After months of anticipation and fanfare, Dr. Atul Gawande is starting his new job Monday as the CEO of the healthcare venture from Amazon, Berkshire Hathaway and JPMorgan Chase.

The healthcare community at large seems to be both skeptical and hopeful about the venture and Gawande’s appointment. His goal will be to create innovations in a burdened and dangerously large healthcare industry, lowering the cost of care while improving health outcomes.

Although Gawande has stayed away from the public eye since his appointment was announced, his background as a doctor and his outspoken advocacy on healthcare reform give some interesting clues on what he may end up doing in the role.

His past work, including his writings as a contributor to the New Yorker, has placed a heavy emphasis on using data to make the system work better, both administratively and on the level of an individual doctor.

But his Twitter feed gives the most interesting clues. While Gawande has refrained from making major speeches or media appearances since the announcement, his Twitter page has been a flurry of activity, both related to and separate from his new role.

Skin-in-the-game isn't working. Average deductibles for employer health plans tripled, and most patients can't afford to do anything except forgo care and treatment. @business https://t.co/E8ijQ5yEQT — Atul Gawande (@Atul_Gawande) June 27, 2018

Gawande Tweeted criticisms of the current status quo of high-deductible health insurance, one area that the new venture will almost definitely be exploring.

Insurance and the relationship between insurance providers and on-the-ground healthcare providers is one of the more complicated and thorny elements of the healthcare system. The new venture could innovate on that by following in the footsteps of organizations like Kaiser Permanente, which offers both health insurance and healthcare to its members.

Gawande also sent out his support of a court ruling that struck down a Kentucky rule requiring that Medicaid recipients work to receive health insurance, a highly political controversy that has raised fundamental questions about welfare in the U.S.

The good news: a Court is actually upholding the law requiring Medicaid to provide medical assistance to poor individuals. If your mental or physical health makes it difficult to obtain or sustain work, then a poor person needs medical assistance more not less. https://t.co/5MB0sOnY5y — Atul Gawande (@Atul_Gawande) June 30, 2018

On the whole, Gawande is a spokesperson for change and new ideas in the healthcare system, but his training as a doctor and healthcare academic also give him a grounded and realistic idea of how to go about making that change.

How his ideas will translate into change is, for the moment, still an open question.