Government, healthcare, defense, and infrastructure look like separate worlds on the surface, but Justin Fulcher has spent much of his career pointing out how much they have in common when it comes to adopting new technology. Each sector answers to strict regulation, carries heavy public accountability, and runs on systems built long before today’s tools existed.

A Shared Diagnosis

Fulcher has written that these sectors “operate as if it were 1975,” a comparison he uses to explain why modernization efforts so often stall despite good intentions. The problem, in his view, is not a shortage of ambition or funding but what he calls institutional drag, the accumulated weight of processes designed for conditions that no longer exist.

Justin Fulcher’s career gives him a direct view into two of these sectors specifically. He co-founded RingMD, a telemedicine platform that connected patients with doctors across Asia, an effort that required navigating healthcare regulation and provider skepticism toward remote care. He later served as a Senior Advisor to the Secretary of Defense, working on acquisition reform and technology modernization inside one of the most heavily regulated institutions in the country.

Lessons That Cross Sector Lines

The overlap between those two experiences, Fulcher suggests, is not a coincidence. Sectors that carry high stakes for public trust tend to develop similar defenses against change, even when the specific rules differ. Compliance requirements multiply, approval chains lengthen, and institutional memory of past failures discourages experimentation.

Justin Fulcher argues that recognizing this shared pattern is useful because solutions that work in one regulated sector often translate to another with only minor adjustment. A procurement reform that speeds up software purchases at the Department of Defense, for instance, may offer lessons for hospital systems facing similar bottlenecks. Rather than treating each sector’s technology problems as unique, Fulcher’s cross sector view suggests government leaders could learn faster by studying reform efforts outside their own field. Refer to this article for related information.

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