David Van Sickle

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David Van Sickle

David Van Sickle

@dvansickle

Healthtech exec, board member, and advisor. Invest Committee @LifeArcVentures. Prev: co-founder/CEO Propeller Health (acq ResMed)

Katılım Kasım 2008
4.1K Takip Edilen6.1K Takipçiler
David Van Sickle
David Van Sickle@dvansickle·
@aakashgupta also interesting that I'm having multiple, simultaneous health-related conversations with AIs (eg, diet choices, medical issues, health goals, exercise/workouts) and it is able to cross-reference + fully integrate those more readily than individual purpose-specific apps
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Aakash Gupta
Aakash Gupta@aakashgupta·
Karpathy is describing a personal operating system and most people are reading this as a post about fitness apps. Think about what actually happened here. He had a goal (lower RHR from 50 to 45), a sensor (Woodway treadmill), a protocol (Zone 2 + HIIT), and a timeline (8 weeks). The LLM stitched all of that together into a custom interface in an hour. No app store. No searching for the least-bad option. No adapting his workflow to someone else's UI. That's what an operating system does. It sits between you and your hardware, manages your resources, and renders the interface you need at the moment you need it. The PC era gave us one OS across all applications. The mobile era gave us one OS across all apps. The agent era gives us one OS across all of life. Your health data, your finances, your work projects, your home automation, all brokered through a single layer that already has your context and builds the interface on the fly. The 1 hour to 1 minute gap Karpathy identifies maps cleanly to how long it took early operating systems to mature. First you had to write your own drivers. Then hardware manufacturers standardized interfaces. Then plug-and-play emerged. Woodway not having an API is the equivalent of needing to write your own printer driver in 1994. Annoying, but temporary. The real unlock is the context layer. Karpathy's agent already knows his RHR baseline, his training history, his schedule. A cold-start app never does. Every bespoke app the agent builds gets better because every previous app taught it more about you. That's a compounding advantage no app store can replicate, because app stores don't share state across apps. Your agent does. We're watching the early boot sequence of the personal agent OS. It's clunky. You have to notice bugs and flag unit conversion errors. But the trajectory is the same one we saw with every prior computing platform: hardware standardizes its interfaces, the OS layer gets smarter, and the user stops thinking about the plumbing entirely.
Andrej Karpathy@karpathy

Very interested in what the coming era of highly bespoke software might look like. Example from this morning - I've become a bit loosy goosy with my cardio recently so I decided to do a more srs, regimented experiment to try to lower my Resting Heart Rate from 50 -> 45, over experiment duration of 8 weeks. The primary way to do this is to aspire to a certain sum total minute goals in Zone 2 cardio and 1 HIIT/week. 1 hour later I vibe coded this super custom dashboard for this very specific experiment that shows me how I'm tracking. Claude had to reverse engineer the Woodway treadmill cloud API to pull raw data, process, filter, debug it and create a web UI frontend to track the experiment. It wasn't a fully smooth experience and I had to notice and ask to fix bugs e.g. it screwed up metric vs. imperial system units and it screwed up on the calendar matching up days to dates etc. But I still feel like the overall direction is clear: 1) There will never be (and shouldn't be) a specific app on the app store for this kind of thing. I shouldn't have to look for, download and use some kind of a "Cardio experiment tracker", when this thing is ~300 lines of code that an LLM agent will give you in seconds. The idea of an "app store" of a long tail of discrete set of apps you choose from feels somehow wrong and outdated when LLM agents can improvise the app on the spot and just for you. 2) Second, the industry has to reconfigure into a set of services of sensors and actuators with agent native ergonomics. My Woodway treadmill is a sensor - it turns physical state into digital knowledge. It shouldn't maintain some human-readable frontend and my LLM agent shouldn't have to reverse engineer it, it should be an API/CLI easily usable by my agent. I'm a little bit disappointed (and my timelines are correspondingly slower) with how slowly this progression is happening in the industry overall. 99% of products/services still don't have an AI-native CLI yet. 99% of products/services maintain .html/.css docs like I won't immediately look for how to copy paste the whole thing to my agent to get something done. They give you a list of instructions on a webpage to open this or that url and click here or there to do a thing. In 2026. What am I a computer? You do it. Or have my agent do it. So anyway today I am impressed that this random thing took 1 hour (it would have been ~10 hours 2 years ago). But what excites me more is thinking through how this really should have been 1 minute tops. What has to be in place so that it would be 1 minute? So that I could simply say "Hi can you help me track my cardio over the next 8 weeks", and after a very brief Q&A the app would be up. The AI would already have a lot personal context, it would gather the extra needed data, it would reference and search related skill libraries, and maintain all my little apps/automations. TLDR the "app store" of a set of discrete apps that you choose from is an increasingly outdated concept all by itself. The future are services of AI-native sensors & actuators orchestrated via LLM glue into highly custom, ephemeral apps. It's just not here yet.

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David Van Sickle
David Van Sickle@dvansickle·
I wonder whether anyone's tried to make a terrestrial radio station powered entirely by AI? (ie, using a combo of tools to write dialogue, research local events / news, speak text, create music, and stitch it altogether and control broadcast)?
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David Van Sickle
David Van Sickle@dvansickle·
For as long as I can remember pulmonary rehab has been a marvel of supply constraint. A safe + effective intervention for COPD that we make available only to a handful. Even if you don’t hear much about it, thankfully there’s been a strong, recent surge in virtual PR programs
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David Van Sickle
David Van Sickle@dvansickle·
We need more people exploring creative ways of building medtech companies at fractions of the costs it took historically
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David Van Sickle
David Van Sickle@dvansickle·
@auren I’m meeting a lot of academic founders (ie scientists and clinicians turned entrepreneurs) now trying to get new companies off the ground. Many are compelling! Would love to connect them to you and Flex
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Dhruv Vasishtha
Dhruv Vasishtha@dvasishtha·
Congrats to @christophmcghee on reacquiring current health from Best Buy and taking back the helm to scale hospital at home and other home based care models. Also interesting move, only other comp that comes to mind is the Ciitizen team spinning itself back out from Invitae.
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Sam Parr
Sam Parr@thesamparr·
Need a new book. Whats your favorite American history book? Can be fiction or nonfiction.
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David Van Sickle
David Van Sickle@dvansickle·
Here for the weird Victorian spam
David Van Sickle tweet media
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David Van Sickle
David Van Sickle@dvansickle·
Too late now, but dang this was a massive study of Propeller Health in COPD. 164 primary care centers, 835 patients, enrolled for a year, yielding 23 percent reduction in treatment failure
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Christina Farr
Christina Farr@chrissyfarr·
Who in my network is in health-tech and in Chicago?
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David Van Sickle
David Van Sickle@dvansickle·
@rtnarch Good news. I hope we can also rationalize biocompatibility testing in medical devices, too, while we're at it
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David Van Sickle retweetledi
Dr. Tom Frieden
Dr. Tom Frieden@DrTomFrieden·
For 75 years, every time any U.S. state has requested epidemiologic assistance (an “Epi-Aid”), CDC sent disease detectives. Now, Wisconsin has asked for help to address newly discovered lead poisoning in Milwaukee. But all CDC experts in lead poisoning were just fired, along with so many others who have spent their working lives dedicated to protecting Americans. As far as I know, this would be the first time the CDC every has not responded to a formal request for assistance from a state.
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David Van Sickle
David Van Sickle@dvansickle·
"Make it seem inevitable" - Louis Pasteur
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David Van Sickle
David Van Sickle@dvansickle·
I refuse to act my age when competing physically with younger people… - Ed Gavagan today in Oldster
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