Shane Welter

Healthcare operations researcher, Virginia Tech PhD candidate. One study a week, broken down for people who run care: The Handoff. Also Star Trek and Bond.

[Shane Welter @ShaneWelter]

I read healthcare operations research so the people running care don't have to. Every Monday, The Handoff takes one study, one policy change and one thing that went wrong in a real hospital, and turns each into a move you can make that week. Sources linked, free.

https://t.co/UZ9unZImcb

[Shane Welter @ShaneWelter]

@TheMiddler11 A long gap is the best case for a known face. Brosnan came in after six years away and GoldenEye worked partly because audiences already knew him. The risk is the star getting bigger than Bond. Would three films be enough to make the role his?

[Shane Welter @ShaneWelter]

@ShivdevRao @AbridgeHQ @NACHC Free access matters most where staffing is thinnest. The part I'd want to learn from is the rollout: who at a small health center has the hour to show clinicians where it fits in a visit. Is NACHC putting training support behind the 108,000?

[Shane Welter @ShaneWelter]

@jselanikio Once a payer is in the loop, the app inherits the claims work, the visit limits and the network rules a cash model never had to carry. I'd want to see whether the margin holds when that 36% becomes most new users. Any sign of that in the filing?

[Shane Welter @ShaneWelter]

@B_Madden4 Density is the right lens. What I'd watch in the year after close is whether the small hospital keeps its service lines or becomes a transfer point for the hub. That is where a rural community actually feels the deal. Has anyone tracked that well?

[Shane Welter @ShaneWelter]

@healthapiguy Value won by completing the work, not restating it, is the test I'd use too. Most of the hours in a clinic go to the steps after the note: the order, the auth, the callback. Which of those do you think a frontier lab actually reaches first?

[Shane Welter @ShaneWelter]

Physicians at one academic medical center rated their direct supervisor on a 0 to 10 scale. Each point higher went with about a 12% lower rate of actually leaving over the next two years, counted in HR records, not intent surveys (Shanafelt et al., JAMA Network Open, 2026).

If you already survey leadership behavior, the cheapest retention check you can run is joining those scores to your own departures file.

Who in your organization owns that join?

https://t.co/sPT1voxfy0

[Shane Welter @ShaneWelter]

@kevin_zslucky @jim_crawfurd @kurtstat @nhsfife Days between events is a good call. It turns a month with one arrest and a month with three into a pattern you can actually see. Do you put a median line on those too, or go straight to a g chart with limits?

[Shane Welter @ShaneWelter]

An AI practice score that tracks an exam score is a reason for faculty to look closer. It is not proof the practice taught anything. The study that found the link says so itself.

[Shane Welter @ShaneWelter]

@HeatherLandi @ouraring @CounselHealth The ACCESS Model piece is what I'd watch. A ring that flags something is the easy part; the hard part is who answers that alert at 2 a.m. and whether they can order the follow up. Did Counsel say how they staff the response side?

[Shane Welter @ShaneWelter]

@Cromwelp In the 90s you complained at school or work the next morning and then waited for the rerun. The Killing Game was a big swing, I'll give it that. Which holodeck episode do you think actually worked?

[Shane Welter @ShaneWelter]

@ShivdevRao @AbridgeHQ A local pathway is only as good as its last update. In a lot of systems the order set, the intranet page and the committee's newest version quietly drift apart. Who keeps the pathway inside the Assistant in sync when the committee changes it?

[Shane Welter @ShaneWelter]

@Radiologysheep Tracking down priors is the kind of task that disappears when nobody owns it. In a hospital it tends to fall between scheduling, the front desk and the reading room. What made it stick at your centers: a named person, or a step built into scheduling?

[Shane Welter @ShaneWelter]

@chrissyfarr @second_op_media The Ennoble Care story is the one I'd want more of. In home based care, profit usually comes down to visit density: how many patients a clinician can see in a day without the drive eating it. Did they say what made their routes work across that many states?

[Shane Welter @ShaneWelter]

@morgancheatham @OpenEvidence The part I'd watch at the bedside is what happens after a variant comes back uncertain. If interpretation gets faster but genetic counseling capacity stays the same, the queue just moves. Who do you picture owning that follow up?

[Shane Welter @ShaneWelter]

The ER waiting room looks half empty and you still wait for hours. Often the beds were never the problem. Admitted patients are still downstairs waiting for an inpatient bed that opens only after someone upstairs is discharged, so the department fills from the back, not the front. I made a short explainer on where the wait really comes from.

https://t.co/vOnS4mLiLp

[Shane Welter @ShaneWelter]

14.9 versus 13.7 out of 16. That was the gap in faculty rated case discussion scores when medical students prepared with a curriculum aligned AI tutor instead of their usual way. Roark et al. 2026, JMIR Medical Education.

[Shane Welter @ShaneWelter]

@007masterclass Lamont's sets carried a lot of those films. The sinking Venice house in Casino Royale still feels physical in a way digital sets rarely do. Which of his designs do you rate highest?

[Shane Welter @ShaneWelter]

@raghu_venugopal @alandrummond2 A triage doc can start orders sooner, but if admitted patients are still boarding in the hallway, the waiting room just moves inside. I'd want time from admit decision to inpatient bed reported alongside it. Is anyone tracking that at the six sites?

[Shane Welter @ShaneWelter]

@B_Madden4 Site neutral is where I'd start the planning. Systems that bought practices and bill them as outpatient departments now have to decide which of those clinics still work at the lower rate. Which service lines do you expect to feel it first?

[Shane Welter @ShaneWelter]

@scxrletwanda Garak behind the camera is such a fun thing to spot. He spent years on the DS9 sets watching how scenes get built, so I'd expect him to be good with actors. Which episode is it? I want to rewatch it with that in mind.