The FDE Bottleneck: Why Enterprise Healthcare AI Is Stuck

The FDE bottleneck is going to break enterprise AI adoption in healthcare.

Forward deploy engineers. The humans who sit between Claude Code and the hospital system that can't figure out how to use it. Every AI company is hiring them at absurd rates right now. There aren't enough.

Meanwhile the tools are insane. I automated a workflow last week that would've taken a team three months to build. MCP, skills, agents—it's all there. The capability gap closed faster than anyone expected.

But org structure precludes action. (It always does.)

Healthcare enterprises have 18-month procurement cycles. Security theater. Pilots that never graduate. They're all waiting in line for the same 500 people who can actually deploy this stuff.

Here's what happens instead: small teams start picking apart the labor market tactically. Not enterprise deals. SMB velocity.

Back office first. Prior auth. Billing. Chart abstraction. Mom-and-pop practices that can't afford to wait.

Then—and this sounds crazy until you think about it—humanoid robots in care centers.

The constraint isn't capability. It's distribution. Healthcare moves slowly, which means anyone moving fast has the whole market to themselves for a while.

We're so early.