startup Survival 101: A Clinician's Guide
2:25–2:37p	Omar Usman, MD	Change Data Capture (CDC): A Defiant Approach
2:50p	Kevin Maloy, MD	Wrap-up

Fall 2024 Conference (Nov 9, 2024)

Time	Speaker	Talk
1:00p	Kevin Maloy, MD	Welcome
1:10–1:22p	Paulius Mui, MD	From 0 to 1: Becoming a Clinician Who Codes
1:30–1:42p	Brian Fung, PharmD	Path of the Clinician Engineer
1:50–2:02p	Joe Izzo, MD	The Coding CMIO — it's okay to get your hands dirty
2:10–2:22p	Karambir Khangoora, MD	Learning to Code as a Clinician: Building Medagogy
2:30–2:42p	Joey LeGrand, PharmD	One Brain Can Be Better Than Two
2:50p	Kevin Maloy, MD	Wrap-up

Podchat — Should Hospitals Mandate GenAI Training? (Aug 29, 2024)

Listen to a short podcast, then talk about whether it's right or wrong. Original from Bill Russell at This Week Health. → Meetup event

clinicians.dev

The Wire

Interactives

Builder's Briefing

What the Vibe

AI & agentic engineering

Context engineering — the foundation

Learn CLAUDE.md / AGENTS.md

Tools of the trade

Skills marketplaces

Healthcare MCPs

Agentic frameworks & orchestration

Communities, courses, substacks

EHRs, FHIR, fake patients

EHRs & FHIR

Generate fake patients

Clinical datasets worth knowing

AI & health conferences

Job boards that don't suck (as much)

So you want to build a startup

Life hacking / survival

LLM matrix tests (alpha)

Past events

Learn `CLAUDE.md` / `AGENTS.md`