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Do business plans work? Here's what the data actually says
New business owners often face the same dilemma: spend time writing a business plan, or spend a week finding their first customers. So which one actually
Do business plans work? Here's what the data actually says
New business owners often face the same dilemma: spend time writing a business plan, or spend a week finding their first customers. So which one actually matters? Xero’s guide to writing an executive summary covers the how. But often, business owners ask a different question: Why? Does the planning itself really impact what happens next?
Downtown Chico business owner voices concerns over street closures for events
A DOWNTOWN CHICO MERCHANT IS EXPRESSING CONCERN OVER THE IMPACT OF STREET CLOSURES FOR EVENTS -- ON THEIR BUSINESS. ACTION NEWS NOW REPORTER BELLA BARBOSA REPORTS FROM DOWNTOWN CHICO { "@context": "https://schema.org", "@type": "VideoObject", "name": "Downtown Road Closure Dilemma", "description": "A DOWNTOWN CHICO MERCHANT IS EXPRESSING CONCERN OVER THE IMPACT OF STREET CLOSURES FOR EVENTS -- ON THEIR BUSINESS. ACTION NEWS NOW REPORTER BELLA BARBOSA REPORTS FROM DOWNTOWN CHICO", "thumbnailUrl": "https://bloximages.newyork1.vip.townnews.com/actionnewsnow.com/content/tncms/assets/v3/editorial/c/47/c47e26d6-03c3-5f35-bf49-37925ab603d7/69bdedc4eb57d.image.jpg", "uploadDate": "2026-03-20T17:45:00-07:00", "contentUrl": "https://cdn.field59.com/KHSL/1774053903-6e1ef36dd09fbebf020833aee86b60da3b3cca3f_fl9-720p.mp4" } CHICO, Calif. - A downtown Chico business owner is voicing concerns about the impact of street closures for events on local shops. Leann Powell, owner of The Peddler’s Closet, expressed concern about events closing down streets downtown and bringing in food trucks and other shops’ products that directly compete with the brick-and-mortar stores in downtown Chico.Powell said an upcoming event held on a Saturday has brought up concerns for her and other business owners downtown, due to it being a busy day for businesses. "We're already struggling, and then to bring in more businesses on top of our businesses and shut our streets down is absolutely devastating," said Powell.Powell noted a decline in business during events like the Thursday Night Market, where street closures allow outside vendors to set up shop. She shared that while organizers for these types of events often offer booths to local businesses, it does not alleviate the burden."I don't really feel like that's a solution because you're bringing in other businesses, you're shutting the streets down. Yes, we can go down and set up a space, but then you've gotta pay somebody to run that space, plus run your own business for the day, and it's really not, it's really not helpful for us," said Powell.Applying for a street closure permit in Chico involves approval from the Public Works Department, the Chief of Police, and the Fire Chief. Permits can be denied only under a handful of circumstances, such as interference with first responders, previously scheduled construction, or existing permits for the same space.Mayor Kasey Reynolds addressed the issue, saying the city council has tasked staff with reviewing the municipal code for street closure permits with the goal of finding ways to minimize negative impacts on local businesses during events.Reynolds mentioned that any recommended changes might require further direction from the city council, depending on the extent of any changes recommended. googletag.cmd.push(function() { googletag.display('ad-1514992'); });
Riverside has a donkey dilemma. Can science offer clues for coexistence?
Researchers at UC Riverside are studying the Inland Empire's wild donkey herd in hopes of gaining insights that can improve coexistence between humans and burros.
Dilemma for Gattuso as Icardi Offers Himself to Lazio
Mauro Icardi has reportedly expressed his desire to join Lazio, but the final call lies with head coach Gennaro Gattuso.Lazio’s New-Look Attack Still Missing a Striker?The Biancocelesti revamped the...
Can AI solve our mental health access problem?
Last week I asked you what worries you most about AI in health. It was close, but your top answer was “AI giving bad health advice.” Last week’s poll results: You’re in good company. This concern was top of mind at a conference I joined at Stanford last week, where researchers, clinicians, and people who build AI systems spent a day debating trust and safety in health AI. Stepping back, I’m also hearing your emerging concerns about AI’s impact on our well-being generally. I see this as a matter of public health, and we’ll take it in pieces as we learn together. Today we’ll focus on AI chatbots used for therapy for mental health. Early this month, Governor Newsom vetoed Senate Bill 903, California’s most ambitious attempt to regulate AI use for mental health. It’s at the center of active debate, and raises the questions patients, family members, citizens, and voters will face as AI moves deeper into health care. Let’s work through it. What is “AI-based therapy”? It’s really two things: purpose-built mental health apps designed to deliver structured support, and general chatbots like ChatGPT, Claude, and Gemini that people increasingly use for emotional support—even if they weren’t built for it. Spoiler alert: I don’t know whether the shift toward AI therapy is good or bad. The evidence isn’t there yet. But I do know it’s already happening, and I have some ideas about how we can roll it out with safety in mind. The therapy dilemma, in a nutshell Mental health challenges are common, and strain health and well-being across populations. Therapy (interactive dialogue with a trained, empathetic practitioner) helps many people heal. The demand for licensed therapists far exceeds the supply in California, and AI-based therapy can narrow that gap. AI-based therapy remains novel, unproven, and not well tested. Right off the bat, we can see we’re dealing with trade-offs here. Since the main driver of demand for therapy from a robot is lack of access to therapy from a human, we’ll start there. It’s too hard to find and afford a human therapist California is short roughly 55,000 licensed, non-prescribing therapists and counselors, about 40% of what we need. Psychiatrists, who rely on talk therapy as a complement to prescribed medications, are even more scarce. Eight counties have none, and density ranges from 1.7 per 100,000 residents in San Benito County, to 68.1 in Marin County. My wife is a psychiatrist in Marin, and even here access is tight. If it’s hard in the best-supplied county, imagine rural Sierra County, or the San Joaquin Valley. In 2024, more than half of Californians who tried to make a mental health appointment struggled to find a provider who took their insurance, compared with 14% for physical health care. When Senate staff posed as “secret shopper” patients and called 120 mental health providers in Medicare Advantage networks, they landed an appointment less than once for every five tries. Insurers pay behavioral health clinicians about 22% less than medical and surgical clinicians for comparable office visits. On top of that, billing denials and prior authorizations hit hardest at the solo and small practices common in mental health. Psychiatrists opt out of Medicare at the highest rate of any specialty. In many places, a cash practice for therapy fills quickly with patients paying $250 or more an hour, with no insurance paperwork at all. Families who can pay cash find providers more easily. Those who rely on insurance, including Medi-Cal enrollees, older adults, rural residents, and non-English speakers, compete for what’s left. So we can’t pretend the human system works, and we can’t blame people for turning to AI for support when they’re in distress. AI is filling the gap It’s estimated that roughly a quarter of AI users use it for mental health support. If you have internet, it’s available 24/7, it’s cheap, and it speaks your language. Uninsured adults are about twice as likely as insured adults to do it (30% vs. 14%). It feels anonymous in ways that may enable people to ask things they’re unsure or embarrassed about. The largely hidden, personal use makes it hard to study whether it’s actually helping people with their mental health issues, but researchers are trying. Does AI therapy work? A 2026 analysis of nearly 40 randomized trials found chatbots showed a real but small reduction in depression symptoms. But most of these trials were compared to an alternative of no therapy, not a human therapist. So the benefit of AI therapy is probably real, but modest, and mostly untested against the alternative of human contact. We need more studies. Serious concerns OpenAI’s own estimate is that more than a million ChatGPT users each week show signs of suicidal planning or intent. These are high stakes encounters, and AI doesn’t always get it right. That’s partly because a chatbot can sound like a therapist, but it has no license, no duty of care, and it’s not clear who to hold accountable when it gets things wrong. AI is also designed to help users in whatever task they’re seeking to accomplish. People may feel like they’re getting therapy, but they’re mainly getting a convincing conversation. It’s easy for an AI companion to wander into gray areas, like playing along with “creative writing” that may be about the user’s own suicidal intent. Courts are driving safety conversations A wave of lawsuits have been filed on behalf of families claiming that chatbots pushed people they loved toward self-harm, including teens who died by suicide. The first settlements came this year. OpenAI is headquartered in San Francisco, and dozens of cases alleging that ChatGPT drove users to suicide or self-harm are now before a San Francisco judge. Character.ai has filed for bankruptcy after several states brought lawsuits accusing the chatbot of pushing dangerous content to kids. But the technology seems to be improving. Last month, an independent evaluation found that newer AI models “almost never endorse suicide.” That’s progress, but our societal appetite for even one preventable death is very low. So how do we move forward? Finding a middle ground Earlier this month the governor vetoed Senate Bill 903, a bill designed to place guardrails on the use of AI for therapy. The bill would have prohibited any AI-based platform from being advertised as psychotherapy, and would have required a licensed professional to review and approve each encounter where AI was used to support therapeutic decisions. Newsom called it overly broad, since even routine screening questions would have needed clinician sign-off. Knowing we’re already short on mental health providers, requiring human review of AI encounters may not relieve our access problems. Still, the answer isn’t no oversight. Here’s one feasible short term solution. Rather than reviewing each encounter, a licensed clinician can design the guardrails: what counts as a crisis, what triggers an immediate handoff to a human, and what gets sampled for audit each month. The AI runs inside that structure. Conversations get checked, failures get reported, and a real clinician owns the framework. Medicine already has models to learn from. The FDA process for rolling out newly approved medications is an example. After a product reaches patients, we keep watching for adverse events. Patient-facing AI needs the same “digital pharmacovigilance”: systematic tracking of harms, near misses, and the types of groups that get hurt and why. It’s also critical that users know that they can reach a human if they’re in crisis. Most chatbots now include messages like these: Bottom line The rush to use unproven AI tools for mental health support is mostly a workaround, a sign of a health system people can’t get into. We need better access to proven care from licensed clinicians. That takes reimbursement that makes accepting insurance viable, and a bigger workforce. But, built and tested well, AI could be part of the answer. It could be the 2 a.m. check-in when no one else is awake, or a way for patients to practice skills their therapist taught them. It could be the first step to get someone the right level of care, and take paperwork off clinicians’ plates so they spend more time with patients. None of this is simple. The SB 903 veto doesn’t end the debate, and the legislature will be back. In the meantime, those of us using these tools need to stay informed, ask hard questions, and hold the companies building them accountable. I’ll try to do my part, and we’ll keep learning together. Love,Matt P.S. If you or someone you know is struggling with mental health challenges, emotional distress, substance use problems, or just needs to talk, call or text 988- you’ll reach a real person— or chat at 988lifeline.org 24/7. Dr. Matt Willis is the author of Your Local Epidemiologist in California. A California native, he’s served as a primary care physician, CDC epidemiologist, and public health officer for Marin County, where he guided the pandemic response. He lives in Marin with his family and their dogs, Teddy and Ramona. Thank you Cynthia He, MD, PhD, and Parnika Saxena, MD, for their guidance in preparing this article. Cynthia works in an outpatient mental health clinic, treating patients who have Medi-Cal or, sometimes, no insurance. Parnika works in an inpatient psychiatric unit, treating patients with public or private insurance or self-pay ability. All opinions are their own and do not represent their employers.
Penguins face rebuild dilemma with ‘living legend’ Sidney Crosby
Josh Yohe questions Pittsburgh Penguins' veteran-heavy rebuild strategy.
Denver's DNC bid faces a deep-blue dilemma
Colorado's blue-state status — and recent progressive primary wins — may complicate the city's pitch.
Cowboys Weekend Headlines: History's brink, Quinnen, Parker dilemmas
The Cowboys are looking to avoid an inglorious feat in 2026, while there are close eyes on two key components in the fight.
How Trump’s ultimatum on DEI divided a Texas city
The debate in Fort Worth echoes a dilemma that local leaders are grappling with around the country: End diversity programs or risk losing all federal funding.
Pirates improved in power rankings despite looming Paul Skenes dilemma
Should Pirates fans be worried about their ace?
Italy’s Meloni faces a far-right dilemma as 'Il Generale' Vannacci rises
Roberto Vannacci, a former Italian army general, is shaking up Italy's political scene with his new party, Futuro Nazionale | KNX News 1070 AM
Matthew Gilbert to launch arts advice column for life’s dilemmas, Entertainment RX
Entertainment RX, a new column from former Globe TV critic Matthew Gilbert, is an entertainment-guided advice column, offering things to read, listen to, or watch that somehow address — or, in some cases, distract from – the issues readers write in about. (Don’t worry, we won’t use your name.)
Chargers Receive Honest Admission on Edge Rusher Dilemma
As Khalil Mack prepares to pass the torch, rookie sensation Akheem Mesidor joins forces with breakout star Tuli Tuipulotu to solidify a high-stakes defensive evolution in L.A.
Diagnostic dilemma: Junk-food diet caused a teen's permanent blindness
A teen's nutrient-poor diet led to irreversible vision problems.
Jeremy Clarkson's health dilemma 'common among farmers'
The TV star shared his worried treatment would overlap with a busy period for his Cotswolds farm.
Trump's diesel export dilemma
Soaring fuel costs are increasing pressure on US President Donald Trump to curb diesel exports ahead of November's midterm elections. But what may seem like an easy fix could unleash a chain reaction that ultimately leaves American consumers and the global economy worse off.
Tennessee Titans Had the Top-Graded Rookie From Week 1
A Titans rookie emerged as a defensive powerhouse during an otherwise disappointing loss, leaving coaches with a major roster dilemma ahead of the clash against Philadelphia.
76ers' 4 High-Usage Stars Create Unique Dilemma
With so many players needing the ball, Philadelphia could have a rough start to the season.
Republicans' midterm health care dilemma
Health care costs are a huge midterm issue, but Republicans are divided on solutions.
August Monthly Review: ChatGPT In Epic
Death, taxes, another frontier lab healthcare launch inspiring truly insane LinkedIn takes. As much as I want to stay away, I repeatedly am the crewman unplugging his ears whenever we pass these sirens. So it’s not the first and probably not the last time we dial up the typewriter rather than tie ourselves to the mast. The full blow-by-blow timeline: Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe The End of the Standalone PHR (Jan 8): ChatGPT Health arrives for consumers, at the time powered by b.well. I was bullish on the approach in that the best way for the PHR to finally solve distribution was to meet consumers were they already are (i.e. When Horizontal Meets Healthcare (Jan 9): OpenAI for Healthcare puts out the shingle for enterprises, with SharePoint ingestion standing in for the EHR integration the product actually needed. Another One: Anthropic’s Healthcare Debut (Jan 16): Claude's version, on HealthEx rails instead of b.well, with Agent Skills for FHIR development as the one true vertical-specific investment. ChatGPT for Clinicians: The Trap Sprung (Apr 24): OpenAI filled in the missing GTM middle with a free product for verified clinicians, effectively peeling the enterprise wrapper off ChatGPT for Healthcare and taking the PLG fight directly to OpenEvidence. OpenAI’s Second Attempt at Health (Jul 31): a relaunch of their patient specific app, now branded Health in ChatGPT, where the privacy partition came out, the connectors thinned, and b.well disappeared in favor of first-party FHIR work against a smaller network Beyond a Shingle So what was announced now? Today, we’re introducing a new electronic health record integration that brings authorized patient context from Epic into ChatGPT for Healthcare, along with the Healthcare Public Data plugin for direct, structured access to official healthcare datasets like PubMed, DailyMed, and CMS Coverage. Together, these capabilities bring ChatGPT closer to the systems and sources healthcare teams trust, while supporting the controls and compliance healthcare work requires. The core portfolio is unchanged from prior announcements we delineated and discussed (aside from the relaunch of patient-facing). Since trade publications still seem to be confusing them by using the wrong names: Enterprise sales motion: ChatGPT for Healthcare Protecting their core product / PLG: ChatGPT for Clinicians Consumer/patient-facing product: Health in ChatGPT So really, this is a feature release (specifically for ChatGPT for Healthcare when it comes to EHR integration). What’s cool about it, though, is that we are moving beyond just putting out a shingle. Everything in the January enterprise launch was horizontalizable: Horizontal tech companies thus generally start verticalization with their “putting out a shingle phase”. Telling the world you’re open for business as a horizontal tech company reliably attracts early inbound interest from buyers who are already trying to force-fit horizontal tools into domain-specific workflows and are eager for any signal that the vendor intends to support their use case more directly. Nothing was really vertical specific, which is exactly what you'd expect from the ultimate hypergrowth horizontal company dipping their toes into specific industries. But eventually you have to stop changing the sign on the door and start changing the product. Can you guess where the horizontal product was going to run out of road? This is the core dilemma writ large: verticalization requires differentiation, while scale economics of consumer and horizontal push toward unification. I’ve buried the lede so deep here it will be painful to some readers, but what should be shocking to no one is that my perspective is that EHR integration is the only path that meaningfully resolves this tension for ChatGPT for Healthcare. Integration with Microsoft Sharepoint is fine, but it is categorically insufficient for any product that hopes to influence clinical decision-making. SMART Money Well here we are, eight months later! Real vertical investment has begun, which surprised a few people. One friend in the industry messaged me: “Absolutely no way Epic gave ChatGPT API access.” Looking forensically at the announcements, the integration is notably read-only across appointment notes, laboratory results, medications, and specialist documentation. So while I’m not a betting man, I'd wager the house this is a SMART on FHIR launch: That sounds a lot like USCDI! The recommended path for the workflow they outline would be SMART on FHIR Their Health AI lead’s post is evocative of both standalone and EHR launch SMART, which another termed “ChartGPT” and “EHR Plugin” The implementation burden for SMART on FHIR is the lowest of the available integrative paths This is the team who literally did patient-facing SMART on FHIR with Epic last month Most importantly, if you’re a horizontal company, you generally still haven’t taken the full plunge and thus (overly) value reusability. SMART on FHIR is the logical compromise: healthcare-specific enough to matter, but standardized enough to reuse. Nobody Asked Judy Another friend asked “I thought they had to go to each health system, or did they go direct to Epic and now health systems opt in?” Given the trust paradigms in healthcare, this functionally cannot be Epic hoovering up all the data for OpenAI and shoving ChatGPT in their customers’ faces (or they would revolt). However, I do believe the aforementioned terrible coverage by TechCrunch and other outlets is probably responsible for that question, given the 325 million reference. When using FHIR as a business associate to an Epic customer, there is no EHR gatekeeping to speak of, as that isn’t how fhir.epic.com works: You register an app You pick your APIs You test against the sandbox APIs You list as “Ready for Production” Hospitals pick your app You test and go live with them Bluntly, nobody had to say yes or no in Verona (nor were they given the chance). Vendor Services (their next developer tier up that I doubt OpenAI is using quite yet in this initial release) certainly has contractual paperwork that some resent, but even there, the twin pressures of mounting antitrust and information blocking make outright gatekeeping increasingly fraught. My friend’s sentiment is, to me, representative of a broader industry neurosis, perhaps a sort of scar tissue of prior eras: people assume the gate is still there and never actually try the door. There are certainly other ways Epic (and any EHR) can put its thumb on the scale, but they are not so dumb as to stand in front of a federally mandated API and play bouncer at this exact moment in time. So I think they can and probably should go deeper, as this release is at best parity and at worst behind vertical-specific competition. OpenEvidence did a basic SMART launch with Sutter Health in February, allowing for more convenient evidence search by providers. They then add patient-context (the equivalent SMART on FHIR flow to what we see here) when Cedars-Sinai went enterprise-wide in May. UpToDate has four distinct applications across deeper workflows like patient engagement listed in Epic Showroom and announced a partnership with Epic to power Art at UGM Abridge and other ambient scribes have invested deeply into the deepest bidirectional clinical copilot workflow with integrations well beyond SMART on FHIR. In that light, the “Who is OpenAI primarily targeting here?” is clear. This release brings them into striking distance of OpenEvidence, but not the others quite yet. They are the only one of the three you can reach without building something truly Epic-specific. When will they go further? Competition is a great motivator to overcome the horizontal demons and start building things that can’t be reused: not across industries, not across EHRs, maybe not past the customer you built them for. That’s the price of actually verticalizing. The question is if and when OpenAI will be willing to pay it. Month in Review Here is the monthly review. As a reminder, this is a regular round-up of the month’s posts and other content to surface things you may have missed across regulation, litigation, interoperability, and beyond. AI assistance is used in these bullet summaries so I can focus on articles. Articles Published: None this month Video Content: The Information Exchange: Standards-based Thruple Edition (Aug 14): Back to school for us too, with Brad reporting in from the CMS Health Tech Ecosystem’s one year anniversary in DC. We get into the January CMS-0057 deadline, the fall rulemaking reading list, and why enrollment still keeps most apps off FHIR. The Information Exchange: Epic Dúnadan Edition (Aug 25): A UGM roundup with Ryan Brickner joining for the first time to check our takes against what the building actually thinks. Rangers, Ergo sitting on top of EHI, and a down-market lineup that needs some cuts. Regulatory: Stacked Deck, Bad Hand (Aug 05): ONC’s website refresh took the entire HIT Policy Committee record with it, so I rebuilt the archive and went looking for the regulatory capture story everyone assumes is buried in there. Stacking the deck and winning the hand turn out to be very different things. The Sixth Generation of Patient Access (Aug 19): A quick catalog of the five generations of patient access we’ve layered on since HIPAA, and the two candidates now competing to be the sixth. One is planned. The other is the market routing around the plan entirely. Court cases: Three Cases Walk Into a Docket (Aug 06): Two surprise settlements cleared the board in a single week, and then Judge Maddox dropped ninety-four pages on Vyne v. Henry Schein. The sleeper is a DMCA holding that makes direct-to-database a considerably riskier business model. Epic v. Health Gorilla: Into the MDL (Aug 10): Nine class actions are headed to Miami, and the Panel signaled it wants to bring the case that spawned them along too. That would leave Epic arguing the requests were obviously fraudulent in one courtroom and unknowable in the other. Amazon v. Perplexity: Agents Are Legalized! (Aug 11): The Ninth Circuit vacated the injunction against Comet, holding that the user is the one accessing the servers rather than the company that built the agent. A real win for agentic access, and a much narrower one than the headline suggests. Veeva v. Epic: Come At Me, Bro (Aug 26): Epic’s response brief wants the dismissal affirmed and, unusually, wants the opinion published as precedent. Buried in it is Epic’s own description of what its non-competes actually prohibit, which current and former employees should read closely. EHRs: The Contract Epic Would Never Sign Today (Aug 04): A 1999 SEC exhibit catches Epic licensing nearly its entire product line, Tapestry included, to the company that became TriZetto. The marketing services menu attached to it is the part that will make you blink. Forecast from Verona (Aug 07): The Epic Almanac makes one argument six different ways: the AI is only as good as the networks behind it. Emmie headlines, Art’s context stack is the most ambitious part, and Penny finally gets an autonomous coding date on the calendar. Works With Epic MyChart (Aug 17): Epic’s first new Showroom category since the death of Workshop certifies hardware instead of software, badge on the box and all. Made for iPhone, but for blood pressure cuffs, and rough news for anyone selling the RPM stack sitting in between. UGM Hot Takes 2026 (Aug 20): Everyone else covered the AI announcements, so I went after Savvy deleting the payment gateway, Rangers as Boost with the timer removed, and a down-market lineup with too many entries. Plus the Health Grid tidbits I cannot help myself on. MyChart Central Grows Up (Aug 24): Device data and Emmie turn Epic’s identity hub into a full consumer platform, which is both a logical answer to ChatGPT and a bit of a mistake. It also happens to be the best scraping target Epic has ever shipped. Industry Analysis: The Wrong Yardstick (Aug 12): Vertical software keeps getting judged against Superhuman and Notion, which is the wrong bar entirely. Your user is comparing your product to a whiteboard and forty phone calls before lunch. Primitives vs. Abstractions (Aug 27): Developers want building blocks, systems of record prefer to hand out business logic, and both sides have a real case. There’s no test from the outside that separates the engineering reason from the competitive one, which is why this keeps ending up in court. Cross-industry Comparisons: The Two Kinds of Platform Power (Aug 18): Attention power and record power are different problems that keep getting handed the same regulatory toolkit. Congress’s latest swing at Big Tech shows both what’s possible and where it falls apart. The Dogs of (Platform) War (Aug 21): A CourtListener alert turned up a property management fight with healthcare’s exact shape and none of the Cures Act. Shell prospects, ghost accounts, a notetaker bot that came back to haunt someone, and a lawyer arguing both sides of the same theory in two states. Fractals All the Way Down (Aug 31): Yardi dominates property management right up until you zoom into one segment, where AppFolio owns it outright and Yardi doesn’t appear at all. Where you draw the line around a B2B software market is about to decide an awful lot of cases. Other News: If Judy Had the Courage (Aug 13): A short eulogy for the era when software was allowed to look insane: WinAMP, bold colors, and everything the grey chatbot era has taken from us. External Media: Portland Monthly Health Tech Meetup: Erin O’Brien channeled my own feelings - maybe it’s just because it’s August and beautiful, but the monthly edition of the PDX Health community meetup was a ripper. Make sure to reach out if interested to join for the next one. STAT’s Coverage of Epic This Month: Brittany Trang of STAT did a fantastic job of breaking the FTC investigation that’s been lurking, as well as UGM related coverage, so I had to give her her wish of a meme. Fall Conferences: I’m pumped to be kicking off my fall conference season in NYC at Nabla Accelerate next month, which Chrissy provided the link to apply for. Here’s the rest of my schedule in case you want to meet up: Commonwell (Redwood Shores, CA): Oct 13-14 Open@Epic (Madison, WI): Oct 21-22 eHealthExchange (Austin, TX): Oct 27 Sequoia Project (Austin, TX): Oct 28-29 HLTH (Vegas): Nov 15-18 RSNA (Chicago): Nov 29-Dec 3 Posts I Liked: HTI-6 Should Unbundle API Certification: Josh Mandel makes the case that HTI-6 should split (g)(10) into separate authorization and data certifications, so a PACS or a genomics platform can certify only the role it actually performs. Imaging is the urgent example, but the structure solves a much bigger problem. On implementing ePrior Auth with Epic: Scott Rossignol’s field notes from a live ePrior Auth build on Epic, including the two app registrations nobody warns you about and the CPT mapping problem waiting at the end. CMS-0057 implementations are going to be such a beast. Healthcare point solutions are starting to look a lot like streaming services: Spencer Dorn runs the cable-to-streaming arc against health IT and lands squarely on the bundling half of the cycle. Bundling can be good! It can also be bad! Life is nuanced. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Mikel Arteta admits to selection dilemma
Mikel Arteta has admitted that Mikel Merino and Martin Odegaard gave him a selection problem over the weekend, having both played so well over the international break.Photo by Justin Setterfield/Getty...
New MatterChat Model Helps AI to ‘See’ the Language of Science
From writing emails to generating computer code, much of the artificial intelligence prevalent in our daily lives has succeeded by mastering one domain: text. However, this leaves a major blind spot in the physical sciences, where models depend on the high-resolution, three-dimensional data of the physical world, like the intricate lattice of atoms in a crystal. Delivering on the promise of using AI for science requires teaching these data-driven text models to seamlessly “talk to” physics-based models. Now, a new AI framework from Lawrence Berkeley National Laboratory (Berkeley Lab), called MatterChat, solves this problem by creating a specialized “bridge.” It connects the conversational power of a Large Language Model (LLM) with a physics-based AI that models “interatomic potentials”: the complex physical forces between atoms. The resulting system already significantly outperforms general-purpose AI tools like GPT-4 at predicting material properties, and the team hopes it can accelerate scientific discovery by serving as a robust research partner that provides grounded insights and generates step-by-step instructions for synthesizing novel materials. A paper describing this work was recently published in Nature Machine Intelligence. “Traditional simulations can provide the physical rigor required for materials science, yet their computational cost remains prohibitive for high-throughput screening. Conversely, while LLMs excel at rapid knowledge synthesis, they inherently lack the ‘structural vision’ to interpret materials directly from their underlying atomic coordinates,” said Yingheng Tang, a postdoctoral researcher in Berkeley Lab’s Applied Math and Computational Research Division (AMCR) and lead author on the paper. “MatterChat was built to solve this dilemma, empowering LLMs with a structural ‘vision’ that allows researchers to leverage their full potential for solving complex, real-world materials challenges.” Empowering language models to solve complex challenges in materials science To build MatterChat, the Berkeley Lab team drew inspiration from technologies like Vision Question Answering (VQA) and Text-to-Image (T2I) generation. In these tasks, AI must translate high-level text concepts into visual images, or vice versa. Doing so requires developers to build tools that “bridge” two fundamentally different forms of data. The researchers adapted this concept to the physical sciences. With MatterChat, they created a “bridge model” that successfully connects an LLM’s general knowledge with the deep understanding of the atomic-scale world encoded in scientific interatomic potentials. Until now, researchers using LLMs to solve materials problems usually had to feed them raw data files as if they were just strings of text. It’s like asking an AI to understand a complex 3D engine based only on a parts list: the LLM can read the names, but it can’t “see” how the atoms fit together in space. MatterChat solves this by training a specialized AI bridge model, pre-trained on millions of crystal structures and an LLM, to align the LLM’s representation of the world with the interatomic potential’s representation of the world. The bridge model can translate physical insights into a format the LLM can actually understand. By giving the LLM these “scientific eyes”— a scientific “inductive bias” in the terminology of AI — the Berkeley Lab team has transformed it into a robust research tool capable of providing grounded scientific insights into complex materials challenges, such as predicting thermal stability or analyzing electronic band gaps. “We think of atoms as living in a physical space, but from a machine learning perspective, they are just vectors living in some very non-trivially structured manifold in a high-dimensional Euclidean space; and, of course, the same is true for the sentences and paragraphs that we use to express our ideas about those atoms,” said co-author Michael Mahoney, Berkeley Lab’s Scientific Data Division (SDD) AI Initiative Research Lead. “The bridge model basically gets those two structures to ‘talk with’ each other.” As a proof-of-concept of this general approach, the team trained their bridge model on a dataset curated by pairing nearly 143,000 stable atomic structures from the Materials Project with their corresponding physical properties. This training data was automatically assembled using the Materials Project’s API and deliberately enriched with properties fundamental to microelectronics design — like formation energy and bandgap — allowing MatterChat to learn the complex patterns connecting a material’s atomic blueprint to its functional performance. To validate their model, the researchers benchmarked MatterChat against a suite of other AI systems, from general-purpose LLMs to other specialized scientific AI methods. The results show that MatterChat consistently outperformed its competitors across a range of tasks. The model was more accurate in classifying material types and demonstrated superior precision in predicting numerical properties. For example, it excelled at predicting a material’s bandgap, a property critical for designing new electronics from high-capacity energy storage to next-generation computer chips. “Our design is significantly more efficient because we don’t have to build a massive AI model from the ground up,” said co-author Zhi (Jackie) Yao, a research scientist in Berkeley Lab’s AMCR. “Instead, we take two powerful, pre-trained models — a structural encoder for materials physics and an open-source LLM — and use them off-the-shelf. The only component we actually train is the lightweight ‘bridge model’ that translates between them. It’s the difference between building an entire car factory and simply designing a smart adapter that connects a world-class engine to a world-class navigation system. This approach is not only computationally efficient, but also makes the system modular, so we can easily upgrade components or adapt the bridge for other scientific domains in the future.” Crucially, this modular design highlights exactly how institutions like Berkeley Lab and the Department of Energy are carving out a highly valuable niche in the booming AI landscape. Rather than competing with Silicon Valley tech giants to build ever-larger language models from scratch, the lab is focusing on the specialized connective tissue that makes commercial AI useful for hardcore science. Because the bridge model approach underlying MatterChat is forward-compatible, it is perfectly positioned to leverage these parallel tracks of innovation. As Mahoney pointed out, “We expect that industry will continue to develop improved LLMs, and we expect domain scientists and facilities will continue to generate new data. An important part of scientific machine learning is not simply to solve problems on today’s data, but instead to develop general methods that will be forward-compatible with orders of magnitude more data, whether from scientific domains or from LLMs.” According to Yao, the MatterChat project, which was initially developed and enhanced with funding from a Berkeley Lab Laboratory Directed Research & Development (LDRD) Program, will now expand its capabilities. In a collaboration with Fermilab, MatterChat is already contributing to a U.S. Department of Energy Genesis Mission project — called Accelerating eXtreme Environment Specs-to-Silicon (AXESS) — that aims to speed up the development of next-generation, high-speed, radiation-hardened detectors for challenging particle physics experiments by using advanced 3D integrated circuits (chiplets) and AI-driven data analysis. In addition to the LDRD support, the team also credits supercomputing resources at the National Energy Research Scientific Computing Center (NERSC), located at Berkeley Lab, with MatterChat’s success. “We are incredibly grateful to NERSC; this research simply would not have happened without access to the Perlmutter supercomputer through their AI for Science program,” said Tang. Wenbin Xu, a NERSC postdoctoral fellow at the time, was also a major co-author of the work, as was Benjamin Erichson, a research scientist in Berkeley Lab’s SDD, highlighting the benefits of AMCR-SDD collaboration on AI for science. ### Lawrence Berkeley National Laboratory (Berkeley Lab) is committed to groundbreaking research focused on discovery science and solutions for abundant and reliable energy supplies. The lab’s expertise spans materials, chemistry, physics, biology, earth and environmental science, mathematics, and computing. Researchers from around the world rely on the lab’s world-class scientific facilities for their own pioneering research. Founded in 1931 on the belief that the biggest problems are best addressed by teams, Berkeley Lab and its scientists have been recognized with 17 Nobel Prizes. Berkeley Lab is a multiprogram national laboratory managed by the University of California for the U.S. Department of Energy’s Office of Science. DOE’s Office of Science is the single largest supporter of basic research in the physical sciences in the United States, and is working to address some of the most pressing challenges of our time. For more information, please visit energy.gov/science.
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AI needs science’s search history
“Actually, that’s where the gold is,” said Alasdair Russell, my graduate school friend who leads a pre-clinical genome editing group at Cambridge. He was talking about the winding road of science that is omitted from published papers. “When you’re discussing how to do the experiment, and why this way is better than another way, and what does the data really mean? I know what it shows, but what does it mean?” At RAAIS 2026, he described how his group has begun logging the twisting path of discovery as it happens, recording the verbal and written exchanges that normally disappear. Ideas become nodes in a living graph: they branch when a meeting produces two plausible experiments, merge when separate lines of evidence converge, and go dark when someone quietly stops pursuing them. In his implementation, one agent scores novelty, while another tries to learn “how scientists think and how they navigate through a complex world of data,” so that high-potential nodes can trigger deeper investigation. As frontier AI labs deploy agents toward scientific discovery, giving AI authentic scientific taste remains a trillion-dollar dilemma. The bottleneck is that the record we have kept for centuries of science might be insufficient to get us there. The experiments that never make the paper Peter Medawar, 1960 Nobel laureate and “father of transplantation,” asked in 1963 whether the scientific paper was a fraud, and answered yes: the form of the paper misrepresents the thinking that produced it. Sixty years on, the diagnosis is unchanged. A paper presents a clean progression from hypothesis to result to conclusion. Lost along the way are the unconventional theories, the abandoned or unaffordable methods, and the underwhelming and inconclusive data. It reads like a browser history with every dead end deleted: the ten open tabs, the four rephrased queries, the wrong turn down a subforum. All scrubbed, leaving one clean path from question to answer as the canonical path. What has changed since then is that the discarded material is now worth something. No high-impact journal wants these artifacts, but raw trial and error is the most likely source of the training data required to develop scientific intuition, or what researchers call taste. Earlier attempts to capture the discards were motivated by scientific integrity. The Journal of Negative Results in Biomedicine launched in 2002 to publish rigorous studies that disputed established models or exposed ineffective treatments. Its archive preserved negative conclusions after they had become papers, rather than the live alternatives and arguments that produced them. BioMed Central closed it in 2017, saying the mission had been served now that other journals publish null results. A less generous reading is that in fifteen years it published around 200 papers because almost nobody wants to read a negative result, let alone write one up when it will not count toward academic tenure. AI models are different. Even an uninteresting negative result can be useful, provided it is labeled. Earlier this year, Anthropic put a version of this to the test. The company pulled 129 decision points from real Claude Code sessions between January and March 2026, showed models the work up to a human detour, and asked what should happen next. Claude Mythos Preview beat the human choice 64% of the time, while Opus 4.5 managed 51%. The comparison was tilted toward the models because Anthropic deliberately chose moments where the human decision had room for improvement. On 127 further scenarios where the human action was already strong, the models improved on it only about 20% of the time. The study was possible because Anthropic’s researchers work inside a tool that logs by default. The reasoning, detours and outcome are produced in the same working environment. Biology has no equivalent. Its reasoning happens in hallways, at benches, in Slack threads and on whiteboards, while the outcome arrives weeks later somewhere else. The record has to emerge from the work itself. Ask scientists to reconstruct it afterwards and we’ll create another polished account. Subscribe A log is not a label Before any of this becomes training data, a negative result has to say what failed. The first paper published in the Journal of Negative Results in Biomedicine examined 234 negative studies across five leading medical journals. Only 30% discussed statistical power, and half clearly defined a primary outcome. Tell a model an experiment failed, without telling it whether the assay was underpowered, a reagent had degraded, or the hypothesis was simply wrong, and it will learn noise with confidence. Decision histories have a second missing label too. When a lab considers five experiments and runs one, only the chosen branch returns an outcome. The other four are experimental counterfactuals. Researchers call this the selective labels problem: the data reveal results only for the actions someone chose to take. Such a record can teach a model to imitate a lab’s taste, but it cannot establish that the taste was good. It also smuggles local constraints into general lessons. A lab that never ran cryo-EM because it did not own a microscope teaches a model that cryo-EM is rarely the right call. Alasdair’s nodes preserve the candidate set, which is the necessary first step. To be useful, each decision record needs six fields: The evidence available at that moment, and nothing that arrived later. The candidates considered, including the ones dismissed in a sentence. For each candidate: the expected result, the confidence attached to it, and the cost in time and money. The route chosen, and the reason. What happened next. How the evidence changed the scientist’s view. These must be timestamped before the outcome, because hindsight turns uncertainty into inevitability. Disagreement also has to survive. Averaging three scientists into one clean rationale reproduces exactly the information loss we are trying to fix. But there is an obvious failure mode here. Once decisions are logged and scored, people log for the record post-facto. Anyone who has watched an electronic lab notebook fill up with retrospective tidying knows how quickly a research tool becomes a compliance exercise. A record that costs a scientist ten minutes of honest reflection per decision is worth far more than one that costs an hour of performance. A publication initiative called Registered Reports offers a useful starting point. Here, researchers submit their rationale, methods and analysis plan for peer review before the data exist, and the journal commits in principle to publish if they follow the approved plan. Nature has now expanded the format across every field it covers. This approach to paper writing timestamps intent before the outcome, but it freezes one plan. A useful search history must also preserve how the plan changed, which alternatives were rejected, when, and on what evidence. Subscribe Run the runner-up Autonomous labs show what happens when decisions and outcomes are connected in a loop. Liverpool’s mobile robotic chemist ran 688 experiments over eight days in a ten-variable formulation space. A batched Bayesian search used each result to choose the next experiments and found photocatalyst mixtures six times more active than the starting formulations. Every completed experiment changed what the system did next. The robot optimized within a goal and search space that humans had already chosen. It did not decide which scientific question mattered. So what this work demonstrates is narrower, but still useful: a search history pays off when the options return standardized outcomes quickly. Open-ended biology is harder because branches can take weeks and the discarded alternatives may never be run. Some exploration therefore has to be bought. Where two branches are plausible and the stakes justify the cost, a lab should sometimes run the runner-up. Otherwise the record captures what today’s scientists usually chose and stays silent on what they systematically overlooked. A funder could ring-fence a small fraction of a grant for the branch not taken, provided that the decision record and the outcome are both deposited. That costs money, but so does having every lab rediscover the same abandoned path. Test whether taste transfers When it comes time to evaluate if our new AI system exhibits taste, the comparison should run across laboratories and fields. At selected decision points in a live research campaign, we should freeze the six fields: the evidence, the candidates, expected results, confidence, costs and the choice made. Experts then rank the options before the outcomes are known, and those outcomes are checked independently later. We could give models one of two diets - papers alone, or papers plus decision histories - and ask them to rank the next experiment on unfamiliar projects. Then, we score information gained per dollar and week, calibration, and how quickly weak branches are abandoned. If histories improve choices only inside the lab that produced them, they amount to useful organizational memory. If they improve choices on unfamiliar problems elsewhere, Alasdair’s group will have captured something science has never managed to write down: a transferable record of taste. Until that happens, a scientific search history is a promising record, not yet a training set.
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Epic v. Health Gorilla: “Working as Designed”
We’ve been on a bit of a legal bender since just before Labor Day, so let’s keep a good thing going! As predicted, Epic does not want its case against Health Gorilla consolidated with the data breach cases, so it filed a motion to vacate the conditional transfer. And because they had to explain to the Panel why this case is different, they put a good chunk of previously unseen Epic v. Health Gorilla discovery record on the public docket! Roll the tape! The Case Against Consolidation Before we get to the fun stuff, let’s do the housekeeping. Epic's motion boils down to three arguments (sorted in ascending order of how well they land): A judge has already decided this. Judge Olguin declined to relate the fraud action to another ELU case (Patterson v. UVA Health), holding that the two do not call for determination of substantially similar questions of law or fact. Epic asks the Panel to treat that (a Rule 42 ruling) as law of the case. The overlap is thin. The three common questions Health Gorilla and the Panel identified are neither numerous nor complex (the qualities the Panel looks for before centralizing). Moreover, they are outnumbered by the questions unique to each side: The breach cases turn on security architecture, notification timing, and patient-level access. The fraud action turns on false treatment attestations and breaches of the framework agreements. Consolidation costs more than it saves. 17 of 21 parties in the fraud action do not appear in a breach case. The cases are also at very different stages: Olguin has a scheduling order running through a January 2028 trial while the breach actions are much more nascent. I like the last two more than the first because they attack the basic economics of an MDL: there just may not be enough shared discovery here to justify dragging all the defendants and a relatively mature fraud case all the way to Florida. On the other hand (while I know exceedingly little about MDL and Rule 42), I have a hard time seeing why a district judge's decision about his own docket would control what the Panel does with the separate § 1407 question. I might be reading between the lines too much, but I sorta think Epic's own brief half-concedes this, framing the two provisions as "two sides of the same coin" but then adding "respectfully submit" (which is often lawyer speak for “we know this is a reach”). The Ladder Gets More Rungs Anyway, the arguments are not why you're here (aside from the lawyers, maybe). Back in June, we discussed how Epic was using the smaller defendants to build an evidentiary ladder toward Health Gorilla and Unit 387. Turns out discovery has been adding a few rungs of its own.
Sundar Pichai: Google’s Frontier Imperative, Compute Scarcity Dilemmas, Future AI Products and Businesses
Alphabet CEO Sundar Pichai has little patience for doubts about Google’s willingness or capacity to compete at the frontier of AI. His company’s latest Gemini 4 Argon model — long-promised and recently delivered — beats OpenAI and Anthropic’s latest public models on coding, math, science, and knowledge-work benchmarks and has placed Google’s AI back among the world’s best. Amid chatter that Google was fine with good-enough lightweight ‘Flash’ models, Pichai pushed back hard against any suggestion that company is limiting its research ambitions. “We won’t do it any other way,” he told me in a Big Technology Podcast interview recorded this week at Google’s Mountain View headquarters. Pursuing cutting-edge research is costly for Google, requiring compute and chips that otherwise could be sold at a high markup by its cloud business. But Pichai said allocating resources to frontier AI development is “ground zero” for Google. “Our cloud business is at any given moment in time forgoing short-term revenues because we are making compute trade-offs to support frontier AI development,” Pichai told me. In our conversation, we discussed Argon (which Pichai says processed three times as many tokens as Gemini 3 in the 72 hours after launch), AI’s role in developing better models, the AI interface of the future, competition with OpenAI, Google’s partnerships with Anthropic and Apple, data centers in space, and the nature of his optimism. You can read the full conversation, lightly edited for length and clarity, below, or listen to it on Apple Podcasts, Spotify, YouTube, or your podcast app of choice. Alex Kantrowitz: Google is back at the frontier with Gemini 4 Argon, which beats OpenAI’s and Anthropic’s public models on benchmarks spanning coding, math, science, and knowledge work. The conventional wisdom was that Google had given up on the frontier to focus on fast, good-enough models for its products. That was wrong? Sundar Pichai: Very wrong. Look, we are so committed to being at the frontier. It’s in our DNA. We won’t do it any other way. We’ve been thinking about the AI frontier for well over a decade now. The frontier is very dynamic. It’s very competitive. It’s very exciting. I couldn’t be more pleased with how Argon has come together. We took our time with it. We made sure we tested it safely and deployed it carefully. We took a bit longer than our other models, given its capabilities. Across the board, be it for agentic work, knowledge work, coding, creative tasks, Argon is one of the really good frontier models. The first 72 hours since we launched, it’s almost up to 25 trillion tokens used, which is about three times what Gemini 3.0 had in the first 72 hours. And we are capacity constrained as we are serving it. Excited, but there are always areas….. You know, the frontier is very dynamic, and you have to keep evolving the models. There are areas which we can see we need to improve as well. We’ll be at work on all of that as well. Which areas? On any given model, Argon would be across the board better at everything if you just look even two months back. But the space is so evolving. Even on coding, for example, there are pockets where we know we need to do better, and there’s clear feedback. We’ll make it better. The argument for standard models is that they’re already good enough to build great products, with the frontier valuable only for certain tasks. Meta built Muse with good models rather than the best, and Google could put standard models into Maps, Gmail, and Search. Why isn’t that sufficient? It’s definitely not how I have thought about it at all. We are deeply committed to driving the state of the art and actually pushing where this technology can go, all the way from transformers. That’s a journey we’ve been on. You will see us continue to do that. When you’re at the frontier, you get an earlier look into the emerging capabilities, earlier than others, which helps you better prepare for the future. We are fortunate to have a wide set of opportunities across consumer and enterprise. Some of our cloud customers, for sure, want the model at the frontier. The frontier models will be better at developing the next set of models in an era of recursive self-improvement. I would argue it matters there. Internally, we have definitely seen a steep point of inflection by deploying Argon to our developers. It definitely tackles problems which our previous models could not do. Being at the frontier puts you at the innovation frontier and helps you drive that as well. There is room for models of all sizes and capabilities. That’s why we did Flash, Flash-Lite, etc. I agree with you that you can develop very good product experiences with not necessarily the most frontier model, because they tend to be slower and more expensive too. But we care about the Pareto frontier, and we’re committed to doing all of that. You said developing frontier models gives you a look at what’s coming. What do you see on the horizon? What makes this moment so exciting is you build something which you think is a culmination of months of work, and you put it out. You already see clear headroom ahead. We’ve all been working on these agentic, long-horizon capabilities, but clearly the frontier is going to have multiple of these agents working together to do things. That’s an example of an exciting paradigm underway. It’s also clear to me that users, both in consumer and enterprise, will have access to some multi-agent framework for them, working all the time doing things. It feels like a moment of infinite possibilities. Sergey Brin said one of Argon’s core innovations was relying more on the model to help develop the model. Yet incidents involving OpenAI’s bots breaking containment and Google’s bots accessing a site they shouldn’t have suggest these systems still aren’t perfectly aligned. Isn’t there reasonable cause for concern about accelerating toward recursive self-improvement? There are three parts to your question. Let’s first talk about RSI itself. You’re right, Sergey mentioned RSI being a critical contributor as we are developing Argon. But to be very clear, today, in a continuum, we are pretty far from the end state of RSI or something like that. The right way to describe it is you have RSI loops along with AI researchers in various aspects of model development. You almost have agents helping AI researchers in some automated way work together to build these models. It’s good to at least understand where we are today, and it’s super exciting. I expect that continuum to keep making progress as we go into next year. The second question is around safety. Security comes from defense in depth. You’re talking about alignment, obviously. We all are doing a lot of work to make sure the models are as aligned as possible. But it’s an active area of research, and there are clear gaps. That’s not the only thing we rely on. You have the work you do on alignment, but beyond that, we put a lot of effort into real-time monitoring as these models are working. Making sure you have good telemetry into what’s happening so that you can intervene in real time if you see unexpected behaviors. How you do that, the architecture with which you do that, how you make sure it’s all sandboxed and isolated in a way that it can continue doing its job during real-time monitoring — these are all areas of investment. Obviously, when we deploy these models, giving customers, enterprises, control, both with real-time monitoring, but their ability to decide where they deploy, what type of data which models ever have access to, etc. All that work is very, very important, and we are doing a lot of that. As an industry, we need to constantly up our game and take the time to do all this stuff, including dedicating the compute required to make sure you can safely deploy these models. The third part is: Is it all enough? This is why there are a lot of conversations in the industry, and I think it’s reasonable to be worried. The right way to approach something you worry about is early on thinking about what more we can do. As an industry, you’re definitely seeing increased levels of work on alignment, testing for safety, etc., as we deploy these models. The next step would be developing better standards so there are cross-industry standards of how we do these things, including the ability to evaluate using independent evaluators. If you look at areas like financial controls, we have accounting standards, we have independent auditors. Those are all the next natural steps for us as an industry to work toward, and regulation will end up playing a role as we go through all of that as well. Google pursues both language models and world models, while some other AI companies like OpenAI have focused more heavily on LLMs as the path to AGI. Why is world-model research important to you? As humans, you obviously perceive the world around you, and you’re taking all those inputs. Making sure these models are able to understand the laws of physics, simulate the world in high fidelity. All that, I think, are key enabling blocks for intelligence. We are working across all possible applications of this. Take an area like robotics. It’s not an accident: If you look at embodied reasoning benchmarks, Argon is state of the art. That all comes from our experience building world models. Inherently, I would expect there will be architectures which will converge all of this in the future. But for us, we view this as, today, this jagged frontier that is intelligence. We want to be at the frontier of all the possible approaches, and that will help us both drive better research, better insights, and develop a much better AGI model, is how we think about it. Some people argue Google should focus on selling its computing resources rather than using them for AI research. Cloud wants to sell compute at a high markup, while researchers need a very big computer to build the best models. How do you balance those demands? Ground zero for us is making sure we are investing in the compute that’s needed to be at the AI frontier. In 2015, I set the company to be AI-first. AI is that key horizontal ingredient across everything we do, all the way from Search to Cloud to Waymo. That is ground zero for us, making sure both for research and developing the models that we have enough compute needed. Beyond that, we have these independent businesses which each have their own long-range plans. They’re using those long-range plans to project forward, and we plan for compute for all of them. The cloud team, they have a business and they have a projection and they have demand signals. They have committed contracts. With that help, we can plan on a long-term compute trajectory for them. We’re fortunate to have this wide set of opportunities. There’s no company in the world which isn’t making trade-offs at any given moment in time. But the first principles we operate on is making sure we have enough compute to invest in the frontier, and that’s non-negotiable, and everything else works on top. Remember, we are building our own compute, our own data centers. There are long lead times. The compute we have today is a function of decisions I made in 2024. Even if you think back to a year from today, last year the agentic coding takeoff hadn’t happened. Today, obviously, when you sit and look at anything, everyone is short—not just us, other companies—and everyone wishes you had two times what you had planned for. That comes with the territory. At any given moment in time, we are planning for what we would need two to three years out in the future. You’re going to find some decisions you make may look suboptimal two years out, depending on where the state of the art is. I don’t spend too much time thinking about it. The way I think about compute allocation is making sure Google DeepMind, both for research and frontier model development, is cutting edge in terms of compute access. After that, we plan for all our businesses. It’s great we can provide our compute to other people too, like we have done. It allows us to scale that up, get real tests for it in the widest application set possible, test it in the real world, and make sure we are at the cutting edge of technology at every layer of our AI stack as well. Ben Horowitz relayed on a podcast that Andy Jassy had said compute was sold out until 2028. Are you seeing the same thing? If today a customer is coming out and asking us for compute in ’27, that is incredibly difficult to do. Even last year we went out and leased some short-term compute to accommodate some customers and help them out. But yes, we are all dealing with similar timelines. Every major technology shift seems to involve overbuilding, from railroads to fiber. Do you think that’s happening here? It depends on the time frames you’re looking at. This level of build, if I take a long enough time frame, it makes complete sense to me. We are at early stages of the most consequential technology ever, and this is not like fiber. It’s not dark. We are using it. We are capacity constrained on a daily basis. The applications, the underlying technology is improving rapidly. But running a company, the way I work through the moment is you look at your demand signals. You look at your committed revenue opportunities that you’re getting in the form of contracts. You balance that with the underlying technical capability, or internally you balance how we are using it internally, the model trajectories. Based on all that, you take a disciplined approach—a confident, aggressive, but disciplined approach—to plan out compute. But when you talk about the broader economy as a whole, you’re having people operate with various levels of risk. I focus on what I can control as a company and plan through it. If your question is, can there be an overbuild? Yes, because you can have some constrained components. Remember, what matters is a set of everything you need to build out that compute. Memory, electricity, electricians…. Land. Like 2,000 components or more. You could get constrained at some point. There could be things which cause bottlenecks, and then you could have overbuilds. There could be external shocks to the economy. There are macro risks. All that is possible at any given time. But am I confident that the compute we are planning for, we will have uses for it given enough time? Absolutely, yes. I was in the room when you said AI would be as profound as fire and electricity. If you believe that, shouldn’t you give researchers the biggest possible computer, even at the expense of today’s cloud profits? We’re all doing some form of that. Our cloud business is at any given moment in time forgoing short-term revenues because we are making compute trade-offs to support frontier AI development. What you’re seeing is true already. But you want to be thoughtful. Even our AI researchers have some constraints, which are also good. That’s what inspires creativity. That’s what helps you come up with a more efficient algorithmic breakthrough, maybe to use less memory. What we are committed to is to invest what’s needed to stay at the frontier. OpenAI President Greg Brockman told me a few months ago that the ideal AI product might have no interface at all—just as natural as conversation. What do you think the interface looks like in the age of AI? Computing historically has been humans adapting to computing. With AI, it’ll be the other way around. The technology will adapt seamlessly to how humans live and go about their day-to-day life. You want to be able to speak to that AI when you want to. It has context. It can be persistently running somewhere, give you continuity. You’re not dealing with a lot of complexity. It’s natural. All that makes sense to me. That doesn’t mean it won’t have any interface, however. Nowadays, even on my phone, Gemini voice models are so good. I can just press the microphone button. I can just ramble. That’s why we call it Rambler. I can ramble. It intelligently corrects with my personal context. Even my friends’ names, weird names, it gets it right, even if it first guesses it wrong. It’s amazing. I’m not going in, backspacing, editing once I finish saying it. It’s remarkable how good it’s gotten. But there are going to be moments you will need an interface. You may want to entertain yourself. You may want to watch a video. You may ask your AI to create something, and you want to watch it, consume it. The way I think about it is, you want it to be as seamless and as natural as possible, and that you are not doing the hard work adapting to whatever the interface is. The technology is adapting to how you’re working at any given moment in time. When I asked Sam Altman about competition from Google, he argued that OpenAI was building AI-native products and implied Google was bolting AI onto existing ones. Do you accept that framing, and can a “bolt-on” compete with an AI-native product? First of all, it’s a very dynamic moment. We are all pushing each other. OpenAI has pushed us as a company too. This is not just we are doing something to them. Far from it. Yes, Google went into its own version of a code red too. In the AI moment, all of us have to respond with varying levels of urgency at any given moment in time. We are constantly building new products as well. Gemini was built from the ground up as a product—the Gemini app I’m talking about. Or tomorrow, as all of us are adapting to agents, are you bolting agents onto ChatGPT, or are they building it natively? How would you think about that? You can always put these questions back. I don’t think of it that way. I think of it as you want to build world-class product experiences that are AI-native and they are winning. Some of it is adapting products, some of it is rethinking new experiences. They will all be part of how you approach this moment. How do you expect to make money from these AI interfaces? If an agent recommends a product and I buy it, should it take a cut of the sale, even if that’s disclosed? I’m going to put enterprise aside. Consumers are going to increasingly value this technology. Take software developers today. Developers are willing to pay for these coding models because it really helps make them more productive. Nobody would want to code the way they were coding three years ago, or even the same time last year. When you’re delivering value, there’s value to be had. I’ve never seen examples where consumer products really scale to billions of users, where people are using it intensely, and haven’t had monetization to go along with it. If you’re providing value to people, there is inherent value to be had. The nature of it may change. You’re asking a scenario in which agents are doing stuff for you. At the end of the day, you will have commercial needs. The agents need to fulfill those commercial needs. The providers on the other side are going to see value in that. There’s going to be some mechanism by which it gets fleshed out. That’s what an efficient system does. But what matters is that you’re building those world-class consumer experiences. I promised myself one product feature request: Can you make Gemini-powered search in Gmail as good as searching Gmail through ChatGPT? What’s going on here? One of the exciting things we announced recently is the unified Gemini agent for enterprise, and we’re bringing that to consumers. These are persistent agents which run 24/7 in the cloud. We’re spinning up a micro VM effectively for every query, and from the runtime, the harness, the model—it’s all a headless service. It’ll work everywhere, and it has your context with you. You can address this agent whether you’re in Workspace, in Search, in Gemini. Agents are going to drive this unification from a customer experience, which people are looking for. When you have a broad product portfolio and you’re moving forward fast, there are always areas where you’re moving forward faster than some other areas. That’s valid feedback. But we are putting a lot of time and effort into making sure, as we build out our agentic experience, that unification and that capability works well across all these services. People have asked where Google’s equivalent of Muse or Dots is. Do you anticipate creating a new product to compete with them? Our goal with Gemini is to be a personal, proactive, and powerful assistant. That’s what we are working toward. You saw us describe the early versions of it at Google I/O this year with Spark. Effectively, already, if you open the Gemini app as a Pro or an Ultra user, you see Chat and Task, and they start giving you that agentic experience. With Argon now, that capability is dramatically accelerated. What we announced recently in our enterprise event, we are bringing that to consumers as well. Soon in Gemini, you will be able to ask something, and it’s a continuum. You don’t need to think about whether you’re asking a chat or an agentic task. It’ll just automatically do the right thing, and it can work persistently in the background securely and get things done for you. Already, empirically, when I look at what’s coming into Gemini in our app, last year you would have tagged them and most of them would have been chats. But a steadily growing percentage is already agentic tasks in Gemini. Yes, we are going to bring personal agents to our consumers. It’ll work in the Gemini app. It’ll work in Google Search. It’ll work in Gmail. You can address it, call it, etc. We want to make sure we’re getting it right. It’ll be powered by Argon, and we are very excited to bring it to our users. Google has invested and committed tens of billions of dollars to Anthropic. What do you see in Dario Amodei that makes you want such a deep investment and partnership? Very early on, when we looked at the founding team of Anthropic, it was very clear to us this was a world-class team which was involved in some of the earliest GPT models. We were quickly able to assess that they would be at the frontier. We’ve always tried to identify and partner with companies which would be at the cutting edge of technology. We’ve done that with SpaceX. We’ve done that with Anthropic. That’s what we saw, and we had a chance to partner. Is your partnership with Apple to license Gemini for Siri expanding, contracting, or standing still? For both us and Apple, that partnership was about translating the capabilities of AI into better experiences for users. I thought Apple has done a phenomenal job of incorporating—they customize these models and build it into Siri—and it’s been great to see the reception. We are committed to doing more. You’re going to do more with them? There’s nothing specific to comment, but it’s a partnership. It’s working well. What have you learned so far about the feasibility of data centers in space? It’s a very exciting project. Projects like this remind me—I still recall that moment in the desert for the DARPA Grand Challenge, watching the Stanley car compete in it, which ended up being the basis for Waymo. With all these technologies, you’re at a moment in time where it looks a bit like sci-fi, but 10 to 20 years down the line, it’s actually working in a meaningful way. I feel the same in space. We’ve always believed in betting big on these technologies. Quantum has been a great example of it. We’re probably 10 years into the journey. Waymo, we are almost 20 years into the journey. Space, we are two to three years into the journey. It’s clear to me that it’s an approach which will make a lot of sense in the future. Being in sub-synchronous orbits with 24/7 access to the most abundant form of energy we have access to will make a lot of sense for this exponential increase in compute that we are going to need. Having said that, this is a challenging project. The team has disciplined milestones. It was a super exciting milestone to send the TPUs up to space. Sometime, as we are speaking, we are expecting a “hello world” moment from them. I look forward to seeing that happen, and we’ll continue investing here too. You previously said 25% of the code written within Google was written by AI. What’s the number today? That number in our world today is meaningless in the sense that every part of what we now touch is influenced by AI deeply. What we are tracking with Argon, for example, it’s been a point of inflection. People are using Argon to really go tackle complex projects, including projects which affect millions of lines of code. In the four weeks since we have launched Argon, we have seen a 30% increase in CLs, and more importantly, almost a similar increase—a one-third decrease in rollbacks. People are writing code more productively and better code with it. We are tracking it with newer metrics now. How are you dealing with opposition to data centers? If you can’t build in the U.S. the way you want to, where else do you go? We’re very committed to building our data centers very responsibly. When I look at our largest data centers in some of the communities where we have been the longest, I visit them, I talk to people. There are people who come and tell us their kids have gone to college because of our investments in these communities, and we’ve grown in those communities. To me, this is about doing it right. Engaging with the communities early, doing it transparently. We are committed to making sure we are bringing incremental power, and we cover 100% of the cost of our power needs for these projects. It’s understanding the impact on neighborhoods and making sure you’re working thoroughly to address them. Done rightly, you can continue making progress. But we are constantly taking feedback into account. I do worry not everyone operates the same way. People have been surprised by data centers showing up in their backyard. Those are all important. As an industry, we should continue to do better. But part of the reason, in a 20-year time frame, we are thinking about things like data centers in space is making sure we are able to put these data centers where maybe the trade-offs will be different. What unproven area of AI is Google working hardest to crack? Is it continual learning—getting models to keep updating after release—or something else? There are multiple parallel paths. You saw with Argon we have a million output tokens. With our Gemini models early on, we had a one-million context window on the input side. These are all examples of breakthroughs we are constantly working on. How do you think about synthetic data? How do you think about continual learning? How do you think about more efficient architectures? We do dedicate a meaningful percentage of our compute to these research bets too. It always goes hand in hand, including our world models. Those are all bets we are placing. Sometimes, as part of these bets, there are ideas that emerge which just make their way into the mainline models. Maybe we don’t fully talk about it, but we have multiple steps in these areas. Working in technology requires optimism that building something will improve the world, but those bets can leave real consequences when they fail. I recently returned to a town in El Salvador where enthusiasm for Bitcoin had given way to unfinished construction and something resembling a ghost town. How do you maintain the optimism you spoke about in your Stanford commencement address while accounting for those risks? I genuinely have a deep conviction that improving technology and improving access to technology makes people’s lives better. It’s been my personal experience in my life, out of which comes that deep conviction, optimism. But with that, I’ve always felt humanity’s journey is always about working hard to harness that technology to make it work well for society. The optimism is not an optimism that you just build whatever you want, whenever. You work hard to make sure you’re building technology in the service of humanity, to make the human condition better. That’s got to be the defining goal as we are approaching it. With that framework, I’m very, very optimistic. We are in very early stages of the kind of progress that we are going to see on many areas. We’re all talking about areas like healthcare. A lot of the progress is ahead. The ability to make things in a fundamentally cheaper way on many things where things have been getting expensive for a long, long time, discovering new materials, etc., which really bend the curve—it’s tough to step today and understand the impact of all that, but they’re going to be very profound. I’m very optimistic, but we have to be rightfully concerned about all the ways this technology can go wrong. Sundar, I know you don’t do many of these. Thank you. Thanks, Alex. Appreciate it.
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