Home Hub: Building the Household Assistant I Couldn’t Buy

Running a home is not for the faint of heart. I have heard, seen, and in some cases tried to implement all manner of home productivity systems. Lately, our family has settled on a Skylight: the kitchen touchscreen where chores, the calendar, and the grocery list all live. It works, but it’s one of maybe six places household information actually lives. The school sends emails. Bills and shipping notices arrive in inboxes split between my wife and me. Appointments land on a Google Calendar. The mental work of pulling all of it together — what’s happening today, who’s doing which chore, which email actually needed a response — fell on a person. Mostly the person was my wife and that wasn’t what we wanted.

Synthesis is still hard. Figuring out next steps can be hard. I have been using LLM intelligence more and more in my life and was convinced that, with a little more synthesis, and a little more intelligence, I can reduce the load. I would have definitely bought this service if it existed. As far as I could tell, it did not. Claude Code had recently unlocked my ability to feasibly get back into coding, so I thought I would try to build it. My own Home Hub.

What it does

Home Hub is a privacy-preserving household assistant. It reads from the tools my family already uses — the Skylight (chores and the family calendar), a dedicated email inbox, Google Calendar — pulls everything into one place, and surfaces it three ways.

A daily email. Every morning at 5:30, before anyone’s awake, Home Hub assembles a briefing: today’s events, the open chores, the action items it found buried in overnight emails, and a look at what’s coming this week. It’s the synthesis that needed to come together in our heads, now done before breakfast.

A web dashboard. Includes prioritized views for today, this week, this month. The same information, browsable, when the email isn’t enough. It removes high-noise signals like repeating events so that we can, for example, focus on the bigger picture when a month’s view of Google Calendar otherwise just looks overwhelming.

An assistant you can talk to. This part has been the biggest unlock. Home Hub runs a conversational assistant over Telegram — I can text it like a member of the household. “What’s on for Saturday?” “Add a reminder to renew the registration.” It also works in the background: when there’s a task that needs research — compare three options, find a vendor, draft an email — it can take a first pass on its own and bring me something to review, rather than waiting to be asked.

The constraint that shaped everything

Here is the design decision I care most about: Home Hub does not run as me.

I was not interested in “connect all your accounts” tools that work by becoming you — full access, your login, your identity, acting on your behalf with the same powers you have. That’s convenient and, to my mind, the wrong model for something that touches my family’s email, calendar, and documents.

Home Hub works the way you’d want a trusted house-sitter to work. It has its own keys, scoped to what it needs, and you can take them back at any time without changing your own locks. Most processing happens in a sandbox, on a machine in my house. The genuinely sensitive material is airgapped elsewhere and separated out. Only sanitized extracts, stripped of the personal details, are ever handed to a cloud AI for the parts that need more horsepower.

But it’s the difference between an assistant I’d actually let near my family’s information and one I wouldn’t.

How it fits together

At the center is a small daily pipeline that does the unglamorous work: pull from each source, classify what’s sensitive, redact what needs redacting, and synthesize. Around it sit the three interfaces — the morning email, the dashboard, the conversational assistant — each reading from the same sanitized core.

(See the architecture diagram below.)

Why I could build this at all

It’s been a long time since I was building software regularly. Even then, small sections of this would have taken me a couple of weeks to implement. Five years ago, a project like this would have meant hiring someone, writing a requirements document, hoping the result resembled what I actually needed, and lots of iteration. The translation from what I know my household needs to working software was expensive enough that I simply would not have done it.

That translation cost has collapsed. With AI-assisted development, the person who understands the problem can increasingly build the solution directly — no intermediary, no requirements telephone game, no loss in translation. I know exactly what my family’s coordination problem looks like, because I live inside it. Now I can express that knowledge as a working system instead of as a feature request someone else might get wrong.

I think this is a small, domestic instance of a much larger shift we will see in our professional lives as well. For a long time, software was built by people who understood software, for people who understood the problem, with a lossy translation layer in between. As that layer thins, a shift will take place to people who understand the problem most deeply and are willing to build. In medicine, that’s the clinician who builds the tool instead of submitting a ticket. At home, that is me, usually while the kids are sleeping.

Home Hub isn’t really a product or package that I intend to share. I will probably get help from AI to consider that at some point. But for now it’s a household assistant that fits exactly one household — mine — because the person who built it is the person who needed it. That used to be a luxury reserved for good coders. I have proved, if only to myself, that it isn’t anymore.

Medication cost transparency: does it make a difference?

Medication costs make up over 10% of health care dollars and are the fastest growing source of medical expense. Many state and federal officials have called for action that Figure 3would add cost transparency to the complex, opaque medication supply chain believing that this will lead to lower prices and higher value care. Though this may appeal to our intuition, evidence that medication cost transparency leads to higher value care is scant. In order to add to the evidence base, four other investigators and I embarked on a 9-month investigation designing and evaluating the effect of medication cost transparency decision support built into the electronic health record. Bottom line: it makes a difference. The results were recently published and are available on the JAMIA website: https://academic.oup.com/jamia/advance-article-abstract/doi/10.1093/jamia/ocz025/5445905.

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Herald: Solving the Data Overload Problem for Doctors

Problem

Logo_3x2Doctors are overwhelmed with data. They spend 12% of their time looking up clinical data when they could be seeing patients and still information gets missed. In fact, the IOM has identified untimely access to clinical data as a leading contributor to the 3rd leading cause of death in the US: medical errors. Existing information systems and electronic medical records are better optimized for billing and documentation than they
are for making care safer. There has to be a better way.

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Reach: Text-Message Appointment Reminder System

Problem

reach exampleIn aggregate, community health centers account for the care of about 20 million people in the US. Over half of these patients represent racial or ethnic minorities and over a fifth (22%) prefer to speak Spanish rather than English.

Most CHC revenue comes from fee-for-service reimbursement paid by Medicaid (40%), private payers (7%), and Medicare (6%). This has led CHCs to pursue many of the strategies for maintaining solvency as other care centers across the US, including increasing patient visit volume and improving operational efficiency.

One problem all clinic sites face is the incidence of no-shows, patients for which an appointment is scheduled but that do not show up. It is estimated that no-shows account for 5-30% of appointments scheduled across the US and it is typically higher at CHCs. No-shows risk failing to deliver appropriate care to patients for whom they are scheduled in a timely or continuous manner, reduce access to scarce healthcare resources for those waiting for appointments, and represent up to 15% of lost revenue for the clinic.

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Squire: Handheld Hospital Assistant

Problem

Effective hospital care requires coordination among multiple individuals including therapists, care coordinators, primary teams, consult teams, and nurses. Unfortunately, this coordination is costly to frontline staff often requiring much time and many steps even to identify the appropriate contact. Existing solutions have significant shortcomings without a highly-available best practice.

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Cardiovascular Risk Calculator

www.cvriskcalculator.com

Introduction

Screenshot 2015-07-11 19.47.57The 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk introduced a new risk assessment calculator based on aggregate data from several cohorts. According to these guidelines, a patient’s risk according to this algorithm is critical in determining if a cholesterol-lowering statin should be prescribed. Initially, this calculator was available only through a somewhat onerous Excel spreadsheet. Moreover, this was nearly impossible to access through mobile phones, a preferred modality. Continue reading

Symcat: Data-Driven Symptom Checker

Problem

symcat_logo_simple_900x260When people get sick, they have several options for obtaining health care. These include going to the emergency room, urgent care center, or calling a doctor or nurse. However, 80% of people experiencing symptoms start with an Internet search. Unfortunately, searching on Google offers spotty results and frequently leads to undue concern. For example, one is 1000x more likely to encounter “brain tumor” in web search results for “headache” than they are to ever have the disease. Undue concern is a contributor to the 40% of emergency room visits and 70% of physician visits that are considered to be inappropriate.

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How Motor Learning Generalizes

Introduction

Every movement we make requires our brains to predict what forces–gravity, an object we’re holding, a strong gust of wind–each of our body Screenshot 2015-07-12 11.03.40parts will experience in order to move in a coordinated fashion. No movement is ever exactly the same and so it is remarkable that we are not constantly tripping over ourselves. It is well-known that humans learn based on previous errors in their movements. My work at the Harvard Neuromotor Control Lab was to investigate how the brain learns to “makes generalizations” about movements and learn from its mistakes. Continue reading

Stroke in AVS App

Introduction

Screenshot 2015-07-11 22.15.36Each year, half a million patients present to emergency departments in the US with acute vestibular syndrome (AVS) characterized by vertigo lasting more than 24 hours. Though this is frequently caused by something benign such as a self-limited viral infection, it may also indicate a more severe condition such as stroke of the posterior circulation. Unfortunately, MRI can miss strokes when obtained early in the disease course meaning half of those with with posterior strokes are inappropriately sent home from the ER. Continue reading

Understanding Tracheostomy as a Risk Factor for Sternal Wound Infections

Introduction

Tracheostomy is an unpleasant, but effective means for transitioning patients off ventilatory support after prolonged periods of respiratory failure following cardiac surgery. There is, however, a perceived risk of patients getting infections of the surgical, sternal Screenshot 2015-07-12 16.13.38wound if tracheostomy is performed too early. This perceived risk means patients are often delayed in tracheostomy, including the benefits of ability to speak, reduced mortality, reduced ICU stay, and reduced delirium until the surgical wound is felt no longer at risk. Continue reading