Human Health is a complex phenomena. Software is a human designed artifact. Digital Health has struggled because we don’t adapt our software for that complexity.

The dominant design approach for modern software is to centralize decisions in algorithms. To say the least, it is efficient. Future often looks like the past for most things, and automating human decisions is convenient to solve for busy-ness. So it goes for “Digital Health”. …

h/t Dilbert Comics

You have to be be Agile in principle, for Agile to work for you in method.

The principle is about accelerating value for users — through fast and efficient value attempts. It is about finding the most efficient way to execute the discovery-design-create cycle in the smallest possible batch. It concerns with the “essential complexity” of building software for user value. You know, the stuff concerning with humans/users that can’t be automated.

And the method should be in service of the principle — first and foremost. Because that prevents the method from becoming that fast galloping horse we have talked…

Software development is creative work.

Outside of physical and metaphorical Silicon Valley, it is regarded as build work, focused on replicating discovered value. Doing yearly budgeting cycles, gathering extensive requirements before project starts, working in big batches and delivering in infrequent releases are telltale signs of build work.

This build metaphor fails when software is a vector for new value. Like when health enterprises have to create software to improve real world health outcomes.

For such scenarios, we have discussed before: Value needs to be discovered. Designs need to be adapted.

A map as detailed as the territory it represents is of no use. Maps become useful when they leave details out. Jorge Luis Borges’ 146 word story, On Exactitude in Science, illustrates this beautifully. A kingdom creates a perfect map “which coincided point for point”. “Following generations”, which didn’t love cartography as much, found it “useless”. They consigned the map to ruin under “inclemencies of sun and winters”.

Fair to say, Borges’ cartographers didn’t have something like Google Maps. Where you can represent the perfect detail, at least in theory. And you can have turn-by-turn directions without getting paralyzed. Also…


I read an old Zen story about a man riding a horse once. The horse was galloping fast, and it appeared this man is going someplace important. Another person standing along the road asked, “where are you going?” The rider yelled back, “I don’t know. Ask the horse.”

I believe this is our situation when we are building software for complex problem domains like human health.

As is our wont, we gather requirements to decide what to build. We believe users know what they want. Requirements understood that way are not requirements. They are expressions of what somebody thinks what…


Marc Andreessen from a16z wrote, or rather proclaimed, in 2011: “Software is eating the world.” The proclamation was fairly prescient for the world of consumer software at least. There are very few aspects of digital consumer’s life left untouched by the magic of software. You can almost feel it: when one tap on our smartphone can summon a car and driver; in software that recognizes our faces; when insomnia induced purchases show up at our doorstep next morning. Such seemingly magical examples abound.

What would be an appropriate reflection on “software eating the world” in 2020? The answer, I believe…

Amarinder Sidhu

Inventing on Principle. Writing to Learn. Rough Drafts @

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