Ordered isn't the same as done
Deciding on a treatment isn't the same as the patient receiving it. Labs, authorizations, pharmacy, scheduling and follow-up sit in between, and the physician keeps the list of what's still open.
Insights/Authors

Co-founder & CEO, Semblance Health
Led $100M+ Data & AI partnerships at IBM and GitLab, spanning enterprise AI platforms, strategic alliances, and commercialization. Published trustworthy-AI and high-performance computing researcher.
BJ writes about the gap between the care a physician orders and the care that actually happens.
Where follow-through breaks in clinical work, and what it would take to know the care you order happened.

· 8 min read
Sicker patients, more specialists, more payer steps, fewer hands. The tools track orders and messages, not whether the care you order actually happens.
Read the essayThree arguments run through everything BJ writes.
Deciding on a treatment isn't the same as the patient receiving it. Labs, authorizations, pharmacy, scheduling and follow-up sit in between, and the physician keeps the list of what's still open.
An insurer won't join a shared tool, and neither will a contracted group or a practice that just changed owners. So verification has to work by observation: a result lands, a note appears, a call comes back.
A model reading a chart can surface a plan with no result. It cannot surface the consult sent to a group that charts elsewhere, or the records request that went out by fax.
From OpenAI just plugged into Epic. It still can't tell you whether the consult came back.
30+
clinicians asked how they track what they're waiting on, since April
Not one physician named the EHR. Paper and memory win because they are the only tools that go wherever the work goes.
“I do it by paper and pen.”
“We've spent our careers building high-stakes AI systems and delivering complex neurological care. We created Semblance to make sure clinical intent survives every handoff—until the work is done.”
BJ co-founded Semblance with Chris R. Collins, MD, MSCS, CRND, a Vanderbilt-, Ochsner- and Jefferson-trained neurologist who practiced at Penn State and Geisinger. Chris brings the clinic. BJ brings years of building enterprise AI and the partnerships around it.
Meet the teamIf you run a specialty practice where treatment decisions wait on labs, authorizations and scheduling, give us twenty minutes. We'll trace the last patient who waited, from your decision to the first dose. You keep the write-up either way.
We're selecting a small number of specialty practices to work with before anything goes live.