Tiny Shifts

Clinical psychologist, AI co-founder, HIPAA-adjacent infrastructure, coaching memory that persists where human coaches can't.

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Context

Dr. Elisha Goldstein is a clinical psychologist with 20+ years of practice. The problem: clients leave sessions with insight and lose it by Wednesday. Coaching works in weekly 50-minute windows; behavior change requires constant repetition.

Strategy

A coaching reinforcement platform that converts session recordings into persistent behavioral memory, then delivers timed nudges between sessions based on what each client is actually working on.

Solution

A behavioral nudge system with cross-session memory, built to clinical collaboration standards. Enterprise B2B model at 85% margins, currently in design partner phase with two coaching organizations.

Technical Architecture

Recording layer (Recall.ai). Extraction layer (OpenAI against structured schema co-designed with Goldstein). Memory layer (FastAPI + SQLAlchemy + PostgreSQL, cross-session pattern detection). Nudge delivery timed to commitment structures from each session.

HIPAA Considerations

Platform operates in HIPAA-adjacent territory. Architecture minimizes PHI surface: transcripts processed into behavioral abstractions. Does not claim HIPAA compliance, designed to support compliant deployment configuration.