Podcasts about ehrs

In today's episode, I talk with Maya Benattar, LCAT, a licensed creative arts therapist in New York, about what happens when you discover your entire license type has been left out of major mental health legislation and you decide to do something about it. Maya shares how she built a coalition that became a full 501(c)(3), hired a lobbyist, and is fighting to get LCATs the insurance coverage mandates and diagnostic privileges they deserve. We also talk about how she keeps her practice sustainable while doing all of this, including why staying out of network has given her the flexibility to show up for the advocacy work without burning out completely. Learn more about the LCAT Advocacy Coalition by visiting https://www.lcatcoalition.org/.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: You've known for a while that the platforms aren't working for you. Platform to Private Pay is a 12-week group program that walks you through the transition, without abandoning your clients or tanking your income while you figure it out. Doors open June 29. Join the waitlist: www.abundancepracticebuilding.com/platform   Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party   Want website copy that actually sounds like you and makes the right clients feel seen? Referral Ready Website Copy is done-for-you copy for your homepage, about page, and up to three specialty pages — built around your voice, your niche, and your people, for just $2,000: www.abundancepracticebuilding.com/referralreadywebsitecopy

The Big Unlock · Julie Demaree, VP, Chief Technology and Digital Innovation Officer, St. Mary's Healthcare In this episode, Julie Demaree, Vice President and Chief Technology and Digital Innovation Officer at St. Mary’s Healthcare, shares a pragmatic approach to digital transformation in rural healthcare, where innovation is driven by operational realities rather than technology hype. A former physician assistant turned technology executive, Julie argues that successful innovation begins with culture, governance, and clinician engagement, not new tools. She discusses how St. Mary's has improved patient safety and clinician experience by rethinking clinical decision support, reducing alert fatigue through careful curation, and involving frontline clinicians in governance decisions. Julie also highlights the importance of optimizing existing technology before investing in new solutions, noting that many organizations overlook capabilities already available within their EHRs. Julie sees significant potential for automation and agentic AI to reduce administrative burden, improve patient access, and help lean teams operate more effectively. She emphasizes that AI adoption must be accompanied by strong governance, user education, and critical thinking. Her message is clear: innovation is not about adding more technology, it's about solving the right problems, eliminating unnecessary work, and building systems that better support patients, clinicians, and communities. Take a listen.

Imagine being penalized for delivering good care to your frailest patients. Medicare's quality scoring program was built for healthy outpatients, not the elderly residents of nursing homes, but it is the system doctors who round in skilled nursing facilities are forced to play. Steve Buslovich, a physician executive and geriatrician, discusses the KevinMD article "How Medicare's MIPS impacts skilled nursing facilities and clinicians." You'll hear how MIPS metrics conflict with the five-star quality measures facilities must report, why tightly controlling A1C in frail elders can cause harm, and how documentation discrepancies between physicians and facilities create financial and legal risk for both. You'll learn which nine measures actually fit post-acute long-term care, why CMS needs frailty-based quality metrics, and how AI and synced EHRs can pull data automatically so clinicians can get back to the bedside. If you practice in or operate a nursing home, this conversation names the rules of a game you didn't choose to play. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

In today's Ask Abundance, I'm joined by Rebecca Smith — Limitless Practice grad, now on Team Abundance, premium-fee private pay practice in New Orleans. We're talking about why a full year of networking can still get you nowhere. Coffee chats. Emails. Showing up to all the things. & still no referrals. Turns out more events was never the fix. We get into why a fuzzy niche makes you instantly forgettable, how to spot if you're networking with the wrong people entirely, & why this is actually just relationships, not a numbers game.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Still struggling to explain what you do and who you help? My $27 Know Your Niche course helps you get crystal clear on your ideal client so your marketing finally clicks, your referrals improve, and growing your practice feels a whole lot easier: https://www.abundancepracticebuilding.com/niche    You've known for a while that the platforms aren't working for you. Platform to Private Pay is a 12-week group program that walks you through the transition, without abandoning your clients or tanking your income while you figure it out. Doors open June 29. Join the waitlist: www.abundancepracticebuilding.com/platform    Need help building and filling your practice? Join the Abundance Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party   Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links

We all know that documentation is a heavy burden for therapists. But home health therapists arguably face one of the heaviest loads, with mandated OASIS reporting layered on top of standard clinical documentation — a dual requirement unique to this setting.They also face challenges that clinic-based therapists rarely encounter: coordinating care across disciplines — physicians, nurses, and other therapists — often without shared documentation systems, as well as navigating privacy considerations and internet instability when documenting in patients' homes.But, as we've already discussed around outpatient EHRs, there are changes on the horizon. In this discussion, we'll zoom in on what's becoming possible in this complex environment, from clinical decision support to practical automation. We'll be joined by Rohit Shetty of AutoMynd — Rohit is excellent at explaining exactly what's possible, while staying grounded in reality.See full course details here:https://otpotential.com/ceu-podcast-courses/home-health-therapy-documentationSee all OT CEU courses here:https://otpotential.com/ceu-podcast-coursesCheck our our live webinar schedule here:https://otpotential.com/live-ot-ceu-webinarsSupport the show by using the OTPOTENTIAL Medbridge Code:https://otpotential.com/blog/promo-code-for-medbridgeTry 2 free OT Potential courses here:https://otpotential.com/free-ot-ceusSupport the show

Part 1 of a 2-part episode From WEDI's Spring 2026 Conference, WEDI Board Member Pam Grosze (PNC Bank) moderates a panel of major EHR leaders who share what's live at scale versus still in pilots, where interoperability is breaking down in real clinical workflows, and the biggest blockers to moving from point integrations to broad payer coverage without increasing burden. The panel: Hans Buitendijk, Senior Director, Interoperability Strategy, Oracle Health Jason Vogt, Manager Development, APIs and Structured Documents, Meditech Sean Cotter, Software Developer, Epic Mohammad Chebli, VP of Interoperability, NextGen Gillian McCabe, Director of Product Management, Authorization Management, athenahealth

Becky DeGrossa, MA, from CounselingWise joins me in today's episode to break down what's actually working in SEO for therapists right now and why the core strategies still matter most for local practices. She shares what's worth paying attention to with AI and SEO, what's mostly hype, and how to focus on the strategies that continue to bring therapists consistent website traffic and client inquiries. Attention Abundance Party members: Becky is our trainer this month! Check out the 'Upcoming Events' section of your Simplero membership dashboard and/or the 'Events' section of the Abundance Community Facebook group for details on how to register for this live event included in your Party membership.  Learn more about Becky at https://www.counselingwise.com/.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party  Want website copy that actually sounds like you and makes the right clients feel seen? Referral Ready Website Copy is done-for-you copy for your homepage, about page, and up to three specialty pages — built around your voice, your niche, and your people, for just $2,000: www.abundancepracticebuilding.com/referralreadywebsitecopy

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A.E. Smith, Ph.D., and we're talking about dropping insurance panels. Specifically, the part nobody warns you about: the fear. We're getting into why the timing is never going to feel right, what it actually looks like to make this move strategically without blowing up your income, and why having a needle-thin niche is the thing that makes all of it possible. Rebecca did this herself and her life is so much better on the other side. Come hear what she has to say.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: You've known for a while that the platforms aren't working for you. Platform to Private Pay is a 12-week group program that walks you through the transition, without abandoning your clients or tanking your income while you figure it out. Doors open June 29. Join the waitlist: www.abundancepracticebuilding.com/platform    Need help building and filling your practice? Join the Abundance Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party   Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links

From Clinic to Consumer On How AI Is Reshaping the Entire Health Experience Host: Megan Antonelli Guest: Kenn Harper, GM, Dragon and DAX Copilot, Microsoft Join host Megan Antonelli who sits down with Kenneth Harper, General Manager for Dragon and DAX Copilot at Microsoft, to explore two major moves reshaping health AI. Dragon Copilot has now scaled to more than 100,000 clinical deployments across nine countries, spanning physician, nursing, and radiology workflows, while the newly launched Copilot Health gives patients a unified view of their health data from wearables, EHRs, and lab results, all between clinical visits. Kenneth unpacks what this dual-track strategy means for health systems, clinical teams, and patients, and what health system leaders need to be thinking about right now. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

In today's episode, I'm chatting with Abundance Party member Weston, a geropsychologist building a private pay LGBTQ+ focused practice, about honing his niche around queer grief and loss, why blogging beats social media for his ideal client, and how to position himself as the go-to referral source in a specialized niche.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building & filling your practice? Check out the Abundance Party (only $345!). Members have access to monthly group calls with me and opportunities to snag a 30-minute 1:1 at no additional charge: https://www.abundancepracticebuilding.com/party  Still struggling to explain what you do and who you help? My $27 Know Your Niche course helps you get crystal clear on your ideal client so your marketing finally clicks, your referrals improve, and growing your practice feels a whole lot easier: https://www.abundancepracticebuilding.com/niche 

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about the part of going solo that nobody really warns you about: the moment you realize the team you thought you weren't even leaning on was actually holding up more than you knew. We get into why the loneliness of private practice isn't really a clinical problem, how to sort out what you actually need from what you're telling yourself you need, and what it looks like to build the kind of support and connection that doesn't require sharing a hallway with anyone.   Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building and filling your practice? Join the Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party   Grab the free '8 Factors to Help You Remember What You Have Control Over & What You Don't' worksheet I mention in today's episode at www.abundancepracticebuilding.com/worksheet_opt. Loads of other free worksheets there, too!

In today's episode, I'm strategizing with Abundance Party member Jessica about getting her caseload down to 25 clients — who stays, who gets referred out, & whether group therapy makes sense for her practice. We get into a client whose relationship behavior is ethically complicated enough that she needs someone who specializes in ethical non-monogamy. And we talk through Jessica's second business: the marketing clarity it needs before it needs anything else, & why letting it grow at the right pace is the smarter play. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building & filling your practice? Check out the Abundance Party (only $345!). Members have access to monthly group calls with me and opportunities to snag a 30-minute 1:1 at no additional charge: https://www.abundancepracticebuilding.com/party  Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open in the fall: bit.ly/LimitlessPracticeWaitlist.

Most physicians spend more time fighting their software than seeing patients, and piling on new tools has not fixed it. Grace E. Terrell, a physician executive, argues that decades of layering electronic health records, population health tools, remote patient monitoring, and now AI onto sixty-year-old billing infrastructure has produced a Frankenstein stack that burns out clinicians and harms patients. This episode is based on her article "Connected health care workflows: From chore to core patient care," published on KevinMD. You will hear why layering new tools on old infrastructure keeps failing, how prior authorization became an arms race, and what a genuinely connected workflow would feel like for a clinician evaluating a patient with suspected spinal abscess. You will also learn the one question to ask any vendor pitching a new tool, and why her company's CIO believes EHRs themselves may not survive the next five years. Listen for a concrete path from chore to core patient care. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

In today's Ask Abundance, I'm joined by Rebecca Smith, Limitless Practice grad and Team Abundance consultant, to talk about the imposter syndrome spiral that hits right before a consult call. We get into why it shows up even after years of experience, the mindset shift that actually helps, and why proving yourself on a consult call is the fastest way to lose the client. We also talk about what your potential client is really looking for when they call, how to make them feel heard instead of interviewed, and why having a simple script makes the whole thing easier than you think.   Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building and filling your practice? Join the Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party   Grab the free First Phone Call Script we mention in today's episode at www.abundancepracticebuilding.com/worksheet_opt. Tens of thousands of therapists have used it to stop dreading consult calls and start converting them. If you've ever hung up wondering what went wrong, this is for you. Loads of other free scripts there, too!

How can interoperability, policy, and technology come together to solve some of healthcare's most stubborn challenges? On episode 108 of Astonishing Healthcare, host Justin Venneri sits down with Brendan Keeler, Interoperability Practice Lead at HTD Health and author of the popular Health API Guy Substack. Brendan shares his journey from working at Epic Systems to becoming a leading voice in healthcare interoperability, offering insights into the intersection of policy, technology, and workflows.Together, they explore the current state of interoperability in healthcare, the impact of CMS rulemaking on prior authorizations, and the challenges of modernizing entrenched systems of record. Brendan also highlights the importance of empathy in solving healthcare's complex problems and shares his thoughts on the future of digital identity and patient data access.Key TakeawaysInteroperability is about ubiquity, not just standards. While digital standards like FHIR and NCPDP are important, true interoperability requires widespread adoption across all stakeholders to ensure seamless data exchange.CMS rulemaking is driving change in prior authorizations. New regulations aim to digitize and standardize prior authorization processes, reducing manual burdens while potentially increasing overall transaction volumes.Modernizing healthcare infrastructure is a monumental challenge. Systems of record like EHRs and claims processing platforms are deeply entrenched, making change costly and complex. Leaders often opt for incremental improvements, such as layering AI on top, rather than full-scale replacements.Empathy is key to solving healthcare problems. Bridging the "empathy gap" by making complex issues like benefit design and regulation accessible to non-experts is essential for attracting talent and driving innovation.Digital identity is foundational for the future of healthcare. Strong identity verification systems unlock trust and enable secure, seamless data sharing between patients, providers, and payers, paving the way for better outcomes.Related ContentHow to obtain Rx data and what to do with itReplay - Unified Care Navigation: A Critical Component of the Future of Health Benefits DesignAH064 - Empowering Plan Sponsors: Data Access & Analysis, with Bridget MulvennaJudi Health Policy Update – It's a Tangled Web of ProgressDisclaimerThis podcast is for informational and entertainment purposes only. The views expressed are those of our guests, do not constitute professional advice, and may not represent Judi Health's/Capital Rx's position on any matters discussed. We make no representations or warranties regarding the accuracy or completeness of the content; information is subject to change and may not be updated.

Sean Yang, founder of Practices.fyi, joins the podcast to talk about the business numbers therapists often ignore and why tracking the right metrics can change everything. The conversation covers the difference between reacting to problems versus actually understanding your practice, which data points matter most for growth, and how better visibility leads to better decisions. Sean also shares how therapists can use AI tools like Claude and ChatGPT to analyze data, streamline tasks, and improve systems while still protecting client privacy and staying HIPAA compliant. A practical conversation for practice owners who want to stop guessing and start running their business with more clarity and confidence.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building & filling your practice? Check out the Abundance Party (only $345!). Members have access to monthly hour-long group calls with me and opportunities to snag a 30-minute 1:1 at no additional charge: https://www.abundancepracticebuilding.com/party  Want website copy that actually sounds like you and makes the right clients feel seen? Referral Ready Website Copy is done-for-you copy for your homepage, about page, and up to three specialty pages — built around your voice, your niche, and your people, for just $2,000: www.abundancepracticebuilding.com/referralreadywebsitecopy 

In today's Ask Abundance, I'm joined by Limitless Practice grad and Team Abundance consultant Rebecca Smith to talk about the fear almost every therapist has when building a private practice: "What if my niche is too narrow?" We get into why broad, vague marketing makes it harder for clients to choose you, how niching actually increases trust and perceived expertise, and why the best niche is usually less about strategy and more about what genuinely lights you up. We also talk about the difference between a niche and an ideal client, why you can always pivot later, and how speaking directly to one person often makes far more people feel seen.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Still struggling to explain what you do and who you help? My $27 Know Your Niche course helps you get crystal clear on your ideal client so your marketing finally clicks, your referrals improve, and growing your practice feels a whole lot easier: https://www.abundancepracticebuilding.com/niche    Need help building and filling your practice? Join the Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party   Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links

Lilly Risch, LCSW, joins the podcast to talk about marketing EMDR therapy and what it actually looks like to attract clients who are the right fit. The conversation gets into why explaining EMDR to the public feels so uniquely challenging, how leading with symptoms like anxiety instead of trauma can change everything, and what it takes to build a caseload that's both full and sustainable. Lilly shares her own experience growing a group practice in Milwaukee, along with practical ways to simplify your messaging, define your ideal client, and communicate your value without losing what makes EMDR special. A practical, grounding conversation for any EMDR therapist who's ever struggled to put what they do into words. Be sure to sign up for Lilly's FREE training for EMDR Therapists, "Take the 'Ick' Out of Your Marketing": https://sincere-snow-26884.myflodesk.com/flow.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Additional Resources: To learn more about today's guest, visit https://www.abundancepracticebuilding.com/blog. Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party   Want website copy that actually sounds like you and makes the right clients feel seen? Referral Ready Website Copy is done-for-you copy for your homepage, about page, and up to three specialty pages — built around your voice, your niche, and your people, for just $2,000: www.abundancepracticebuilding.com/referralreadywebsitecopy 

In this video, Paul L Wilder, Executive Director of the CommonWell Health Alliance, discusses the spread of health data exchange as it involves not just providers but new actors such as payers, public health, and patients themselves.CommonWell, a nonprofit QHIN that started in 2013 and has an enormous reach today, contains IT vendors ranging from startups to big EHR vendors, and providers now as well. For a long time, Wilder says, EHRs supported only unidirectional data exchange: they would allow it to be extracted but not inserted. Now it's more bidirectional.Learn more about CommonWell Health Alliance: https://www.commonwellalliance.org/Healthcare IT Community: https://www.healthcareittoday.com/

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about something a lot of therapists quietly wrestle with after they've "made it" in private practice: what happens when the practice is working… but you're not excited anymore. We get into the weird grief of realizing the thing you worked so hard to build no longer feels like the dream, why burnout is often less about your job and more about a life that's gotten too small, and how to start reimagining your practice without blowing everything up overnight. We also talk about the pressure therapists put on themselves to stay passionate forever, the freedom that can come from letting therapy become the easy part of your life, and why sometimes the next version of your practice starts by getting out into the world and remembering you're allowed to have fun again. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes®, my personal favorite, for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Feeling successful on paper but disconnected from your practice? Limitless Practice is our 12-week coaching program for therapists ready to redesign their practice, raise fees, work less, and build a business that feels exciting again: https://www.abundancepracticebuilding.com/lp   Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links   Need help building and filling your practice? Join the Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party

Special discounts up for AIE Melbourne (LS discount) and AIE World's Fair (group discounts up to 25% - CFPs still open for Autoresearch and Vertical AI) Cya there!Abridge did not start as an “GPT wrapper”. It was founded in 2018, years before the Cambrian explosion of AI application layer companies. OpenAI launched ChatGPT publicly on November 30, 2022 and by then, Abridge had already spent years doing the unglamorous work of building trust for one of the highest context, most important workflows in healthcare: the conversation between a patient and a clinician.Abridge's original wedge was clinical documentation. Listen to the visit, generate the note, reduce the clerical burden, and let clinicians spend more time with patients instead of the EHR. By focusing on how doctors actually document, how health systems actually buy, how EHR integration actually works, how clinicians verify outputs, and how missing context during a visit turns into downstream friction across billing, prior authorization, quality, and follow-up, the adoption of LLMs became a force multiplier on a workflow already optimized for sensitive context gathering.The company has scaled fast: Abridge says it is projected to support 80M+ patient-clinician conversations this year across 250 large and complex U.S. health systems, with support for 28+ languages and 50+ specialties. It raised $300M at a $5.3B valuation in June 2025, after a $250M round earlier that year.Today, Janie Lee and Chaitanya “Chai” Asawa of Abridge join us for another crossover pod with Redpoint's Jacob Effron (who is on the board of Abridge) to dive into how Abridge is building the clinical intelligence layer for healthcare starting with ambient documentation, then expanding into clinical decision support, prior authorization, payer/provider/pharma workflows, and eventually real-time agents that act before, during, and after the patient conversation. We go inside the product, data, infra, evals, workflow, privacy, and org design choices behind bringing AI into one of the highest-stakes enterprise environments from 100M+ medical conversations and specialty-specific evals to real-time alerts, EHR integration, de-identification, clinician-scientist teams, and why healthcare may solve some of the hardest AI problems first.We discuss:* Why Abridge started with clinical documentation, “pajama time,” and saving clinicians 10–20 hours a week* The transition from ambient scribe to clinical intelligence layer: save time, save money, and save lives* Why conversations between patients and clinicians may be the most important workflow in healthcare (patient visit summary feature)* Chai's “healthcare-coded Glean” framing: context is king, but healthcare raises the stakes on safety, evals, and rollout* Why Abridge wants AI to feel like “air conditioning”: always in the background, but only interrupting when it truly matters* The prior authorization example: turning a denied MRI weeks later into real-time guidance while the patient is still in the room* Why payer policies, EHR data, medical literature, and hospital-specific guidelines make the problem hard, and also create the moat* How Abridge thinks about ambient form factors: mobile, desktop, in-room devices, nursing workflows, multimodality, and future AR* The multi-sided healthcare customer: CMIOs, CFOs, CIOs, clinicians, patients, payers, and pharma* The hardest AI problem at Abridge: high-quality, low-latency, low-cost real-time support in a high-stakes clinical setting* When Abridge uses frontier models vs proprietary models, and why its unique data from medical conversations matters* Why “every agent is a coding agent underneath,” and how the EHR can be thought of as a filesystem for healthcare agents* How Abridge approaches personalization across individual doctors, specialties, and health systems* Why “AI slop” is AI without context, and how edits, memories, and clinician preferences create a data flywheel* Abridge's eval stack: LFDs, LLM judges, in-house clinicians, third-party evaluators, specialty-specific evals, and progressive rollout* HIPAA, PHI, de-identification, one-way anonymization, customer contracts, and learning from healthcare data safely* What changes when you operate at 100M+ conversations: reliability, cost, post-training, model routing, and infrastructure optimization* Why the same clinical conversation can serve doctors, patients, payers, pharma, and future clinical-trial workflows* How Abridge works with EHRs, and why deep interoperability is table stakes for clinician adoption* Why healthcare AI has regulatory tailwinds, why 80/20 does not work here, and why high-stakes domains may drive AI forward* Why Abridge embeds “clinician scientists” into product and eval teams* What Chai learned from Glean about search, quality, and durable AI infrastructure* Why the future of AI infra may look like context layers, event-driven systems, Kafka, Temporal, sockets, CRDTs, and tools built for humans* Why Janie changed her mind on “PRDs are dead,” and why crisp written clarity matters more in complex AI products* How Abridge uses Claude Code, Cursor, and coding agents internallyAbridge:* Website: https://www.abridge.com/* X: https://x.com/AbridgeHQJanie Lee:* LinkedIn: https://www.linkedin.com/in/janiejleeChaitanya “Chai” Asawa:* LinkedIn: https://www.linkedin.com/in/casawaTimestamps00:00:00 Introduction and what Abridge does00:02:05 From ambient documentation to clinical intelligence00:04:04 Clinical decision support and context as king00:06:57 Alert fatigue, proactive intelligence, and prior authorization00:12:36 Ambient AI form factors and healthcare customers00:16:59 The hardest AI problems in healthcare00:18:26 Frontier models, proprietary data, and model strategy00:21:07 The EHR as a filesystem for agents00:24:03 Personalization, memory, and clinician preferences00:30:40 Evals, LLM judges, and progressive rollout00:36:47 HIPAA, de-identification, and privacy00:39:21 100M conversations and operating at scale00:44:10 EHR integration and the clinical intelligence layer00:46:39 Healthcare regulation, latency, and high-stakes AI00:50:11 Clinician scientists and long-tail quality00:53:04 Lessons from Glean and durable AI infrastructure00:57:03 The future of agentic healthcare workflows00:57:34 PRDs, product clarity, and building serious AI products01:03:11 AI coding tools at Abridge01:04:06 OutroTranscriptIntroduction: Abridge, Clinical Intelligence, and the Latent Space x Unsupervised Learning CrossoverSwyx [00:00:00]: Okay. This is a special crossover Latent Space Unsupervised Learning pod.Jacob [00:00:07]: Very excited to do this.Jacob [00:00:08]: At this point, we get together once a year.Swyx [00:00:10]: Once a yearJacob [00:00:11]: And this is a fun occasion to get to do it on.Swyx [00:00:13]: I really wanted to talk to Abridge but I felt very underqualified because healthcare is not something we cover very intensely. It just so happens that Redpoint's our big investors and supporters of Abridge.Jacob [00:00:27]: Anytime you want to have a portfolio company on your podcastJacob [00:00:29]: Please, by all means.Swyx [00:00:31]: So we'll introduce our guests. Chai and Janie, welcome to the pod.Janie [00:00:34]: Thanks for having us.Chai [00:00:35]: Thank you.Janie [00:00:35]: We're excited to be here.Chai [00:00:36]: Thank you.Swyx [00:00:36]: So for listeners, what do you guys do, just to situate you guys in the company?Janie [00:00:42]: Abridge is a clinical intelligence layer for health systems. We really started with documentation and building for clinicians and as we think about reducing the burden that clinicians have, they're spending 10 to 20 hours a week on documentation. There's a massive doctor shortage in the country. We also think that conversations between patients and clinicians are probably the most important workflow in healthcare. It's where care is given and received but if you think about the 20% of our GDP that goes towards healthcare, almost everything is a derivative of that conversation, whether it's the claim, the payment, the actual diagnosis given, the treatment. And we've started with a conversation to reduce the burden for doctors on documentation but we're really excited about the path ahead as we become this broader clinical intelligence layer.Chai [00:01:34]: I'm Chai. I work on clinical decision support at Abridge.Swyx [00:01:37]: Yes.Chai [00:01:37]: And so as Janie said, we're uniquely situated where we started off with the clinical note. What I'm really excited about and where we're expanding towards is what are all the things you can do before the conversation, during the conversation and after the conversation if you did have access to all the context about patients, payer guidelines, medical literature and put that together and to serve, how healthcare could look fundamentally different.Swyx [00:02:01]: And that's the context engine that you guys have?Chai [00:02:04]: Yes.Swyx [00:02:04]: Is that what it's called? Okay.Swyx [00:02:05]: So historically, as I understand it, the company started in 2018. A lot of people would be familiar with the AI voice notes form factor that doctors would be “Well, do you consent to being recorded?” It replaces handwriting and what have you. But it sounds like more recently there's been a big transition in the company. Tell me about the broader transition.From Documentation to Clinical Intelligence: Save Time, Save Money, Save LivesJanie [00:02:26]: So from a transition perspective, we really think about our journey as The first act was: how do we help save time? And that's where a lot of that original product was.Swyx [00:02:37]: By the way, one of those interesting statsSwyx [00:02:39]: On your landing page was, doctors spend time after hours.Janie [00:02:43]: They call it pajama time.Swyx [00:02:44]: Why is that pajama time?Janie [00:02:46]: Doctors after work in their pajamasSwyx [00:02:48]: In their pajamas. OhJanie [00:02:49]: At home are just writing and catching up on their notes every day.Janie [00:02:53]: Some of our favorite customer love stories, we have a Slack channel called Love Stories. We have clinicians telling us, “Abridge has helped us, from retiring early or we're now finally able toJanie [00:03:06]: go home and eat dinner with our kids for the first time.”Chai [00:03:08]: Save the marriage in some cases.Swyx [00:03:10]: One of the quotes was “We're not divorcing anymore.”Swyx [00:03:12]: I'm asking, “Why?”Swyx [00:03:14]: Because they're working too much.Janie [00:03:16]: But, in terms of where we're going and where we're expanding, we really think about our second and third acts around how do we help health systems save and make more money. Health systems are operating with record-low operating margins. It's getting harder and harder to serve patients and they have regulatory, some tailwinds but also a lot of headwinds coming their way and AI is ripe for helping on the saving and make-more-money piece. And then ultimately, how do we help save lives? The fact that our software and our product is open millions of times a week before, during and after a patient walks in the room, gives us massive opportunity with products like clinical decision support, which Chai is building but so many others to improve patient outcomes and probably one of the most important workflows and problems to be going after right now.From Glean to Healthcare: Context Is KingJacob [00:04:04]: One thing that's interesting, Chai, is you came over to Abridge from Glean and clinical decision support, which for our listeners is, in the context of a visit, helping a doctor figure out the right type of care. It's really a search problem in many ways, going through lots of different data sources. Very analogous to your previous role as one of the earliest engineers over at Glean. I'm sure a lot of our listeners are curious what's similar about the problems that you're going after now and what feels different, now that you're in healthcare.Chai [00:04:33]: Very similar. Taking a step back, with every wave, there's a lot of very similar patterns that happen across different products. A lot of social networking products look the same. A lot of credit-based products look the same. And we're seeing that very similar in the agent era with many companies, of course, in Redpoint's portfolio and so forth. And the key insight between both companies is that you have amazing models but context is king. Context is what puts them to work. So I see it in a lot of ways, a lot of similarities in this is a healthcare-coded version of Glean but the differences are really interesting. A couple things that come to mind. First and foremost, the rigor of the setting we're in. The downside risk is extremely high here in healthcare. It can be fatal in some cases. You prescribe something that the patient is allergic to for example. Whereas at Glean, it's “Oh, you got the question wrong.” It wasn't the end of the world in most cases. And so what does that mean? That shapes our evaluation strategy, both offline evaluation, progressive rollout and there's a lot more we could go into there. Second thing that comes to mind is, vertical versus horizontal. In both cases, there's a large variance but when Glean is, it's a much more horizontal company, there's a variance of personas, companies that you're working with. We also have a variance of personas, different types of specialties, different hospital systems. But the variance is a little more narrow. So from a product perspective, you're able to focus far more, especially when you have a maturing technology and you're building new products that never existed before. It lets you go after them much more easily and especially in healthcare where so many problems were solved with labor and process, that it's extremely ripe for AI to keep helping augment and enable. And the final thing that's really interesting, Abridge specifically compared to many other companies in the AI area, is the modality we started with where we're ambient and we're always listening in the background. And many more AI products will go that way but it's how we started. And that's the greatest form of AI we can create, AI that's seamless. You're not looking at your screen. It's always there. It's always helping you out and being proactive. The Jarvis vision that, every hackathon I went to over the past decade, there was always a Jarvis competitor. But Abridge very much started from the opportunity and continues to go that way.Ambient AI and Alert Fatigue: When Should the Product Interrupt?Jacob [00:06:57]: One thing that is super interesting then from a product perspective is you have this always-on seamless in the background and then you have to decide when you break the wall almost and say, “Hey, clinician, you might not have thought about X,” or whatever it is that you want to do. And in healthcare traditionally there's been this idea of alert fatigue and a million pop-ups and then a doctor just ignores all of them. It's probably a pattern that a lot of builders are thinking through now. How do you think about the right way to intervene or to pop up in a doctor visit?Janie [00:07:26]: It's such a good question. Alerts are notorious in healthcare specifically. Over 90% of alerts are ignored. The first and most important thing is context is everything, as Chai alluded to and I also think about how do we go from being reactive alerting to really proactive intelligence at the point at which it matters most. One thing we like to say is we want our product to feel like air conditioning. It should be in the background just making things better and if there is something that has great clinical risk and we're acutely aware that intervening now and not later is incredibly important, we should decide to act. But if you think about proactive versus reactive, instead of alerting a clinician during a visit when they're with their patient having a pretty serious and sensitive conversation, how do we prep a clinician before they walk into the room with that patient? And so historically, clinicians might have to manually go through charts with a patient that they've had over the course of months or years and they'll try to suss out what are the things they should be doing. You can imagine a world with Abridge. We'll summarize all of the most recent context for you, tell you based on the reason for a visit the patient is coming in for the types of things you should be discussing. And so you're going into that conversation prepped rather than walking in cold to that patient visit and then having this product interrupt you five or 10 times throughout the visit. And there might be times where it's really important to interrupt. We have a product called Prior Authorization and so this is when you may go into a doctor's office with knee pain. They'll prescribe you an MRI and so many of us have had this experience before, where in four weeks you'll get a call saying, “Hey, Sean, that MRI that you were prescribed wasn't approved and why don't you come back in? We'll figure it out.” In a world with Abridge, we might choose to quietly but still alert a doctor in that visit. And alert is probably not even the word we would want to use. Before a patient leaves, we would want to tell the doctor, “Hey, Doctor, before Sean leaves, you should ask him, has he had physical therapy and has his pain lasted for more than six weeks? Because the Aetna plan that he's on in California requires six things. We've already confirmed four of them have been met ‘cause we have all the context. But these two last criteria, if you can address with Sean before he leaves the room, we could guarantee that your MRI is approved before you leave.” And so when you think about clinical usefulness, impact to the patient, there are instances in which if we can catch a doctor while the patient is still in the room, as we think about save time, save money, save lives, we get to check all of those boxes. But when doctors have 15 minutes between visits, we have to be really thoughtful about when it matters.Prior Authorization: Reducing Latency in CareChai [00:10:23]: There's this interesting product opportunity AI has is reducing latency in the world. For example, prior authorization is an example of where care gets delayed and so great AI can reduce that. And the problem with alerts before partially is a technical problem: the quality of your alerts really matters. They're going to get ignored if you get alerts that... Similarly in engineering, where they're noisy alerts that you can't act on. But if you can make really high-quality alerts with both the context, as Janie said, and really high-quality models, then you can create a whole other game.Janie [00:10:53]: And I really like that experience because it starts to tease apart, what makes this so hard and unique. One, to make that prior authorization example possible, think about all the data that you need to have. You need to integrate with the electronic health record to know all of the patient context. Do we have access to your previous labs, previous imaging? And then to match you and to know that you're on Aetna, we have to collect all of the different payer policies and they vary by state. Some of these payer policies live on websites. Some of them live in unstructured 50-page PDF files.Jacob [00:11:31]: I thought this episode wasJacob [00:11:31]: To make sure we didn't scare people from healthcare.Janie [00:11:34]: But when you think about the things that make it hard, it also gives you the moat.Janie [00:11:39]: And then the second is the AI and the model quality we need to be able to hang our hat on. And so the bar, similarly when I worked at Opendoor, I worked on pricing models. Every outlier wiped out the margins of 30 and so similarly here in healthcare, the bar for accuracy is so high. And then I'd say the last is workflow is everything. If insurance companies deploy AI, it typically happens too late and this is when you have the notorious comical examples of AI just fighting each other when it's too late. But if we can pull forward the use of both the AI but also the ability to solve problems when the patient's in the room, you can start to collapse what typically takes weeks or months after your visit, ideally down to minutes or real-time. And it's where healthcare is both very difficult but also extremely rewarding if you can crack it.Product Form Factors: Mobile, Desktop, In-Room Devices, and ARSwyx [00:12:36]: Just to get some baseline on the form factors, because I've seen some videos on your website and stuff. You guys talk a lot about ambient AI. Is it primarily on the phone? Is there any other form factor that people get Abridge in? Is there an Abridge room setup where it's always on? I don't know.Jacob [00:12:55]: An Abridge podcast studio.Janie [00:12:58]: Primary form factor is mobile and desktop. UsuallyJanie [00:13:00]: Clinicians are walking in and out of rooms with mobile but at the end of the day, when they're closing out their notes or wanting to prep for the day ahead, they might use desktop. We have been having a lot of really interesting partnership conversations with a lot of these in-room device companies as you think about the power of multimodality and even more data, as you think about all of what is not captured today. It is fascinating to think about, especially even as we go into building and scaling our nursing product. It's one where nurses constantly, as they're walking in to check in on a patient for two minutes or maybe even 30 seconds,Janie [00:13:43]: Starting an Abridge experience is probably going to take longer than the visit. And so what can we do with in-room devices that are always on starts to raise really interesting and fun product questions.Swyx [00:13:54]: I was thinking, the way in tech companies we have all these Google MeetSwyx [00:13:58]: And other things, we might as well set up entire rooms with just Abridge tech.Chai [00:14:02]: Very much. AR glasses and related form factors are also relevant: how do we bring the information to the clinician in real-time without a screen, while still letting them focus on the patient?Swyx [00:14:18]: Do you think they want that? I'm skeptical of AR, but I'm curious what you've tried.Chai [00:14:26]: Admittedly, it's not a near-term product roadmapChai [00:14:29]: By any means. I'm being far-fetched.Jacob [00:14:31]: There's some sick AR stuff for surgeries.Swyx [00:14:33]: Really?Jacob [00:14:33]: When people are trying to visualize, you're about to make an incision but you want to see, what the cut might look or what the body might look like inside and they can layer in imaging.Swyx [00:14:43]: That's cool.Chai [00:14:45]: At some point in the future.Janie [00:14:46]: But there are a lot of our largest customers and at the largest health systems integrating already and so even as we think about building into it, unlocks a lot of product capabilities.Swyx [00:14:57]: And just to establish the terminology. Sorry, and I know I'm asking basic questions somewhat for myself but also for the audience who might beHealth Systems, Buyers, Clinicians, Patients, and PayersSwyx [00:15:05]: Less integrated. When you say health systems, it's like the Johns Hopkins, the Kaiser Permanentes.Janie [00:15:09]: Mayos, the Kaisers of the world.Swyx [00:15:10]: These are your customers, right? And the outcome that you deliver for them is happier doctors, reduced cost of processing, reduced mistakes. It's weird in a sense that I feel like there's also, a secondary customer, the customer of the customer and I don't know if you — do you think about it that way?Janie [00:15:28]: The other interesting and complex part of building product is we have our buyers, who are the chief medical information officersJanie [00:15:39]: The chief financial officers, the CIOs of these large health systems. Our users today are clinicians but if you think about who downstream is impacted, it's patients. And so as we build, with every product in mind, we think about who we're building for, who the secondary user is and what does that mean either in terms of experience, security compliance, ROI that we have to make tangible. And so like you said, time savings is one of them. But for CFOs, they care a lot more than just time savings. We have to show for every dollar you put into Abridge, because you have more compliant documentation or because you have fewer queries coming from your billing team, we save or add real dollars to your bottom line or top line, are things that we're constantly thinking about because of the dynamic across all three sets of users.Chai [00:16:32]: There's a whole other axis too with the payers and pharmaChai [00:16:35]: as well. Connecting all these three big stakeholders in healthcare isSwyx [00:16:39]: Do the payers ever see your data? Sorry, the payers meaning the insurers, right?Chai [00:16:44]: Yes.Swyx [00:16:44]: They also see Abridge data?Chai [00:16:47]: NoSwyx [00:16:47]: Like the direct integration to you guysChai [00:16:48]: They wouldn't see the raw Abridge data but when you're working together on something like prior authorization, whatever information they need, we'd communicate to them.Jacob [00:16:59]: That's cool. I would love to dig into the AI side. You still have a lot of problems on the AI side. And so maybe to start at the highest level, what's one of the hardest problems you have to solve in AI at Abridge today?The Hardest AI Problems: Quality, Latency, and CostChai [00:17:11]: To make things simple, let's take, building off the prior auth example. So one thing Janie talked about is okay, this data is all over the place and there's this combinatorial explosion of procedures, payer policies and even sometimes different health systems. There can be some cross-product of all of these different considerations you have to take into account. But what's really hard about this problem is doing it real-time in the conversation. So, in any AI product, usually the three KPIs you care about are quality, latency and cost. Now, what we're saying is we want you to do this real-time in the conversation, guiding the clinician. How do we do it in a way that does not break the bank? But we're using — But we also need very intelligent models because you're working with this cross-product of data and this, all this context layer as well. So you need high intelligence and high-quality because you don't want the alert fatigue but you also need to be fast and cost-effective. And so that's where a lot of clever engineering goes. It's okay, without getting into all the details here, can you model these policies in some intermediate representation or other things that you can do that can make this problem tractable? And of course, the Pareto frontier is always changing but we are also trying to do this now.Model Strategy: Third-Party Models, Proprietary Data, and Medical ConversationsJacob [00:18:26]: What implications has that had for what you take off-the-shelf and say, “ what? We don't need to be world-class at X. We'll just take this from the model providers or from some infrastructure player,” and what you're “No, this is where we spend most of our time focused on”?Chai [00:18:38]: This is, the fun challenge in AI?Jacob [00:18:42]: It changes every three months? SoChai [00:18:42]: Of course, with the shifting landscape, we try to be extremely thoughtful on predicting the trends of where third-party models are going and where we can uniquely go. And, sometimes when you talk about AI models, we're the models are just going to get infinitely better. But I don't think... It may be in the grandness of time you could say that but, within every month, every quarter, there's specific ways they're getting better. They're training on a lot more, coding data to be better coding agents, for example. And soChai [00:19:14]: We have to think about where are the things that won't — unique data that we're uniquely training on or to step back a little, where is a proprietary model bringing advantage to us is if it can give higher quality or lower cost and latency for similar quality, very similar to many other companies. And when we can do that is when we have proprietary data. So, for example, we have on the order of eighty million or hundreds of millions now getting close to of medical conversations.Jacob [00:19:44]: It's insane.Chai [00:19:45]: This is a unique data set. And this data set, it's very interesting because this data set is effectively a large part of the trace between the patient and the provider. That's where the quote-unquote debugging happens in healthcare. We have these traces at scale, as in as, our CEOs even called it, an exhaust that comes out of our product. And so when you have these traces, that's how you can train better agents on certain use cases, whether it's your transcription diarization use cases or so on or like note generation models and we can do that much cheaper and faster. But we're always also working with these third-party model providers. We closely collaborate with them and that's how we predict where the trends are going. The thing that I think about a lot is that, I know that the model providers are going to train much more on agentic workflows and so forth, so that's great, so that you have a better agentic harness. But the other thing that's interesting is that the model providers, because a large class of the consumer model providers is healthcare queries, that they might, optimize to train a lot of healthcare data to encode the knowledge in its weights. And this is just a great thing for us as well, where the off-the-shelf models can keep bett-getting better at general healthcare information, such that what our strategy is, we have a constellation of models, we can use something for this, that and, we only care about, at the end of the day, the best product experience.EHR as File System: Agentic Workflows and Real-Time InterfacesJacob [00:21:07]: And, you have, overall capabilities improving. I'm curious, as these models get better, is there something you look at and you're “, three months ago, we really couldn't do that but God, the the latest models really allow us to do it”?Chai [00:21:19]: So here's something interesting that I've, been toying with. So all models are... This wasn't super obvious a year ago but now it's become clear and clear that almost every agent is a coding agent underneath the hood? So you give it whatever file system, it can write its own code and so forth. So when you think about within healthcare and the use case that we have, you can think of the EHR effectively like a file system. It's just — it's a storage of all this information. It's a lot of information there that cannot fit into the context window, at least of today's models and you want to use that context effectively for all these product use cases we're talking about. And so if you have better agents that can, manipulate data, read that data, treat it as a file system as we see they're going and we know model companies are investing this way, then that very directly benefits us.Swyx [00:22:09]: Yeah. Okay, cool. Again, just establishing basic things. But we're going back to the model stuff. I'm really interested in double-clicking more on the real-time, element, which is pretty important for both of you. Is it — Is real-time just batches of every one minute, every five minutes? Is that how we do it? Or is there some more native, genuinely real-time in the sense that OpenAI has a real-time API or Gemini has a real-time API?Chai [00:22:35]: Yeah. Yeah. So today it is more on the on the batch basis but there's interestingChai [00:22:41]: Prototypes that we have that we're still not fully, full time, voice in text out or in that sense. But, can you trigger your models, your agents or agentic workflows, depending on the right times in the conversation?Chai [00:22:58]: And so you can imagine, different techniques to bring this latency down and, you want to bring the feedback loop down as much as you can. And so a lot of clever engineering there without fully... Maybe one day we'll do full voice in and text out, train a model to do something like that.Swyx [00:23:15]: You do — People don't want voice in voice out?Chai [00:23:18]: Now we aren't creating experiences that are, during the conversation, inter — It's almost likeSwyx [00:23:25]: Might be too disruptiveChai [00:23:26]: Too disruptive until, who knows, maybe eventually you could have full voice agents once we — the quality and we improve the comfort of the technology. But right now gra — that change is much more gradual and it's more text focus, text out.Janie [00:23:42]: And so much of currently what our product is trying to do is allow a clinician to focus on their patient and maybe at some point but right now patients, clinicians don't want a third voice, at least in a literal voice in that room. And so how do we be there with all the contacts and information ready at hand when there's the right moment?Personalization: Individual Doctors, Specialties, and Health SystemsJacob [00:24:03]: Jenny, one thing I'm curious about is how you think about, personalization in the product. I imagine, every doctor is a special snowflake in their own way, has their own way they like to do things. There are probably a bunch of different approaches you could take to doing that, both within the model layer itself but then also just with clever prompting or engineering. How do youJacob [00:24:20]: Deliver on that?Janie [00:24:21]: It's such a good question. Personalization is massive for us. We think about personalization at three levels. The first is at the individual, the second is at the specialty level and then the third is at the health system or the organization level. To your point, there are a lot of individual preferences. You-When a note is produced, it almost is a reflection that is so deeply personal of a doctor's work and how they give care. And so do they have preferences on things like style? They might want bullets versus paragraphs, really concise versus comprehensive. They also might have phrases that they really like to use or the templates that they want every note to be structured. And, we see it in our feedback all the time. We want two spaces in between sentences or I refuse to use this tool. And so that's something that we've had to build in. And the tricky part is how do you make sure that stylistic preferences don't interrupt accuracy and quality and that's something that we've really had to refine and hone over time. Second is at the specialty level. A cardiologist note or workflow is going to look very different from a dermatologist workflow.Jacob [00:25:32]: I assume cardiology notes are the highest stakes for you guys, given your CEO is a cardiologist.Jacob [00:25:36]: It's “Oh my God, make sure we get this one.”Janie [00:25:37]: Shiv, our CEO, is still a practicing cardiologist. He rounds once a month. And so, first call when we want just quick and easy user feedback too.Janie [00:25:46]: But, specialties require a lot of personalization, both in terms of what does the product look and so we make sure that as new users onboard, we catch that and the product proportionally reflects that. But also on the back end, evals at the specialty level, they are hard-earned to calibrate and get. What does a really great dermatology note look like? What makes it complete? What makes it compliant and billable is very different than a primary care doctor. And so it's not just about what does the product experience look but on the back end tuning and really deepening our understanding for the specialists. What does great output look like? And that's, a problem that we need to calibrate internally, externally, online, offline but, takes lots of cycles but is necessary in a high-stakes environment. And then at the health system level, for products like clinical decision support, you have health systems who've spent years or decades refining their best practices and they want to know, “Hey, we love your clinical decision support product but how do we embed our own hospital guidelines into them to inform clinicians before, during or after a visit what brest — best practices should look like?” And as you think about, deepening moats as well, when health systems, trust us with that data, allow us to productize it and directly into the clinical workflow, makes us a really great partner to health systems who want to build something that truly meets their needs, their practicing guidelines.AI Slop, Memory, and Product Data FlywheelsChai [00:27:23]: And I want to add onto that. The for the clinical documentation problem, it's very similar to AI writing that doesn't feel like your own and then we call that slop. But the way I describe one framing of slop is like AI without context. But we have all that context and both the clinicians, can have it and can guide it. And so part of the other interesting exhaust for us is, memory is, one of these new systems recordsChai [00:27:49]: Almost.Janie [00:27:50]: And we also have all the edits people make on our product and when you think about a data flywheel and how we get better over time becomes really powerful as a mechanism to just going deeper in personalization.Jacob [00:28:04]: It's interesting. I love this idea of working with systems on the guidelines they built up over a long time. I feel like so many of the best AI app companies today are... The question is: How do you take the expertise that a law firm or a bank has built up over many years and then add that as context and also a special sauce over, a an AI tool? And so seems like y'all are really doing that very effectively.Janie [00:28:24]: We're now starting to have our customers ask, “What are other customers doing?”Janie [00:28:28]: “And how are they doing it?”Janie [00:28:30]: And as we think about having visibility across such a large set of care being delivered right now, a really interesting place we could also partner.Swyx [00:28:40]: I'm just curious. I — This may be a nothing question but, how different are health system guidelines from each other? Don't they all converge to the same thing? And if not, where do they differ?Chai [00:28:52]: At a really high level, they're going to talk about very similar things but the difference is probably in some more of the details. “Oh, you should refer to specialists only when XYZ conditions are met,” or so forth and maybe different organizations have different practices and guidelines around that. But high level, talking about similar things but the details are what, of course, that shapes the context and the decisions you make.Swyx [00:29:15]: And this all goes into the context engine and it might affect the notes but maybe not.Chai [00:29:21]: The — For these local pathways, we're definitely thinking about it a little more for our clinical decision support product.Chai [00:29:26]: So yeah.Swyx [00:29:27]: Which is your stuff, yeah.Swyx [00:29:28]: And then the memory which you raised, let's just tell us more about that. What have you tried in memory? What's the structure of the memory? What works? What doesn't work?Chai [00:29:38]: There's, of course, many different ways you could do memory, where it's okay, can you bake it into the model weights or can you do it in some external store? For us, what's interesting is, of course, when you think the models are rapidly changing, whether it's in-house or third-party, baking into the model weights, sometimes you worry that it could be a little throwaway. And so, how do you... You need to find a way that you decompose the problem, the preferences from the underlying models and so forth. The thing we're right now most both that's easiest to start with and we're excited about is having, a separate store for memory, where you have, for example, a memory sub-agent that's, working in the background, figuring out what are the important parts of the clinician's actions that we want to remember for the long term. And then you can also imagine, other things where in the — you have background jobs that are running that are collating these, memories similar to Sleep, of course and what other pattern, patterns products do as well. Learning over all these action, all the action data we have, again, note edits, the conversations they did and the actual transcripts.Evals: LFD, LLM Judges, and Clinical SafetyJacob [00:30:40]: What about evals? How in the world do you... It is such a complex product surface area. We would love to hear you riff on that and also how has that evolved? I'm sure you've gotten better at it, so any learnings along the way.Janie [00:30:50]: From an evals perspective, we, from day one when we build any new product or feature, we think about, what does good look like? And there are table stakes things like clinical safety but then you start to get deeper into what does good quality look like. And when you go into something like our core product, there's stuff like style and completeness and there's things like does this note become something that can be billable, which is very high stakes for a health system. We have a number of ways in which we get confidence for this. We have, internal in-house clinicians who do what we call an LFD process to give us our very first pass at is this or isn't this a good enough output, look at the effing data.Jacob [00:31:41]: LFD?Chai [00:31:42]: That's why I was smiling. I was “Is Janie going to mention what it stands for?”Jacob [00:31:46]: I was not... There's like a million acronyms.Jacob [00:31:48]: How am I supposed to know that I don't? So “Oh yeah, of course, an LFD.”Swyx [00:31:51]: I've never heard of LFDs.Chai [00:31:53]: It's a bridge for sure.Janie [00:31:55]: I got through three days and then I had to ask someone.Janie [00:31:58]: I thought it was just me that didn't knowJanie [00:32:01]: It's our internal process.Swyx [00:32:02]: But look at the data as a meme in ML, ‘cause you tend to not look at it. You just want to look at number go up.Chai [00:32:06]: Exactly.Swyx [00:32:07]: But yes.Janie [00:32:08]: But so, we make sure we look at the data and then as we think about all of the components of good output, we, one, create LLM judges across all of these and we make sure with annotated data and either internal or external evaluators, we feel like these judges are calibrated. And then depending on the stakes, we also work with in-house and third-party evaluators across all of these before we ship any big change. And the goal is, in terms of evolution, how do you go from this process taking months, down to weeks, down to days? Some of it is, a true science and ML problem. A lot of it's also just, hard operational work. Have you planned ahead in terms of what you need? Have you really optimized the capacity that you need across all of the different specialties you need? Have you gotten a really good sense of which third parties are great to work with for what use cases? This takes a lot of domain, expertise and, lots of mistakes and errors in figuring that out. And so as much of it is an ML problem, so much of it has also been operational gains that are hugely important, where domain-specific expertise is everything.Specialty-Level Evaluation and Progressive RolloutsJacob [00:33:23]: But it's funny, ‘cause I feel like people talk about healthcare like it's one giant market and the reality isJacob [00:33:26]: It's, dozens and dozens of sub-markets. And so it feels like in your evals you have to build that up across the board, probably.Swyx [00:33:34]: And is specialization the primary cardinality at... That's the word that comes to mind.Janie [00:33:40]: Sometimes, depending on the product or the use case. And so if we're making a note improvement or feature for a particular specialty, definitely but we have products that are for nurses. We have products that, are really aimed at making the document or the output a lot more billable. And so we'll want to work with coding teams and not necessary clinicians. And so likeJacob [00:34:05]: Coding meaning healthcare coding.Janie [00:34:06]: Yes. Yes.Jacob [00:34:07]: NotChai [00:34:07]: Yes. I see you.Swyx [00:34:07]: Other kinds.Janie [00:34:09]: But is this output proportional to the work that was delivered? Is there sufficient documentation to justify the amount that a health system may end up charging? And so, specialty sometimes but also domain, very different across all of the different products that we're working for. And building out that network is, not easy and is where a lot of our operational investments have gone into.Chai [00:34:35]: And I view a lot of analogies to self-driving cars here, where, part of it is we really want progressive rollout of features to test in the real world is this useful? Is this going to work? One big difference compared to past lives is before I'd build a product, maybe I'd alpha it and then I'd like GA it the next week, ‘cause I'm “Go, move fast, ship,” and whatnot. But the mentality is like you... I want to make contact with the reality as quick as possible but I want a progressive rollout. Because as much as I get as large of an offline eval set, I want the distribution of that to match real-life distribution. And over time, by rolling out early, similar to Waymo has a tagline, “The world's most experienced driver,” another thing that can, at least linearly increase for us is, both the size of our evaluation offline and online, that and it all feeds back.Janie [00:35:25]: Something that's been earned over time, speaking of evolution, is just the trust we've gotten with customers. Historically, a lot of these health systems, when they bring on new vendors, their release cycles are quarters, sometimes twice a year. We've gotten our customers onto monthly release cycles, which is pretty fast for health systems but what is more exciting over the last, call it, few quarters, has been, a subset of our customers have said, “We want to innovate with you. We trust you,” and we have a pretty, decent chunk of our customers who say, “We'll develop with you outside of these monthly release cycles. We have a higher tolerance. We know that the stakes are very high but we want to be the first ones using these products, giving you feedback.” And so for a pretty substantial set of our customers, we've been able to convince them to be able to ship, in this gradual way before GA. Something we talk about a lot internally is, trust is earned in drops, earned in buckets and so we still can't do what I used to do when I worked at Loom. We had 30 million users. I'd just be, rolling out experiments left and. The bar is still quite high for iterative rollout but because of the trust we've earned, we're able to learn at pretty high volume very quickly.Privacy, HIPAA, and De-IdentificationSwyx [00:36:45]: Your scale is still pretty huge.Swyx [00:36:47]: One thing I want to... We were going to go into scale? In a sec. One thing I wanted to call up, follow up on evals, which, again, just coming from a generalist engineer point of view, just thinking through what would people be scared of in doing this, the privacy and HIPAAJacob [00:37:00]: Elements of this. I have zero experience in that. What do you have to do? What is surprisingly not that bad?Chai [00:37:06]: So one thing that's really important here from a compliance perspective is very much that any of the data we use needs to be de-identified, any real-world data we use as a basis of online eval sets we're learning from. And so you have to — And there's, very clear, government guidelines, what counts as PHI. And so we've even have built models that can take, for example, a clinical transcript and remove all the key PHI indicators and so you have a scrubbed/de-identified version. And then once you... And so one thing that's important is first you've got to get confidence in that model in the first place? And prove that out. Because, now you have, multiple probabilistic systems on top of each other.Chai [00:37:46]: But once you have that, then you can train on it use it for evaluation and so forth, provided one of the cool things also that you can do from a business side is the right data contracting as well with your partners.Jacob [00:37:57]: Is the anonymization one way? Once it's done, you cannot undo it? Or is there someoneChai [00:38:01]: YesJacob [00:38:02]: Who holds the master key that can... Yeah, okay. So it's one way.Chai [00:38:05]: It's one way. Yeah.Jacob [00:38:06]: That's how it works. I just wanted to... Because, there's a lot of this, learning from feedback and everything that, you would want to debug more but you can't because you just physically don't allow yourself to.Janie [00:38:17]: Some of it's also written in our customer contracts in terms of who can or can't access PHI data, how long do we retain it,Jacob [00:38:27]: Very goodJanie [00:38:27]: Before it gets de-identified. And so we have a pretty high bar for who can access that PHI data, just to make sure that we always respect our customer data and privacy. But that's something that we partner with our customers on too, to make sure that as we want full, as close to precision as possible in that qualityJanie [00:38:48]: We can still use it.Jacob [00:38:50]: But it'll be fascinating to see how that space evolves? Because you think about, I used to work at a company that, did a lot of healthcare data in the cancer space and if you asked, the average cancer patient, “Hey, do you want people, do you want other patients to be able to learn-”Chai [00:39:03]: Take it.Jacob [00:39:03]: “... Learn from your experience?”Chai [00:39:04]: Take it all.Jacob [00:39:05]: They're “Please.”Jacob [00:39:06]: “I'd love, nothing more than for other people to be able to learn fromJacob [00:39:10]: The experience that I had.” And so in the past it was a lot harder to do that learning. But with this technology, that might really be practical and so it'll be fascinating to see how that continues to evolve.Chai [00:39:21]: There's so much in our data set of 100 million conversations.Chai [00:39:26]: You can imagine things like insights that you can give to the clinician. How could you, oh, how could you have reacted to this? In coaching or insights around, which treatments are effective or, like... Because you have this, again, this data source that was never captured before but that's, where, intuition or experience is created from, going back to this idea that the conversation is the agent of truth.Operating at Scale: Reliability, Cost, and Token EfficiencyJacob [00:39:46]: Back to the 100 million conversations, I feel like you have this insane scale that maybe only a few other AI app companies have and everyone else dreams of. So not everyone has had to confront this yet but maybe just talk about some of the challenges of operating at that scale and what, our listeners have to look forward to if they ever get to this level of scale.Chai [00:40:05]: At large and larger in scale, so of course there's a general, infrastructure reliability. When you... In any given startup, you're building the plane while it's flying. So there's some notion of that. But what gets interesting on the AI and ML side for sure is this, as you get at more and more scale, so one, you have the data to first and foremost do this. But, you start thinking about costs or infrastructure in a whole different way at scale versus, a prototype.Chai [00:40:34]: You can use the most expensive model, you can burn as many tokens as you want but when you're doing 100 million conversationsJacob [00:40:41]: Token max on leaderboards are less upsetting than that context.Chai [00:40:45]: . When you're doing that and so that comes for we have the data and we also have the team that's able to post-train based on this and you can optimize for efficiency, especially in areas where you believe that maybe a lot of the quality headroom is less so and you don't expect the other off-the-shelf models to go that way, such that you want to do, efficiency maximization, in terms of compute and tokens.Jacob [00:41:08]: I feel like you guys live in the future in some way where most use cases today are really just in use case discovery mode, where it's “God, I really hope I can find something that can get to scale,” and so you're always going to use the most powerful model. And then the few things that do get to this level of scale, you start to do those optimizations.Chai [00:41:22]: It's a natural trajectory where it's like zero-to-one, we're not talking about any of these optimizations.Chai [00:41:26]: But when maybe we're in the one-to-100 or so forth, then we're in optimization mode and, what works out really well is you've got all this data from zero-to-one that lets you do this.What Comes Next: The Conversation as the Shared Healthcare PlatformJacob [00:41:36]: That's fascinating. I feel like one thing that's so interesting about the Abridge footprint is that you're in the doctor-patient visit in real-time. I always like to say, there's like probably 50 years' worth of product you could build on top of that. What gets each of you, I don't know, what are you most excited about building, either in the short term or medium term or even, long down the line?Janie [00:41:53]: Something that I get really excited about is that the same conversation can serve so many stakeholders. If you think about the conversation, a doctor needs to know what is the documentation, how do I make sure that this fully represent the care I gave? A patient needs to know, “What the heck just happened? This was really overwhelming. What are my next steps?” A payer needs to know, was this the proper and appropriate care given? A pharma company might want to know why isn't this drug being properly used or is there a good candidate for this clinical trial that I'm about to run? And where I get excited is that our product and our platform and our infrastructure can be the same product across all of those things and start to what's today, separate, very expensive, complex systems that serve each one of these stakeholders in very different ways, start to collapse all of that into a singular platform that enables not just more efficiency across the board but also better outcomes for everyone. And, all of us experience healthcare in probably very painful ways and knowing that there is a world in which we can simplify a lot is really exciting to me and it all starts with the conversation.Chai [00:43:15]: It's interesting. Of it very similar to going back to the KPIs that any AI product cares about. How do you increase quality of care? How do you reduce latency to care? And how do you reduce costs? Which is a huge, in healthcareJacob [00:43:28]: They call it the triple aim in healthcare.Chai [00:43:30]: But very similar to building AI products and the thing that really excites me is when we talk about that latency piece, we talked about one example earlier of prior authorization, can you reduce the latency to care? But you can imagine so much more. Oh, as soon as the lab value gets updated, do you have like a background agent that, kicks off and uses all the context to be “Oh, hey, the patient should do this next,” for example. And of flagging that to the clinician who's always in the loop but reducing that latency, to care. And then you can imagine this is much further down the road but it's like even connecting that to the direct patient and the consumer. And so how can you, how can you build a bridge to all of these things?EHR Partnerships and the Clinical Intelligence LayerJacob [00:44:10]: Very cool. The connections piece is just an ever-growing thing. And one of the key partners is the EHR and I wonder what that relationship is like. Will they, look at this as, something that is valuable enough that they want to own someday?Janie [00:44:29]: Our partnerships with the EHR is, we know that we have to be extremely close partners with all the EHRs who we partner with. Being able to not only pull and push all of the data into the right places is, not only table stakes, if we can't do that, health systems don't want to use us. The second and the reality of today is clinicians spend a lot of their days in the EHR. So much of what allowed us to win in the largest health systems was pretty direct and, very close partnerships with some of the largest electronic health records that allowed us to pull and push data with APIs that weren't ready out of the box. And clinicians want to save clicks. Anytime we introduce a new product that, adds two clicks for them in their day, they're “We're not going to use it.”Janie [00:45:21]: They have 15-minute back-to-back appointments with their patients. They're spending, hours during pajama time doing documentation. Every second and every minute counts and so we really think about being deeply integrated into the EHR as also table stakes to getting real usage and adoption. And anything that we build or introduce, we really talk about earn the right internally a lot, which is we have to provide so much value or save so much time that people will use us. But those are the two things that are close to us, is we know that the product won't be used unless it is deeply interoperable.Chai [00:46:01]: And strategically, to your point, it's like what does EHR want to own versus us? EHRs are really focused on the clinical workflows and so forth but some of the things that we're talking about here, I do these traditionally are outside of the domain where it's oh, connecting pairs and providers together with provider policies or the clinical trial matching, as Janie brought up. And so these are, entirely — we position ourselves as building this entirely new intelligence, clinical intelligence layer across, again, providers, pharma and, payers.Chai [00:46:33]: And so that's a it's a whole different ballgame that we try to playChai [00:46:36]: In combination with them.Jacob [00:46:37]: But it's like a different layer of scope.Healthcare AI Regulation, Technical Depth, and What Changed Their MindsJacob [00:46:39]: I'm curious, you are both relatively newcomers to healthcare. People have these, there's lots of futuristic healthcare AI takes of “Oh, everything will look different.”, now that you've been in healthcare for a bit, you live at the edge of AI, what have you, changed your mind on around this, as you think about what healthcare looks like in ten, 20 years? Any updates to your mental model from the time being close to the problems?Chai [00:47:02]: One thing that IChai [00:47:04]: Was hesitant about before and it's a common thing when I'm trying to recruit engineers that people ask me around, is definitely oh, healthcare, heavily regulated space. And it is, rightfully so. You want to keep, the patients at the end of the day safe. But one of the interesting things that, is a that surprised me how much it is coming to the company is there's a lot of really favorable regulatory tailwinds as well. Where you think about, government really wants interoperability between all these systems that we talked about and so agents can access this information. The government just in January, the FDA released updated guidance on clinical decision support, what I work on in such a way that they used to have guidance from like 2022 that required you to have, mention all these options and do all these other things but it's a very forward and forward-looking way. And so for me, what's been really cool to work on is this, there's this very special moment both in AI in general, we all know that but there's a special moment also regulatory in healthcare as well.Janie [00:48:05]: One thing I would call out is for the very reasons things are higher stakes or, potentially considered more difficult in healthcare, it's where some of the hardest AI problems will get solved first, just because the bar is so high. When I first joined, I was “Oh, this is where we'll be on the tail end of where, all of the AI innovation will be able to be applied.” But when you think about, zero error evals or multi-step workflows that have really low tolerance, a lot of the innovation will happen here just because we have to or else we can't ship.Jacob [00:48:42]: ‘Cause like in other domains, you'd much rather just solve the 80%-is-good-enough problems firstJanie [00:48:46]: 80/20 doesn't work hereChai [00:48:48]: And building off that, traditionally, there was a bit of stigma that, oh, healthcare companies are not that interesting from a technical perspective or I've seen that or faced that myself. But these are really hard and fun problems from a pure technical perspective beyond just the impact. How do you bring the latency of this thing down and make it really high-quality?Reducing Latency: Clinical Workflows, Agents, and Implementation RealityJacob [00:49:07]: How do you bring the latency of things down?Chai [00:49:10]: Yeah. Yeah. Yeah. So okay, let's answer the latency question. And maybe hopefully not too redundant with some of the things I've said earlier but some part of it is with any latency, you have to like what is, what is really your bottleneck. In a lot of workflows, it's sometimes it's the model itself. And so that's where like our data flywheel, our post-training team and so forth come in so that can you make the models far more efficient. So that's one aspect of latency. But there's whole other aspects of latency where it's okay, on top of that, if you use a constellation of different models, can you use — can you first use like a — it's like thinking fast and slow. Can you use a cheap, fast model that triages and hands it off to a larger model where you get more intelligence and so forth and so all theseChai [00:49:56]: Clever tricks to make it work.Chai [00:49:58]: And by the way, we are totally — we also realize that the parameter frontier is changing and so these tricks will — may not get us to where we want to be in five years but we need to if we want to build a useful product right now.Jacob [00:50:11]: Should we go to the quick-fire or you want to ask more about Abridge? We can stuff everything that's not Abridge into the quick-fireSwyx [00:50:16]: I don't mind. I was — I feel like Janie was on the topic of more long tail stuff, which isSwyx [00:50:21]: Not the eighty/twenty thing and that really matters. And I'll —, if you have any tips or cool stories or just general approaches that have worked for you that's interesting to dig into.Janie [00:50:32]: One of them is even just how we staff our teams looks different than a traditional software engineering team, I'd say.Swyx [00:50:40]: Let's go.Clinician Scientists, Edge Cases, and Evals at ScaleJanie [00:50:41]: We have a bunch of folks with different roles who are clinicians and so we have this role called the clinician scientist and I heard one of our leaders refer to them as mutants recently. But they are people who've had clinical backgrounds, so MDs typically, who are also deeply technical, somewhere, on the spectrum of like a full stack engineer all the way to like extremely scrappy prompter. But having each of these people embedded within our teams instantly raises the bar for everything that we build because not only are they determining, is this product clinically useful but they're deeply embedded in our whole evals process. And so when we talk about LFDs, when we talk about what is our actual evaluation criteria, you don't want Chai or me creating what those are because we don't have clinical background. But is probably unique to Abridge but has been game changing. And when you think about where the puck is going, you have people build with clinical backgrounds who are technical and where AI tools are going, they just becomeJanie [00:51:53]: More and more, critical and like the killers of the team. And so that's one. And then the second is just the scale at which we do evals to catch that long tail up front before anything ever gets into production is something that we've pretty much like really started to fine-tune, both from a scale but when do we know we need to get several hundred versus several thousand offline responses, what helps us make that quick decision and make this less of an art and as much of a science as possible. But that's also been something we've had to tune over time.Swyx [00:52:27]: And you have partners who opted in to give you those evals.Janie [00:52:31]: So we work either internally or with third-party for offline evals and then we have customers who also agree to give us, whether it's like thumbs up, thumbs down to like choose this or that, a lot of data to get us to what is as close to fully confident as possible.Swyx [00:52:51]: The term that comes to mind isSwyx [00:52:53]: Like active learning on things where you're weak. I feel like it's a lost artSwyx [00:52:58]: Is a lot of the polish that comes into doing something like this.Janie [00:53:02]: Really.Chai [00:53:03]: Hundred percent.Lessons from Glean: Technical Foundations and AI App InfrastructureJacob [00:53:04]: Maybe, on a totally unrelated note, Chai, you had a very, storied run at Glean b

In today's episode of the Abundant Practice Podcast, I chat with Abundance Party member Liz about building a private practice from the ground up, including how to move through the early uncertainty of getting clients and setting sustainable fees. We dig into raising rates, marketing to other therapists, and shaping a website that clearly reflects a niche in trauma and personality disorders like BPD in a more psychoeducational way.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building & filling your practice? Check out the Abundance Party (only $345!). Members have access to monthly group calls with me and opportunities to snag a 30-minute 1:1 at no additional charge: https://www.abundancepracticebuilding.com/party  Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links. 

AI may be the hottest topic in healthcare, but most organizations still aren't ready to use it at scale.  In this episode, host Sandy Vance chats with the CEO of Hart, Dominique Gross. Together, they break down the real barriers holding healthcare back: from fragmented data and legacy EHR systems to inconsistent standards and limited access. Dominique shares how building a semantic data layer is helping organizations unlock their data, scale innovation safely, and move from pilot projects to real enterprise impact. In this episode, they talk about: Many healthcare organizations are eager to adopt AI, but they struggle to scale beyond pilot programs due to foundational data challenges. The most immediate barrier to innovation is simply gaining access to all relevant data across fragmented and legacy systems. Data quality is just as critical as access, as organizations must normalize and clean their data before it can be used effectively. Legacy electronic health records often contain valuable historical data, even if organizations are hesitant to use it due to inconsistencies. Patients ultimately benefit when their full medical history is accessible, rather than only recent encounters. HART has developed a semantic data layer that acts as a “translation system” across different EHRs, enabling consistent data use. This approach allows organizations to aggregate, migrate, and stream data more efficiently across dozens of systems. One health system successfully scaled from connecting a small number of affiliates to centralizing more than 60 data sources over time. The same organization was able to complete a major EHR migration in under 12 weeks by extracting, normalizing, and preparing data for a new system. Proprietary data models within EHR systems create significant barriers to interoperability and data portability. Despite increasing regulation and improved standards, accessing complete and meaningful data remains a challenge across vendors. Market consolidation is likely to continue, as organizations seek fewer vendors that can handle multiple data needs. Clinical research remains an underutilized opportunity, with many organizations still relying on manual processes to identify eligible patients. Improving data accessibility could dramatically accelerate patient recruitment and engagement in clinical trials. Simple improvements in data completeness and standardization can have immediate impacts on reimbursement, efficiency, and patient care. A Little About Dominique: As CEO of Hart since 2023, Dominique Gross provides healthcare data leadership, guiding the company's mission to eliminate healthcare data fragmentation and empower organizations to achieve true interoperability. With more than two decades of experience driving health IT innovation and go-to-market strategies, Dominique has shaped Hart's focus on making the impossible possible every day, ensuring that every innovation at Hart advances both operational efficiency and equitable patient care.  Prior to joining Hart, Dominique led strategy and growth initiatives at multiple firms, working as one of the industry's prominent healthcare technology executives to launch connected care solutions for veterans and major health systems. Her leadership philosophy centers on collaboration and integrity, guiding Hart to serve as both a technology provider and a trusted partner for healthcare's most complex data challenges. Dominique is a frequent speaker on the future of healthcare data ecosystems and a strong advocate for patient empowerment through healthcare data accessibility. 

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about something most therapists feel but rarely admit: the guilt that shows up the moment you say your rate out loud. We get into why you can believe in your worth completely and still feel it in the room, why you might be making financial decisions on behalf of clients who never asked you to, and what it actually means to put a real offer out there and let it land. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Need help building and filling your practice? Join the Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party    Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links

Kat Love of katlove.com joins the podcast to talk about therapist websites and what actually gets clients in the door. The conversation gets into why so many therapists spend money on the wrong things, how animations, contact forms, and luxury redesigns aren't what's converting visitors, and what it actually takes to get someone to choose you. Kat breaks down the two jobs your website has to do, getting found and getting chosen, and shares practical guidance on copy, photos, and video. If the goal is to stop wasting resources on features that don't move the needle and actually build a site that works, this is a strong place to start. Attention Abundance Party members: Kat is our trainer this month! Check out the 'Upcoming Events' section of your Simplero membership dashboard and/or the 'Events' section of the Abundance Community Facebook group for details on how to register for this live event included in your Party membership.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Additional Resources: To learn more about today's guest, visit https://www.katlove.com/.  Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party 

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about something every therapist with a website has probably lost sleep over: why people are finding you, landing on your site, and then just... disappearing. We get into why SEO and conversion are two totally different animals, why your copy might be accidentally educating people instead of making them feel understood, and how something as unsexy as a booking widget might be the thing standing between you and a full caseload. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Still not sure who you're trying to work with? The Know Your Niche course will get you there in about two hours with worksheets, prompts, and a niche you can actually market: www.abundancepracticebuilding.com/niche   Want website copy that actually sounds like you and makes the right clients feel seen? Referral Ready Website Copy is done-for-you copy for your homepage, about page, and up to three specialty pages — built around your voice, your niche, and your people, for just $2,000: www.abundancepracticebuilding.com/referralreadywebsitecopy   Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links

Rachel Hulstein-Lowe, LICSW joins the podcast to talk about gender diversity and what it actually looks like to show up as an affirming, competent therapist right now. The conversation gets into why so many clinicians are afraid of getting it wrong, how that fear often leads to unnecessary referrals out, and what it takes to build real confidence working with LGBTQIA clients. Rachel shares both her professional experience and her personal perspective as a parent, along with practical ways to deepen self-awareness, challenge assumptions, and create safer spaces for clients. If the goal is to move beyond good intentions and actually show up in a meaningful way, this is a strong place to start. Be sure to check out Rachel's 6-Step A.F.F.I.R.M. Program™ and take the free AFFIRMation Quiz to help you determine your affirmation style as a parent.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Additional Resources: To learn more about today's guest, visit https://www.abundancepracticebuilding.com/blog & www.rachelhlowe.com. Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party 

AI Won't Replace Pediatricians—But Pediatricians Using AI WillIn this Pediatric Lounge episode, hosts George and Herb talk with Dr. Igor Trogan about why AI is becoming essential for independent pediatric practices, emphasizing that ambient AI scribing restores eye-to-eye patient interaction, improves documentation, and enables more accurate CPT coding and billing. They discuss financial pressures from declining reimbursement and rising overhead, how EHRs were built largely for accounting and reporting, and the need to balance evidence-based pathways with clinical judgment. Dr. Igor Trogan describes using HIPAA-compliant Google Gemini agents to support coders, catch underbilling, generate rebuttals to payer downcoding, and improve care quality by finding care gaps and medication or dosing errors. He also shares using Base44 (non-HIPAA) to rapidly build custom operational apps (inventory, scheduling, command-center dashboards), plus website chatbots, insurance-card and immunization-record agents, AI-generated training materials and social media content. They conclude the best first step is adopting ambient AI.00:00 Podcast Intro and Premise01:24 Why AI Is Now Essential01:50 Ambient AI Restores Connection05:05 Billing Pressures and EHR Mandates08:15 Care Pathways vs Clinical Judgment13:05 Pediatrics Complexity and Art17:17 AI for Coding and Billing Accuracy24:15 Fighting Downcoding With AI25:50 Quality Checks and Care Gaps33:08 Clinical Safety and Error Catching34:41 Custom Apps for Operations37:03 Scheduling App Fix39:06 Vibe Coding Explained39:56 Practice Hub App40:42 War Room Dashboard42:57 Will EHRs Be Replaced47:17 Website Chatbots Agents49:53 Ambient AI Billing Boost53:49 NotebookLM For Students55:34 Care Gaps Holy Grail01:00:50 Dashboards Outreach Agents01:02:42 Marketing Training With AI01:03:54 First Step Start Today01:04:37 Closing CreditsSupport the show

In this episode of Bright Spots in Healthcare, recorded live at the ViVE 2026 conference, Eric Glazer sits down with Dr. Pavitra Krishnamani from MD Anderson Cancer Center to explore what it actually takes to build scalable digital health systems. As both a practicing emergency physician and digital health innovator, Dr. Krishnamani brings a frontline perspective to one of healthcare's biggest challenges: why so many digital health tools fail to scale, and what separates technologies that succeed from those that don't. While the industry continues to invest heavily in AI, wearables, telehealth, and other digital tools, many health systems are still struggling with fragmented solutions, low adoption, and limited real-world impact. The path forward isn't more tools, it's better systems.  In this episode, you'll learn: Why workflow integration matters more than features in digital health adoption How AI, wearables, telehealth, VR, and EHRs must work together as a connected ecosystem What health systems should evaluate before bringing in new technology, including ROI, maintenance, and unintended consequences The role of human-centered design in building solutions clinicians will actually use  Why adoption fails without clinician buy-in, flexibility, and cultural alignment How to design more effective pilots and avoid common implementation pitfalls Why education and mindset are critical to scaling AI and digital health What it takes to move from siloed tools to scalable, system-level transformation Key Takeaway: "Education begets innovation" - Pavitra P. Krishnamani, MD. Scalable digital health isn't about deploying more technology, it's about aligning technology, workflows, and people into systems that actually work in practice. Learn More from Dr. Krishnamani: http://pavitramd.com/. Dr. Krishnamani expands on many of these ideas in her upcoming book: Home is Where the Health Is: How Digital Innovation and Technological Advances are Transforming Healthcare and Wellness. The book explores how technologies like AI, wearables, telehealth, and data systems are coming together to reshape healthcare delivery and move care closer to where patients live their daily lives. Connect with Dr. Krishnamani: Instagram: https://www.instagram.com/docpavitra  LinkedIn: https://www.linkedin.com/in/pavitra-krishnamani   Partner with Bright Spots Ventures: If you are interested in speaking with the Bright Spots Ventures team to brainstorm how we can help you grow your business through credibility building content and trusted executive relationships, email hkrish@brightspotsventures.com About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about the slow periods nobody warns you about. The summer dips, the post-holiday drop-offs, the stretches where the phone just stops ringing. We get into why it's not a sign you're failing, why the therapist Facebook groups are the worst place to turn when you're spiraling, and how to plan your year so a slow month feels like a reset instead of a red flag. If you've ever watched your caseload dip and convinced yourself your practice is falling apart, this one's for you. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Doors for our summer cohort are open now through April 27th; Spots per cohort are limited. Learn more here: www.abundancepracticebuilding.com/lp  Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links.  Need help building and filling your practice? Join the Abundance Party today and get everything you need — courses, trainings, scripts, templates, monthly group calls — for just $345: www.abundancepracticebuilding.com/party

The gap between billion-dollar EHRs and the reality of life at the patient bedside has never been wider. While healthcare systems race toward AI and automation, nurses are often left fighting the very systems meant to support them. Join host Beth Friedman and DJ Tucker, Managing Director of Healthcare Informatics at Healthcare IT Leaders, for a conversation about technology and human-centered nursing. With over 40 years of combined clinical and informatics experience, Beth and DJ dig into the hard truths of EHR adoption and why go-live is just the starting point for true transformation. The bottom line? Technology doesn't just owe our nurses great efficiency; it owes them the capacity to be fully human with their patients. Tune in to discover how to move beyond “shiny penny” tools and build a digital environment that protects the heart of healthcare, our nurses. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

In today's episode of the Abundant Practice Podcast, I chat with Limitless Practice graduates Jasmine, Kate, Aubrey, and Maria about how they transformed their overwhelmed practices into ones that actually work for their lives. We explore what it really looks like on the other side: dropping Medicaid panels, leaving insurance altogether, cutting client loads, raising rates, and finally taking a vacation. We dig into the mindset shifts that made it possible, the discomfort of setting real boundaries, and how learning to use data instead of feelings changed the way they make business decisions. We also cover the power of community, what sustainable caseloads can look like, and how your practice can fund a life you actually want to live. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: These therapists went through Limitless Practice and never looked back — and doors to our Summer 2026 cohort are open now through April 27th (or sooner if we fill up!): www.abundancepracticebuilding.com/lp. Need help building & filling your practice? Check out the Abundance Party (only $345!): www.abundancepracticebuilding.com/party 

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about the weird moment when the practice you once wanted starts feeling like it was built for someone you're not anymore. We get into what to do when your goals change but your business hasn't caught up, how to make smart shifts without blowing up what's already working, and why a steady caseload isn't the same thing as being fulfilled. If your practice is successful but no longer feels like yours, this one's for you. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: www.abundancepracticebuilding.com/limitlesswaitlist.  Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links. 

Dr. Bob Wachter describes his career as the result of “what happens when a political science major becomes an academic physician.” Rather than focus on one specialty or scientific domain, he became fascinated by the healthcare system itself and has spent more than 40 years examining how care is organized, where it breaks down, and how technology can help make it better.The author of more than 300 articles and six books, Dr. Wachter famously coined the term “hospitalist” in 1996, helping give rise to one of the fastest-growing specialties in medicine. Among other roles, he has served as president of the Society of Hospital Medicine and chair of the American Board of Internal Medicine. He also founded and directed the Division of Hospital Medicine at the University of California, San Francisco (UCSF), where he is currently Professor and Chair of the Department of Medicine.For the past 15 years, Dr. Wachter has focused much of his attention on the impact of technology on healthcare, a topic that shaped his two most recent books. In The Digital Doctor, he explored why electronic health records created as much frustration as progress. But he has since come to see that EHRs were never the full answer, only the foundation healthcare needed before better tools could emerge. On the day ChatGPT was publicly released in 2022, Dr. Wachter recognized the major shift ahead, paving the way for his newest book, A Giant Leap.In this episode of Healthcare is Hard, Dr. Wachter joined Keith Figlioli to discuss why AI is different from previous waves of health IT, how quickly it may change care delivery, and the opportunity for AI to address many of healthcare's long-standing problems. Some of the topics Dr. Wachter and Keith discussed include:Why “better than today” may be the right benchmark. One of Dr. Wachter's core arguments is that AI does not need to be perfect to be valuable in healthcare. If clinicians are currently expected to review 600-page charts in minutes, keep up with a flood of new medical literature, and navigate increasingly complex administrative tasks, then tools that can summarize, suggest, and support – even imperfectly – may still represent a meaningful step forward. The real challenge will be keeping isolated failures or headline-grabbing mistakes from derailing progress that is net positive. Reshaping the patient-doctor relationship. Dr. Wachter expects patients to be increasingly informed by the ability to use AI to review records, understand symptoms, and map care decisions. However, he warns that it could create tension for clinicians that are already working within tight visit windows and may need to spend more time responding to GPT-generated advice. He also discussed how it raises bigger strategic questions for health systems, as AI-guided navigation may begin to influence where patients seek care, and even which institutions they trust. Elevating primary care. Dr. Wachter sees AI as a kind of specialist in a clinician's pocket, opening the possibility for primary care physicians to do more by offloading routine work and improving their ability to support complex cases. He also discussed how patients will be more likely to shift away from health systems, and more towards new entrants in the market for primary and preventative care.   Underestimating the speed of change. In Dr. Wachter's view, many leaders don't yet realize how fast AI will change healthcare. For health systems, the risk is not just missing out on productivity gains. It is losing control of the patient relationship, the referral pathway, and ultimately an organization's competitive position. To hear Keith and Dr. Wachter discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders. 

In today's episode of the Abundant Practice Podcast, I chat with Abundance Community member Shani about her plans to expand her group practice. We explore various aspects of running a group practice, including hiring strategies, marketing approaches, and financial considerations. We dig into establishing clear leadership boundaries and expectations for managing staff, revenue targets, compliance requirements, and the importance of using W-2 employees. We also cover office space options, ways to strenghten her professional reputation, and how to maintain a healthy work-life balance for both practice owners and employees.  Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: www.abundancepracticebuilding.com/limitlesswaitlist.  Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links.  Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party 

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about something a lot of therapists are too burned out to even name: what happens when the practice you built for freedom starts feeling like the thing you need a vacation from. We get into why you might be counting down to cancellations, why your caseload has become the biggest rock in your life, and what it actually looks like to restructure things so your practice fits around your life instead of the other way around. If you started this work to have more freedom and somehow ended up with less, this one's for you. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: www.abundancepracticebuilding.com/limitlesswaitlist.  Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links. 

Danielle Keenan-Miller, Ph.D., CEO of MindScience Collective, joins me to talk about how therapists can turn the knowledge they already use every day into teaching CE courses. We get into how to know what you're actually qualified to teach (it's more than you think), what the process of getting started really looks like, and how one training can open the door to more opportunties, income, and referrals over time.   MindScience Collective is a CE platform that's changing the game for driven therapists who don't want to settle for outdated or uninspiring CEs.  With a modern platform, inviting presenters, and evidence-based content that's immediately applicable, you'll be earning CEs while honing your craft and solving moments of clinical stuckness. Abundance Practice listeners can access courses for 10% off using the code abundance10.    Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com.   Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: https://www.abundancepracticebuilding.com/lp Need help building and filling your practice? Grab the Abundance Party for just $345: https://www.abundancepracticebuilding.com/party 

Special guest Danielle Keenan-Miller, Ph.D., CEO of MindScience Collective, joins me to talk about how therapists can turn the knowledge they already use every day into teaching CE courses. We get into how to know what you're actually qualified to teach (it's probably more than you think), what the process of getting started really looks like, and how one training can open the door to more opportunities, income, and referrals over time. If you've been curious about doing something beyond one-to-one work, this is a really practical place to start.   MindScience Collective is a CE platform that's changing the game for driven therapists who don't want to settle for outdated or uninspiring CEs.  With a modern platform, inviting presenters, and evidence-based content that's immediately applicable, you'll be earning CEs while honing your craft and solving moments of clinical stuckness. Abundance Practice listeners can access courses for 10% off using the code abundance10.   Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com.   Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: https://www.abundancepracticebuilding.com/lp Need help building and filling your practice? Grab the Abundance Party for just $345: https://www.abundancepracticebuilding.com/party 

Special guest Danielle Keenan-Miller, Ph.D., CEO of MindScience Collective, joins me to talk about how therapists can turn the knowledge they already use every day into teaching CE courses. We get into how to know what you're actually qualified to teach (it's probably more than you think), what the process of getting started really looks like, and how one training can open the door to more opportunities, income, and referrals over time. If you've been curious about doing something beyond one-to-one work, this is a really practical place to start. MindScience Collective is a CE platform that's changing the game for driven therapists who don't want to settle for outdated or uninspiring CEs.  With a modern platform, inviting presenters, and evidence-based content that's immediately applicable, you'll be earning CEs while honing your craft and solving moments of clinical stuckness. Abundance Practice listeners can access courses for 10% off using the code abundance10.   Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com.   Links You'll Love:   Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: https://www.abundancepracticebuilding.com/limitlesswaitlist. Need help building and filling your practice?   Grab the Abundance Party for just $345: https://www.abundancepracticebuilding.com/party   

Special guest Danielle Keenan-Miller, Ph.D., CEO of MindScience Collective, joins me to talk about how therapists can turn the knowledge they already use every day into teaching CE courses. We get into how to know what you're actually qualified to teach (it's probably more than you think), what the process of getting started really looks like, and how one training can open the door to more opportunities, income, and referrals over time. If you've been curious about doing something beyond one-to-one work, this is a really practical place to start. MindScience Collective is a CE platform that's changing the game for driven therapists who don't want to settle for outdated or uninspiring CEs.  With a modern platform, inviting presenters, and evidence-based content that's immediately applicable, you'll be earning CEs while honing your craft and solving moments of clinical stuckness. Abundance Practice listeners can access courses for 10% off using the code abundance10.   Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com.   Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: https://www.abundancepracticebuilding.com/limitlesswaitlist. Need help building and filling your practice? Grab the Abundance Party for just $345: https://www.abundancepracticebuilding.com/party   

AI-driven scribe solutions are freeing doctors to focus on patient care. Unburdening physicians through AI documentation. In this episode, Pat Williams, CEO and Co-Founder at iScribeHealth, talks about making EHRs easier to navigate for high-volume specialty physicians. He discusses transitioning from a network of human scribes to a high-accuracy AI model that leverages a decade of market data. He also explains how real-time AI can coach providers to adhere to managed care rules and prevent claim denials at the front end. This episode focuses on removing the administrative boat anchor so doctors can focus on patients and their families.  Tune in to recapture your time and focus! Resources: Connect with and follow Pat Williams on LinkedIn. Follow iScribeHealth on LinkedIn and explore their Website! Listen to the Truly Integrated podcast.

Episode 218: Statin Therapy Fundamentals What are statins? Zohal: Statins are medications that lower cholesterol by inhibiting the enzyme HMG-CoA reductase, which prevents cholesterol synthesis in the liver. By doing so, statins decrease low-density lipoprotein cholesterol (LDL-C).  Why should we lower LDL? Zohal: There are four main lipoproteins that transport fats in blood, including chylomicrons, VLDL, LDL, and HDL. This is where we get our “bad cholesterol” vs. “good cholesterol”. Of these, LDL is most associated with an increased risk in cardiovascular disease, while a higher HDL is associated with lower risk. Thus, reducing LDL subsequently reduces the risk of cardiovascular disease.  Arreaza: The lowest LDL I've seen was 25, and the highest HDL was 60. HDL doesn't really have a strict upper limit, but most people fall between 40 and 60. Extremely high HDL—above 100—may not always be protective and can sometimes signal underlying issues. Zohal: My HDL is 70! Statins are used for both primary prevention, meaning preventing cardiovascular disease before it occurs, and secondary prevention, meaning preventing disease progression in patients who already have cardiovascular disease. History of statins. Zohal: In the early 1900's, researchers were studying the association between cholesterol and atherosclerosis, and at that time, they primarily used animal subjects. These studies were initially not taken seriously, because most believed cardiovascular disease in humans were simply due to aging and was not preventable.  It wasn't until the middle of the century when researchers began observing that increased levels of LDL and decreased HDL was correlated with an increased rate of heart attacks. This finding prompted interest in determining the pathway of cholesterol synthesis in the human body.  Statins were first discovered in the 1970s when researchers identified compounds that inhibit a critical step in cholesterol synthesis. The first statin approved for clinical use was Lovastatin in 1987. Since then, multiple statins have been developed, including Atorvastatin, Rosuvastatin, Simvastatin, and Pravastatin. Further clinical trials in the 1990s and 2000s showed that statins significantly reduce myocardial infarction, stroke, and cardiovascular mortality. Why do Statins Matter in Primary Prevention Zohal: Cardiovascular disease is the most common cause of death worldwide. As previously mentioned, elevated LDL cholesterol contributes to the development of atherosclerotic plaques within arteries, which can lead to heart attack and stroke. By lowering LDL cholesterol and stabilizing plaque formation, statins implemented in a timely manner significantly reduce the risk of atherosclerotic cardiovascular disease. Arreaza: One of the things I love most about primary care is prevention. You're working upstream, often quietly, humbly, helping people avoid disease before it starts. And the truth is—you rarely see the full impact of your actions. You don't get a notification that says, “this patient didn't have a heart attack because of you.” But every time you help someone control their blood pressure, quit smoking, improve their diet, or stay consistent with their medications, you're shifting their tracks. You're reducing risk in ways that may never be fully visible. That's the paradox and the beauty of it: in primary care, your highest victories are often events that never happen.  Who Should Receive Statins for Primary Prevention? Zohal: Recommendations slightly differ depending on who you ask. We look to the U.S. Preventive Services Task Force, the American College of Cardiology, and the American Heart Association for their recommendations regarding statins for primary prevention. USPSTF on statins. The U.S. Preventive Services Task Force (or USPSTF for short) is an organization that works to improve the health of people nationwide by making evidence-based recommendations on effective ways to prevent disease & prolong life. They recommend statins for the primary prevention of cardiovascular disease in: Adults 40–75 years old With one or more cardiovascular risk factors such as dyslipidemia, diabetes, hypertension, or smoking AND a 10-year cardiovascular risk of 10% or greater Their recommendations are graded A, B, C, D, and I, depending on the strength of evidence and this is a Grade B recommendation. Arreaza: So, you have to meet all the criteria to receive a statin, according to USPSTF: 40-75, one CV risk factor and a high 10-y ASCVD score, by the way, the ASCVD risk calculator was introduced in 2013 by AHA/ACC. It is available online for free and many EHRs have integrated this tool into their software. For example, if you use EPIC, you can type .ascvd and get a score automatically. What about patients with a cardiovascular risk less than 10%? Zohal: For patients with a 7.5–10% risk, some may offer statin therapy on a case-by-case basis as this is a Grade C recommendation. But I'll get more into this later. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!  _____________________ References: Grundy SM, et.al, Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-e1143. doi: 10.1161/CIR.0000000000000625. Epub 2018 Nov 10. Erratum in: Circulation. 2019 Jun 18;139(25):e1182-e1186. doi: 10.1161/CIR.0000000000000698. Erratum in: Circulation. 2023 Aug 15;148(7):e5. doi: 10.1161/CIR.0000000000001172. PMID: 30586774; PMCID: PMC7403606. https://pubmed.ncbi.nlm.nih.gov/30586774/ U.S. Preventive Services Task Force. (2022, August 23). Statin use for the primary prevention of cardiovascular disease in adults: Preventive medication.https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medicatio American College of Cardiology ASCVD Risk Estimator: https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/ Guideline Central. (2026, March). ACC/AHA dyslipidemia guideline spotlight (March 2026).https://www.guidelinecentral.com/insights/mar-2026-accaha-dyslipidemia-guideline-spotlight/ Endo A. A historical perspective on the discovery of statins. Proc Jpn Acad Ser B Phys Biol Sci. 2010;86(5):484-93. doi: 10.2183/pjab.86.484. PMID: 20467214; PMCID: PMC3108295. https://pubmed.ncbi.nlm.nih.gov/20467214/ Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: www.abundancepracticebuilding.com/limitlesswaitlist. Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links. Need help building & filling your practice? Check out the Abundance Party (only $345!): https://www.abundancepracticebuilding.com/party

Special guest Amber Lyda, Psy.D., joins me in today's episode to explore how therapists can optimize their websites for AI search engines—covering the three key steps of elimination, grouping, and matching—so you show up when potential clients use AI to find care. She discusses how to create effective bridge copy, incorporate credibility elements, and leverage video content to enhance your visibility, plus what the evolving landscape of AI in healthcare marketing means for your practice. With 85% of Americans now using AI to find healthcare providers, this is an episode worth tuning into. Grab Amber's free AI Recommendable™ Check — a quick tool to find out whether your practice is currently positioned to show up when AI goes looking. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: https://www.abundancepracticebuilding.com/limitlesswaitlist. Need help building and filling your practice? Grab the Abundance Party for just $345: https://www.abundancepracticebuilding.com/party

In this episode of the Oncology Brothers podcast, we dived into the transformative role of artificial intelligence (AI) in oncology and medical practice. Joined by Dr. Travis Zack, Chief Medical Officer of Open Evidence, we explored how large language models (LLMs) are revolutionizing the way clinicians access and utilize medical information. Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Apple Podcast: https://podcasts.apple.com/us/podcast/oncology-brothers-practice-changing-cancer-discussions/id1653340966 Follow us on social media: ⁠X/Twitter: https://twitter.com/oncbrothers ⁠Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Key topics included: The rapid evolution of AI in healthcare and its implications for patient care. How Open Evidence differentiates itself by focusing on reliable medical sources like NCCN, NEJM, and JAMA. The importance of integrating AI tools into clinical workflows to enhance decision-making and patient outcomes. The business model behind Open Evidence and the ethical considerations regarding data usage. Future prospects for AI in oncology, including potential integration with electronic health records (EHRs) and clinical trials. Join us as we discuss the exciting advancements in AI technology and how they can empower oncologists to provide better care for their patients. Don't miss this insightful conversation that highlights the intersection of technology and medicine! Subscribe to our channel for more episodes on FDA approvals, conference highlights, and treatment algorithms in oncology! #AIinHealthcare #Oncology #MedicalAI #CancerResearch #HealthcareInnovation #OncBrothers

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about the exhausting math of a practice that requires you to keep showing up at full speed just to stay afloat. You're tired, you miss your life, but every time you think about cutting back, the fear of losing income stops you cold. We get into why that fear is actually a sign something needs to change, and how to work less without blowing up everything you've built. If you've been telling yourself you'll slow down eventually, this episode is going to light a fire. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: www.abundancepracticebuilding.com/limitlesswaitlist. Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links. Need help building & filling your practice? Check out the Abundance Party and use promo code PODCAST at checkout to get your first month for just $1: https://www.abundancepracticebuilding.com/party

In today's episode of the Abundant Practice Podcast, guest Sanjana Sathya, co-founder at Thrizer, explores the growing shift in the therapy industry toward private pay practices and what that means for both therapists and clients. She shares how the out-of-network billing process works, ways to make it more manageable, and how clients can better understand their benefits to make mental health care more accessible and affordable. Use code ABUNDANCE or visit https://join.thrizer.com/abundance for a free trial and waived credit card fees for the first $2,500 in charges. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: bit.ly/LimitlessPracticeWaitlist. Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links.

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're talking about the thing nobody warns you about: the longer you're in practice, the harder it can get. We dig into why a full caseload and steady income can still leave you feeling like you're slowly being buried, and what it actually takes to build something you can stay in without losing yourself. If you've been grinding through it and hoping it evens out eventually, this one is going to hit. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: www.abundancepracticebuilding.com/limitlesswaitlist. Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links.

In today's episode of the Abundant Practice Podcast, I chat with Abundance Community member Laura about her niche of women in male-dominated fields who struggle with body image and eating disorders, particularly those using GLP-1 medications. We explore website content strategy and marketing approaches, including visual elements and the use of ACT therapy. We also discuss networking strategies and building professional relationships through various referral sources in the medical field. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: bit.ly/LimitlessPracticeWaitlist. Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links.

In today's Ask Abundance, I'm joined by Abundance consultant Rebecca A. E. Smith, Ph.D., and we're getting into something a lot of therapists feel but won't admit: the practice you built to give you freedom might be the thing trapping you. We get into the rhythms, the systems, and the hard truth about why being a great therapist doesn't automatically make you great at running a practice. If you've been feeling the weight, losing the energy, and wondering how much longer you can keep doing it this way, this episode is for you. Sponsored by TherapyNotes®: Looking to switch EHRs? Try TherapyNotes® for 2 months free by using promo code ABUNDANT at therapynotes.com. Links You'll Love: Have a full practice but feel like you're running on empty? Limitless Practice helps you work less and make more. Spots per cohort are limited. Get on the waitlist and be first in line when doors open April 21st: bit.ly/LimitlessPracticeWaitlist. Get your FREE weekly worksheet and other helpful practice-growing tools here: www.abundancepracticebuilding.com/links.