· 5 min read
The expensive incidents are the ones nobody owns
Your longest outages are rarely your hardest technical problems. Most of that time is spent finding out whose problem it is.
Order out of operational chaos.
I lead the operational systems behind digital patient experience — the incident response, the vendor operations, and the knowledge architecture that decide whether healthcare technology actually works when a patient needs it.
In short
Four careers, one instinct
Find where a complicated system actually breaks, then build the thing that keeps it from breaking the same way twice.
Juan Ramon Hernandez started as an aerospace design engineer at Boeing, trained in medicine at the University of Arizona College of Medicine, spent roughly a decade running a small business through the worst housing market in living memory, and has spent the last decade-plus in enterprise healthcare technology.
Today he supports Epic MyChart and the digital front door patients use to reach their care at a national nonprofit health system — leading response when high-severity systems fail, owning operational quality across third-party support partners, and building the knowledge architecture that turns each incident into something the next responder can actually use.
The unifying skill isn’t any single technology. It’s reading a system end to end — people, process, vendors, software — and seeing the whole picture when nobody else can.
Writing
Specific enough to disagree with
· 5 min read
Your incident dashboard is lying to you
Most operational reporting is a confident summary of inconsistent data. Here is the ten-minute test that tells you whether yours is.
What I do
Six areas, one underlying discipline
01
Incident Command
Leading high-severity production response for patient-facing systems: establishing ownership, coordinating across teams and vendors, keeping executives informed, and converting every incident into knowledge the next responder can use.
02
Digital Patient Experience
Product support and operational ownership for Epic MyChart and the consumer-facing digital tools patients use to schedule, message, pay, and access their records.
03
Vendor & Operational Leadership
Managing third-party partners who deliver Tier 1 patient-facing support — service quality, escalation paths, operational readiness, and alignment to organizational objectives. Influence-based leadership across a large cross-functional ecosystem.
04
Knowledge & Operational Intelligence
Turning scattered operational work into structured, reusable organizational knowledge: SOPs, documentation architecture, taxonomies, and the reporting that gives leadership a real picture of operations.
05
Applied AI in Operations
Designing AI-assisted workflows for real operational problems — ticket standardization, issue-pattern matching, knowledge capture, and decision support — with a hard line on data governance and patient privacy.
06
Product & Systems Strategy
The through-line across every chapter: reading a complicated system, finding where it actually breaks, and designing the process that keeps it from breaking the same way twice.
The arc
Twenty-five years, four chapters
1997 — mid 2000s
Aerospace Design Engineer
Boeing
Structural design work on commercial aircraft, in an environment where a missed tolerance is not a bug ticket.
Systems thinking, root-cause discipline, and documentation habits that never left.
2004 — 2009
Medical Training
University of Arizona College of Medicine
A second bachelor's degree in biology, then medical school — completing clinical rotations in emergency medicine, general surgery, internal medicine, pediatrics, family medicine, and radiology.
A clinician's read on how care actually gets delivered, and why the systems around it matter as much as the systems inside it.
~2010 — 2014
Owner / Operator
Real estate services business
Ten years running a small business through the worst housing market in living memory — operations, customers, payroll, and margin.
Firsthand knowledge of what it costs to keep a service business running when the numbers stop cooperating.
2014 — present
Healthcare Technology
A national nonprofit health system
Four progressive roles from Senior Solutions Engineer to Senior Technical Product Analyst, supporting Epic MyChart and the digital front door millions of patients use to reach their care.
Enterprise incident leadership, vendor operations, and the knowledge systems that make both repeatable.
How I think
Four things I keep coming back to
Every incident should improve the next responder
An outage that gets fixed and forgotten is an outage you will buy again. The resolution is half the work; capturing what was learned in a form the next person can find is the other half, and it is the half most organizations skip.
Standardize before you analyze
Most operational dashboards are confident summaries of inconsistent data. If tickets are categorized six different ways by six different teams, no amount of reporting sophistication will tell you the truth about your operation.
The hard problems are the ones with no owner
The issues that take days to resolve are rarely technically difficult. They sit between teams, between vendors, between systems — visible to everyone and owned by no one. Finding the whole picture is the actual skill.
Models change, knowledge endures
AI is genuinely useful in operations, and the specific model matters far less than people think. What compounds is the structured organizational knowledge underneath it. Build that, and the reasoning layer stays interchangeable.
Credentials
Education and certifications
Education
- BSE, Aerospace Engineering Arizona State University · 1997
- BS, Biology Arizona State University · 2004
- Medical training — clinical rotations completed University of Arizona College of Medicine · 2006 – 2009
Certifications
- ITIL 4 Professional
- SAFe 6 Product Owner / Product Manager (POPM)
- Google AI Certifications
- Epic PX100 — Patient Experience Fundamentals
- Epic MYC200 — MyChart Administration
- Epic CLN205v — User and Security Basics
Get in touch
If you’re living one of these problems, I’d like to hear about it.
I write in public because it sharpens the thinking, and because the useful conversations come from people who read something here and disagreed with part of it. Operations and service management leaders, teams putting AI into real operational workflows, anyone stuck with an incident process that produces heat instead of knowledge — that’s the conversation I want.
Roles, advisory work, and collaborations tend to follow from those conversations rather than the other way around.