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It is hard to believe that in 2025, we are still dialing to schedule doctor appointments, get referrals, refill prescriptions, confirm office hours and addresses, and handle many other healthcare tasks. In fact, I created Zocdoc nearly 20 years ago to help patients avoid the dysfunctional phone experience and schedule appointments online. But I must confess that I have to pick up the phone sometimes, tooand I dread it. I am not alone. According to a recent survey my company conducted, most Americans say they dread calling their doctor about as much as they dread getting a shot. At best, it is an inconvenience. At worst, the phone is a barrier to care and a wildly inefficient and costly channel for providers. Given that billions of healthcare interactions occur over the phone each year, this is a calamitous liability. Relying on technology that was revolutionary in 1876 is no way to manage Americas healthcare administration. Especially because 150 years later, a new technology has emerged that will transform how healthcare operates: artificial intelligence. While AI incites a range of feelings when it comes to its clinical implications and possibilities, I am much more focused on leveraging AI to solve healthcares administrative challenges. Considering these burdens cost $600 billion to $1 trillion annually, AI offers a remarkable opportunity to increase efficiency, reduce waste, and deliver first-class experiences for everyone. As I see it, the effort to leverage AI to improve healthcare administration will unfold in three stages: Assistive, Autonomous, and Augmentative AI. Assistive AI: Supervised Intern In the Assistive stage, I view AI as a capable but dependent intern. It supports healthcare workersbut requires ample supervision. Take AI scribes, for example. Although the technology takes records and transcribes patient encounters, physicians must still review and revise the notes to ensure they are correct. However, because AI scribes cannot yet work autonomously, documentation burdens remain and there is not a pure efficiency gain. And they do not even begin to clear the waste and friction burdening office staff and patients. Autonomous AI: Productive Peer AI that works independently defines the Autonomous stage. Instead of an intern, think of the technology as a peer. This is where efficiency gains begin to accrue, and it is where we are now. To understand Autonomous AIs potential, lets return to the phone. In healthcare, the phone is bad for business. Up to 20 percent of calls go unanswered, with each missed call costing provider organizations $200 to $300 in lost revenue. Half of Americans say theyre likely to switch providers if they cannot get through to their doctors office. The phone is also bad for health outcomes. More than half of patients admit to delaying care when they cannot reach their doctors office, while a third admit to giving up on scheduling a visit entirely. Autonomous AI is perfectly suited to remove these challenges. Appointment management is high volume, with billions of calls a year. It is highly volatile, with fluctuating peak times that are hard to efficiently staff. And it is highly rote, with most scheduling tasks being simple and repetitive. This makes appointment management a prime area for AI, freeing staff to focus on more valuable, complex responsibilities. In fact, the best AI phone assistants can successfully and independently handle more than 70 percent of a practices inbound scheduling calls. The AI phone assistants ability to scale efficiency, improve the patient experience, and help practices counter macroeconomic headwinds and bolster their bottom lines is compelling. Augmentative AI: Superhuman Colleague When AI surpassesand then scalesanything humans can do, we enter the Augmentative stage. Soon, polyglot AI phone assistants will detect and then offer to converse in a patients preferred language. AI models will recognize patients appointment preferences, from cadence of visits to time of day and day of the week. AI will even predict the likelihood of a patient attending an appointment and then create custom engagement plans to increase those odds. Augmenting AI will also excel at anticipating patients needs. It may contact a patient before a prescription runs out and offer to refill it with their pharmacy, or it may proactively schedule a checkup at their preferred appointment time. This might sound futuristic, but given AIs rapid advances, this stage is fast approaching. My prediction is this is likely only 12 to 18 months away. AI or Obsolescence It is tempting to point AI toward healthcares moonshots, but our biggest and most immediate opportunities for transformation lie in fixing the basics. With AI, we finally have the technology to bring Americas healthcare experience out of the 1800s and into the modern age. In doing so, we can remove the friction, barriers, and waste that have disempowered patients and saddled providers for decades. Change will happen suddenly, and then all at once. Because AI improves by the minute, healthcare organizations that wait to adopt this technology lose more ground every day. In no time, they will find themselves as relevant as a rotary phone.
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E-Commerce
Greenlands coastline is huge: a sprawling 27,394-mile labyrinth of fjords, glaciers, and ice-choked waters, longer than Earths circumference. Its length and topography makes it one of the planets longest and most logistically hostile to patrol in peacetime. Now, with countries like Russia and the United Statess neo-imperialist plans to grab as many Arctic natural resources as possible, it is one of Europes frontlines. Which is why people like Jens Martin Skibstedglobal partner and VP of foresight and mobility at design studio Manyoneare thinking about how to better protect a wonderland that is key for the future Denmark and the European Union.For decades, Denmark has relied on the Sirius Dog Sled Patrol (yes, soldiers using sleds and good boys), satellites, and sporadic aerial surveys to monitor this vast expanse. These methods are slow, costly, and imprecise. For example, in 2023, a tsunami in Dickson Fjord went unnoticed for a year, clearly exposing the systemic gaps in this mixed surveillance system. [Image: Manyone]Skibsted and his design team originally thought drones could be a solution. Drones are efficient, they can act in swarms, and they can be fitted with cameras and sensors that can feed an artificial intelligence system to keep track of that vast ice landscape at all times. But traditional drones have problems. The big ones are long range but expensive to operate and require human crews. The small ones dont have enough range: Their batteries run out after a short time and they need to return to a base to reload. Skibsted and his team thought that they needed a new solutionone that could fly, so they could quickly cover large patches of territory, but also one that could operate entirely on its own, landing, recharging, and taking off again. The AquaGlider, as they called their drone, is a solar-powered autonomous drone. It reimagines the USSRs ekranoplan, a large airplane-like vehicle once feared by NATO, which the Red Army wanted to use for coastal invasions. Its origins trace back to the 1960s, when Soviet engineer Rostislav Alexeyev designed a hybrid aircraft-boat that exploited ground effect, an aerodynamic phenomenon where wings gain increased lift and reduced drag when flying within one wingspan of a flat surface. By skimming 1030 feet above water, these mammoth craft, like the 550-ton Caspian Sea Monster, achieved fuel efficiency double that of airplanes, hauling military assets at 300-plus mph. Soviet GEVs were plagued by instability in rough seas, navigational hazards, and political abandonment after the USSRs collapse. [Image: Manyone]Its ironic that a machine inspired by Soviet ingenuity could become Europes first line of defense in a region where Russia is rapidly militarizing (and which Trump also wants to control). But Skibsted saw potential in this forgotten tech to create a new kind of vehicle. The proposed AquaGlider would fly on its own for weeks at a time, taking off and landing on water; its designed to recharge while floating thanks to solar panels, and avoids storms by simply sitting on the water rather than flying. The drones make the most efficient use of energy, dozens of them zipping along the huge coastline a few feet above the water to absorb information and transmit it to base, surveilling everything from illegal fishing to Russian submarine activity.[Image: Manyone]Engineering perpetual motionThe AquaGlider is basically a wing that uses two propellers to speed forward, trapping air against the ocean or ice. This creates an air cushion that allows it to glide with minimal energy. This ground effect lets it travel twice as far as a conventional aircraft on the same power. During takeoff, retractable hydrofoils lift the hull above waves, reducing drag until the craft transitions to flight. If storms surge, electric thrusters enable vertical takeoff, though Skibsted told me in an email interview that this zaps the battery and is a last resort.[Image: Manyone]Solar panels cloak its wings and underbelly, harvesting energy even in twilighta critical feature near the Arctic Circle, where summer brings 24-hour sunlight and sometimes the sun rays go almost parallel to the ground for most of the day. Still, Greenlands winters, with months of darkness, pose a problem. Here, the AquaGlider docks with buoys that store energy from waves and offshore wind farms. These buoys double as communication relays, transmitting data to satellites or coastal stations.[Image: Manyone]Durability is baked into its graphene-coated composite hull, which resists corrosion and iceberg collisions. It avoids obstacles like any driverless car, Skibsted tells me, relying on Lidar and thermal sensors to navigate. For icinga fatal flaw in Soviet designsthe drone borrows deicing systems from modern aircraft designed to work under extreme conditions, like those of Air Greenlands he says, using heated surfaces or pneumatic boots to shed frost.[Image: Manyone]The geopolitical iceberg aheadFor now, however, after all the technical work done with an unnamed drone manufacturer that was Manyones client, the AquaGlider remains a design on paper. The client aborted the project because they were too busy making drones for the Ukraine war, Skibsted says. So, basically we own it ourselves. We dont know what will happen, but Denmark is investing heavily in the arctic.Indeed. Denmark knows that things may get really bad. Russias Arctic ambitions loom large. Its shadow fleet patrols the GIUK Gap (Greenland-Iceland-U.K.), mapping underwater cables and wind farms for potential sabotage. Danish intelligence warned that Russia could mobilize for regional war within five years, which now have been updated to just two if NATO appears divided, according to Troels Lund Poulsen, the Danish defense minister: Russia is likely to be more willing to use military force in a regional war against one or more European NATO countries if it perceives NATO as militarily weakened or politically divided. In response, Denmarks 20242033 defense agreement has committed $570 million to maritime upgrades, including autonomous drones, underwater sensors, and 21 new Home Guard vessels.[Image: Manyone]The AquaGlider fits neatly into this strategya low-cost, persistent patrol akin to Ukraines low cost maritime drones, which have destroyed or damaged at least 26 Russian naval vessels in the Black Sea since the war began including the Red Navys Moskva flagship. But Denmarks immediate investments are pragmatic: four minelaying ships and underwater drones will deploy by 2030. But theres also a section of the budget that will be dedicated to autonomous surveillance crafts that can monitor the coastlines, Skibsted tells me. Thats where AquaGlider can fit. It makes sense from a design perspective. It will be up to the engineers to make it a reality, if it picks up the interest of the Danish government.
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E-Commerce
Charles Suppon has big plans for the Tunkhannock Area School District. At any given time, the northeastern Pennsylvania districts chief operating officer can rattle off statistics about fields in which its schools excel: arts, AP classes and softball, as well as on-the-job training programs for future farmers, welders and more. Goats and chickens roam the high schools courtyards, where students also tend to koi fish; in the hallways just beyond, high schoolers tinker with tractors, build furniture to sell and offer free tax services for the broader community. But Suppon speaks with vigor when he talks about the five-megawatt system he hopes to install across five solar arrays on the districts buildings and surrounding property. The solar panels will heat the districts pool and serve as the basis for new curricula and jobs training classes on the solar industry. For a rural district of around 2,000, Tunkhannock is punching above its weight class, he believes. Were a smaller school district doing big things. Suppons district is in a bright red portion of Pennsylvania northwest of Scranton, narrowly outside one of the states more prolific natural gas regions. For him, solar is simply a pathway toward cost savingsjust as natural gas, from which the district earns royalties off several leases, has been. Tunkhannock believes it could save upwards of $1 million a year by switching to solar, money that could be used for student initiatives. It was always a financial decision, Suppon said. We wanted to be able to offset our energy costs, produce our own energy, and only pay distribution [fees] back to the grid. Theres one catch: Tunkhannocks plan to go solar is contingent upon winning more than $1 million in funding from the states Solar for Schools program. Currently in its inaugural year, Solar for Schools was born from a bill that faced an uphill battle in a legislature where environmental bills often die by attritiona battle that required its creator, progressive Rep. Elizabeth Fiedler (D-Philadelphia) to reach across the aisle and help marry what are often competing interests in the statelabor, education, and climate. But that money for Tunkhannock might not come through because of the stiff competition for the limited funds. While last years state budget gave the Solar for Schools program $25 million to disperse to school districts, the program received applications that add up to nearly four times that amount from schools and districts large and small, rural and urban, and conservative and liberal. I was pleased, but hardly surprised, Fiedler said in an email to Capital & Main of the demand. The disparity between the grant programs budget and the size of its application pool mirrors a broader reality within the state Legislature: Despite clear and growing demand for solar energy, the political will to meet it has yet to catch up. A 2022 poll of more than 1,300 Pennsylvanians conducted by Vote Solar Action, an advocacy group urging pro-solar legislation at the state level, found that 65% of Pennsylvanians support large-scale solar farm development in the state. More than 80% said they support rooftop solar, while 73% support natural gas and 52% support coal. I [have] visited nearly every corner of the state, from Waynesburg to Bethlehem, and in every place I met folks who wanted to save money on electricity, create good local jobs, and preserve the beauty of their communities, Fiedler said. Yet the state lags far behind most others in solar development: Pennsylvania currently ranks 49th in the nation for its growth in solar, wind, and geothermal generation over the last decade, according to the nonprofit advocacy group PennEnvironment. It has fallen behind other major fossil-fuel producing states, like Texas, the countrys second-largest solar generator in 2023; California, where solar and wind together comprise close to half the states energy generation; and New Mexico, which Environment America, the national organization behind PennEnvironment, ranked 4th in the U.S. for renewable energy production in 2024. Just 3% of Pennsylvanians now have solar panels on their roofs, Vote Solar Actions poll foundthough 31% said theyd be interested in installing them. The lag could be attributed, in part, to interconnection delays by the regional grid operator PJMthough many of its neighbors in the same system, like Washington D.C., New Jersey, and North Carolina, have eclipsed Pennsylvanias solar production. Because of increased demands predicted by PJM, utility bills in Pennsylvania are slated to increase this summer. Fiedler sees solar production as an antidote to what could be an oncoming energy crisis in the state. We must generate more electricity, she said. Nuclear, wind, geothermal, and gas power plants can all be part of the solution, but the fact is we need energy now, and solar is the fastest. But solar initiatives continue to hit gridlock in the halls of state power. After making its way through the state House last summer, a bill that would have enabled community solara program that allows multiple residents to enroll in a shared solar array separate from their homesdied in the Republican-controlled Senate. The bills author, Rep. Peter Schweyer (D-Lehigh), who introduced it as a way to make solar accessible for renters, apartment dwellers and those who cant afford solar panels by themselves, has had to reintroduce the bill and start over again this session. Gov. Josh Shapiros attempt to pass an updated renewables target also failed to gain traction in the Legislature last session. Where a 2004 target required 05% of the states energy generation to come from solar, the new plan would have required the state to reach a 35% target by 2035 that included solar, wind, and nuclear energy generation. He has reintroduced it as part of a broader energy package dubbed the Lightning Plan. In a divided legislature, the fate of both initiatives is tenuous. As renewable energy faces sweeping attacks at the federal level under the direction of President Donald Trump, states are stepping up to hold the line. Whether Pennsylvania will prove itself to be a meaningful player in this fight remains an open question. Climate change has become politicized, said David Masur, executive director of nonprofit advocacy group PennEnvironment. Which then potentially can create more powerful special interests who are opposed to common sense policies and have a vested self-interest in the status quo, and politicians having sort of a knee jerk reaction to oppose things [that] are probably good even for their very own constituents. Case in point: Solar for All, a federal grant program initiated by the Biden administration that awarded Pennsylvania $156 million for residential solar installations on low-income households, was designed to save residents $192 million over the next 20 years in energy costs while averting 43 million tons of planet-warming carbon dioxide emissions from entering the atmosphere, the equivalent of removing more than 9 million cars from the road for a year. These funds quickly became a negotiating chip. During deliberations over the 2024 state budget, a line was inserted into an omnibus fiscal code bill that prevented the state from accessing the funds. Though the Solar for All program was just one of several dozen federal environmental grants Pennsylvania won under Biden-era initiatives, the budget bill specifically calls out that one program. It requires legislative approval for the programs funds to be disbursed. So, Fiedler sought out exactly that when she authored HB 362, a bill that would force the Legislature to vote on allowing the Pennsylvania Energy Development Authority, the states independent financing authority, to distribute funds it has already been awarded. Fiedler said the funds are already under contract with the federal government. HB 362 passed the House Energy Committee, which Fiedler chairs, in March. It now sits in the state House, home to a slim one-vote Democratic majority, as a battle to free the money falters after being confronted with a last-minute hurdle. Two days after the bill passed, Rep. Craig Williams (R-Chester County), introduced an amendment that would require the states utility regulator to promulgate regulations on net meteringa system that allows residential solar users to sell surplus energy back to the grid to incentivize the buildout of rooftop solar. Environmentalists fear the amendment could open the door to doing away with net meteringa major financial incentive for many residential solar owners. Reforming net metering has long been a priority of the American Legislative Exchange Council, a conservative lobbying firm that disburses model bills to states, including those fighting renewable energy and attacking environmentalists. The group argues that paying solar owners for the energy they produce is costly for utilitiesthey pay them retail rates, rather than wholesale rates, and residential solar producers may end up generating enough energy to offset distribution fees theyd pay for the wires that move energy around the grid. Utilities then pass those costs onto consumers, and nonsolar users end up subsidizing their neighbors with solar panels, they argue. Williams has used similar language in opposing solar legislation; environmentalists generally disagree with this premise. Critics were quick to point out that, prior to joining the Pennsylvania House in 2020, Williams spent more than 10 years as general counsel for PECO, a Philadelphia-based utility that has come under fire from environmentalists for neglecting to increase its share of renewable energy. State lobbying and campaign finance records show the company spent more than $600,000 on lobbying in 2024, and donated $6,000 to Williams in 2024 between a failed run for attorney general and a successful campaign to keep his seat in the state House. The trade group that represents PECO and other utilities, the Edison Electric Institute, has long challenged net metering as states have grown their share of solar production. The more people who generate energy from their homes, the less [utilities] get to build out their larger operations, said Elowyn Corby, Mid-Atlantic regional director for Vote Solar Action. Williams amendment passed with support on both sides of the aisle. Environmentalists, however, consider it a poison pillone that could weaken the states fledgling solar industry. In Pennsylvania, probably the best thing we have going for solar is net metering, said Masur, the PennEnvironment director. Minus Williams amendment, Fiedlers Solar for All bill makes common sense, Corby said. At its heart, the goal of this legislation is to make sure Pennsylvania doesnt send federal money that belongs to our neighbors back to DC, Fiedler said. The Solar for All program focuses specifically on serving homeowners who might otherwise be unable to afford solar panels of their own. In Pennsylvania, funds are specifically earmarked for low-income households, who are guaranteed at least 20% savings on their electricity bills. Its unclear whether Fiedler will push forward to advance HB 362 now that it includes a threat to net metering. In the coming months,the state Legislature may also vote on initiatives that would put solar panels on municipal and emergency response buildings; warehouses and distribution centers; and townhouses governed by homeowners associations. Shapiro has proposed reupping the Solar for Schools programs $25 million appropriation in the 2025-2026 budget, set to be finalized by June 30. Though Fiedler said shes pleased to see the program reinstated, she said that number is the minimum we should budget. Jim Gregory, a former state representative and now executive director of the Conservative Energy Network-Pennsylvania, has committed himself to convincing his former colleagues of the importance of renewables in a diverse state energy portfolio. If that money is going to be made available, we want to see it made available to low- and moderate-income families in rural Pennsylvania, he said. Gregory said hes watched as attitudes toward solar among conservatives in state government have shifted. I dont oppose anyone who wants to put solar on their rooftop or anything like that to help with utility bills, said Rep. Kathy Rapp (R-Warren) at a recent meeting of the House Energy committee on Fiedlers bill. Rapp has, for several sessions, introduced legislation requiring solar operators to create end-of-life plans for their arrays, which has yet to pass. Though far from an all-out embrace of solar, Rapps language offers a window into a softening stance on renewables. In 2019, Rapp wrote on her Facebook profile that solar and wind energy pose serious environmental risks, and called its supporters radical Green New Deal proponents. Despite past roadblocks, Fiedler remains optimistic about the fate of solar initiatives in the state. She sees the Solar for Schools program as evidence of broadening support for clean energy. I believe there is political will for solar and all types of energy development in the state, she said. A lot of that success comes from the broad stakeholder coalition we built and from the support of colleagues on the other side of the aisle. For school districts like Tunkhannock, the states ability to reach consensus has very real consequences. With the fate of federal solar tax credits unclear, district leaders say they are currently on the edge of their seats. The Solar for Schools grant could end up being a lifeline. To say not getting potentially a million dollars in grant money wouldnt affect us at all I think would be a lie, said Suppon, the school districts chief operating officer. This piece was originally published by Capital & Main, which reports from California on economic, political, and social issues.
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E-Commerce
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