The Minute Before A proposal by Phil Morehead. Not affiliated with Two Chairs. Email Phil

What a therapist needs to know in the minute before the door opens.

A working prototype. Claude turns each client's measurement based care history into a brief you can read between back to back sessions. Pick a client.

This week with Dr. Avery Lin

24 synthetic clients

    Safety, rules onlyNeeds attentionGoing wellEngagement

    Written by Claude from PHQ-8, GAD-7, alliance and quality of life.

    What changed
      Worth raising
        Alliance
        Try opening with
          What Claude saw, and what it never sees

          Sent to Claude

          Kept with the rules layer

          How it did across all 24 briefs

          Every brief was checked three ways. Did it catch each signal planted in the data? Did it use a number or date that isn't in the record? Did it cross a line a brief should never cross: diagnosis, medication or risk? These are real Claude runs, captured once and replayed here.

          The checker, checked

          A perfect score only means something if the checker can fail a brief. So I broke six on purpose.

            The product call behind the prototype

            The model never touches risk.

            PHQ-9 item 9 never reaches Claude. Rules catch it and pin it to the top of the brief for the clinician to act on. Look at Grace: her brief is all good news, and the pin sits above it anyway.

            Why this, first

            Two Chairs already does the hard part. Measures come in at nearly every session, and the outcomes are why health plans sign. The open question is what the scores change between sessions. A therapist with a full day of back to back sessions has about a minute to look. So the first bet is small and specific: turn data you already collect into the one thing worth raising today.

            What it costs, and what it buys

            Keeping risk with rules costs a flashier demo. It buys clinician trust, and clinician trust is the whole adoption curve. A brief that's wrong about a plateau is a bad minute. A brief that's wrong about risk ends the product.

            How I'd know it's working

            Opened before the session most of the time, with a target the team sets in shadow mode. Rated useful by therapists most weeks. More plateaus and alliance dips raised in the session they appear. On the other side of the ledger: zero risk language from the model, zero invented numbers, and a clinician override rate we read every week.

            Clinicians

            Now
            Session brief in shadow mode with a pilot group
            Next
            The brief feeds the AI note assistance you already shipped, so nothing gets typed twice
            Later
            A weekly caseload view: who needs attention, and why

            Clients

            Now
            Keep the measures under a minute and on mobile
            Next
            Show clients their own progress in plain words
            Later
            Between session check ins that route to their therapist, not a bot

            Health plans

            Now
            Outcomes stay the proof: engagement, improvement, cost per member
            Next
            Plan level reporting built on the same signals
            Later
            Contracts priced on measured improvement

            An outside in roadmap, built from public information only. The first 90 days is where I'd find out what's wrong with it.

            How I'd grow senior PMs now

            AI makes building cheap, so the scarce skill is judgment. I grow senior PMs toward principal by handing them a domain and a number to own across clinical, client and commercial, then getting out of their way.

            • Every PM prototypes. A working demo in week one beats a ten page spec.
            • Evals are acceptance criteria. If you can't score it, you can't ship it.
            • Know where the model must not go. The best calls are often what AI shouldn't do.

            First 90 days

            1. Days 1 to 30: listen

              One on ones with every PM and with my Engineering, Design and Data peers. Sit in on clinical ops and intake. Learn how a session actually runs before saying anything about it.

            2. Days 31 to 60: name it

              Write down where product is strong and where it needs attention. Agree on one planning rhythm with Engineering that both sides trust.

            3. Days 61 to 90: commit

              A strategy the team co-wrote, a roadmap story leadership can repeat, and one bet in flight with its numbers attached.

            I'd like to talk about the role.

            I'm Phil Morehead. I led a 60+ person product org at Launch by NTT Data and shipped a patient intake app to 36 hospitals on Epic and Meditech data. Today I'm the AI native builder at Sparq, where I took the firm's Claude certifications from 36 to 100 in under four weeks. I built this to show how I think, not just what I've done.