Matt Solnit spent 26 years in enterprise technology before walking into healthcare knowing almost nothing about it. He's now CTO of Pearl Health, a value-based care platform supporting over 10,000 providers and a quarter of a million Medicare beneficiaries across 40+ states.

Mario talks to Matt about why US healthcare data access is shockingly poor in 2026, how Pearl uses predictive models to tell doctors which patients need attention before they end up in hospital, and what it took to get an entire engineering team to a 96% Claude Code acceptance rate. Matt also gets into why he thinks humans will stop writing code within 18 months, how Pearl built an AI on-call agent that cut analyst ramp-up time in half, and why identity remains an unsolved problem in American healthcare.

In this episode, we discuss;

• Where the data comes from.
• Day-to-day as CTO. Identifying where to apply technology, guiding the board, and why ChatGPT's launch five months after he joined changed everything.
• What makes a great engineer in 2026.
• Startup engineers versus enterprise engineers.
• Why Matt chose healthcare.
• The 96% Claude Code acceptance rate. How a $20,000 Anthropic credit led to company-wide standardisation, and why command-line tools converted the holdouts.
• Balancing technical skill and cultural fit.
• Building culture in a remote-first company.
• The AI on-call agent.
• Where AI stops and humans start.
• The identity problem in US healthcare.
• Advice for new CTOs.
• What Matt would tell his 2022 self.

Watch the episode on YouTube: https://www.youtube.com/@SynaxiaGroup

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Extra Stuff:

Do you want a copy of our Startup Engineering Market Report?

What's in the report?

1. Who's hiring the most engineers in your region/industry?
2. Gender diversity statistics
3. Is demand for engineers increasing or decreasing?
4. What are the key trends in the startup market?

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Get in touch: https://www.linkedin.com/in/mario-michaels/

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Follow the Podcast: https://www.linkedin.com/company/transformational-blueprints-podcast/

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Follow Synaxia Group: https://www.linkedin.com/company/synaxia-group/

Peter Csiba has spent twenty years building infrastructure that can't afford to be wrong. Web search at Google. Platform engineering at Robinhood, handling roughly a billion dollars a day in transactions. Now he's Engineering Manager at Assort Health, leading the team responsible for EHR interoperability at a company that just hit unicorn status, a $120M Series C from Menlo Ventures, $222M raised total, revenue up 20x in fifteen months.

Mario talks to Peter about what actually breaks when you try to write data back into Epic without disrupting a health system's workflow, why he moved too fast with EHR partners early on and had to rebuild that trust, and what the Robinhood outage of January 2021 taught him about engineering for systems where the cost of being wrong is high. Peter also gets into the "write-only code era," the tension between flashy AI-generated demos and real engineering rigor, and why he thinks getting your first EHR integration right is a people problem before it's a technical one.

For any CTO or VP of Engineering thinking about their first healthcare data integration, or any engineer wondering what actually predicts a good hire in a fast-scaling startup, this one's dense with specifics.

• What Makes Great Engineers
• EHR Interoperability with Epic
• Scaling Integrations Seed to Unicorn
• AI Code Output vs Healthcare Rigor
• Lessons from Robinhood Outages
• Risk vs Compliance Balance
• Outages and Shipping Speed
• EHR Interop Edge Cases
• API Limits and Monetization
• Voice AI Startup Lessons
• Founder Stress and Volatility
• First EHR Integration Advice
• Finance vs Healthcare Mindset

Watch the episode on YouTube: https://www.youtube.com/@SynaxiaGroup

-------------------------

Extra Stuff:

Do you want a copy of our Startup Engineering Market Report?

What's in the report?

1. Who's hiring the most engineers in your region/industry?
2. Gender diversity statistics
3. Is demand for engineers increasing or decreasing?
4. What are the key trends in the startup market?

-------------------------

Get in touch: https://www.linkedin.com/in/mario-michaels/

-------------------------

Follow the Podcast: https://www.linkedin.com/company/transformational-blueprints-podcast/

-------------------------

Follow Synaxia Group: https://www.linkedin.com/company/synaxia-group/

In this episode of Transformational Blueprints we speak with Doug Nissinoff, the founder of Intelligent Ventures, a pre-seed to Series A VC focused on AI and healthcare.

Doug shares his path from biology and clinical research to biotech investor relations, startup consulting across 25+ life sciences companies, and launching a $1M fund with 25 hands-on LPs and five investments, plus a 10-week accelerator offering $25K checks and a NYC demo day. He explains how they assess founders—especially “grit,” coachability, and traction like LOIs and early angels—and why clinicians on the committee better judge workflow fit and real demand.

Doug discusses why most AI healthcare startups default to SaaS, why regulated diagnostics/devices are underbuilt, how to spot AI-washing via weak data strategy and superficial partnerships, and predicts growing agentic AI, consolidation, and fewer “me too” products like scribes.

We discuss;

- Doug’s Early Career Path

- Startup Breakthrough Story

- From Consulting to VC Fund

- Accelerator Program Launch

- What Makes a Great Founder

- Why Healthcare SaaS Dominates

- Avoiding Me Too Products

- Clinicians in Deal Review

- Funding Filter Signals

- LOIs and Angel Proof

- Data Moat Not Wrappers

- Pitch Fine Print Traps

- Passing on a Weird Bet

- Team Changes the Read

- Signals and Hiring Advice

- 2027 Agentic AI Outlook

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Get in touch: https://www.linkedin.com/in/mario-michaels/

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Follow the Podcast: https://www.linkedin.com/company/transformational-blueprints-podcast/

-------------------------

Follow Synaxia Group: https://www.linkedin.com/company/synaxia-group/

Watch the episode on YouTube: https://www.youtube.com/@SynaxiaGroup

-------------------------

Extra Stuff:

Do you want a copy of our Engineering Market Report?

What's in the report?

1. Who's hiring the most engineers in your sector?
2. Gender diversity statistics
3. Is demand for engineers in startups increasing or decreasing?
4. What are the key trends in the startup market?

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