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What if the hardest part of building technology isn’t the interface, it’s earning a place in systems that already work? Daniel Burka left Google Ventures to spend eight years building health tech in rural clinics across India, Bangladesh, Ethiopia, and Sri Lanka. Mahima Chandak builds AI-powered screening tools for frontline healthcare workers. Elyce Cole is the organizational psychologist focused on the power structures and team dynamics that determine whether technology actually reaches the people it's meant to serve. Together they co-founded Hard Problems, a not-for-profit with a goal to help more technologists to work on the world's hardest problems, like climate change and public health. Their platform Simple is used a million times a month to manage hypertension across some of the most constrained clinical environments on the planet. In this conversation: why paper was their real competition, what it takes to get a clinical visit down to 13 seconds of data entry, why they deliberately hid individual productivity from managers, and what co-design looks like when your government partner is going through a coup. Follow along 00:54 — Introduction 02:05 — What Hard Problems is and why they named it that 07:12 — Paper as competition 10:51 — The psychology of change 12:44 — 13 seconds: designing a clinical visit 17:49 — What they let go of in their product decisions 20:34 — Data, surveillance, and system design 25:02 — Co-design with nurses 29:21 — Co-design with governments 32:22 — From shipping to sustaining 35:52 — The beachhead analogy 37:37 — How to enter the space 39:27 — AI at the edge: oral cancer screening 44:09 — The unmissable For complete list of takeaways, recap & resources, visit https://unmissables.substack.com/p/ep... Enjoying Unmissables? A like, comment, subscribe on youtube, ⭐⭐⭐⭐⭐ on Spotify and a review on Apple helps more people find the show. 🫶🏽