← Latent Space: The AI Engineer Podcast
Latent Space: The AI Engineer Podcast
AI-Native Healthcare: 100M Doctor Visits, 10–20 Hours Saved, Prior Auth in Minutes — Janie Lee & Chai Asawa, Abridge
01:05:20
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- [00:04]
Host 1
Okay. This is a special crossover, latent space, unsupervised learning pod.
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Host 2
Very excited to do this once a year. At this point, we get together once a year, and this is a fun occasion to get to do it on.
- [00:14]
Host 1
I really wanted to talk to Abridge, but I felt very underqualified because healthcare is not something we cover very intensely. And it just so happens that redpoints are big investors and supporters of Abridge.
- [00:27]
Host 2
Anytime you want to have a portfolio company on your podcast, please, by all means.
- [00:31]
Host 1
So we'll introduce our guests, Chai and Janie. Welcome to the pod.
- [00:34]
Janie
Thanks for having us. We're excited to be here.
- [00:36]
Chai
Thank you.
- [00:37]
Host 1
Yeah. So for listeners, what do you guys do? Just to situate you guys in the company.
- [00:43]
Janie
Bridge is a clinical intelligence layer for health systems. We really started with documentation and building for clinicians, and we think that 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 obviously 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 diagnoses 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 the. This broader clinical intelligence layer.
- [01:34]
Chai
I'm Chai. I work on clinical decision support at Abridge. And so I think, as Ginny said, that we had this. 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, peer guidelines, medical literature, and put that together and to serve, you know, how healthcare could look fundamentally different. Yeah.
- [02:02]
Host 1
And that's like the context engine that you guys have. Is that what it's called? Okay. So historically, as I understand it, probably started in 2018. A lot of people would be familiar with the AI voice notes, form factor that doctors would be like, well, do you consent to be being recorded? It replaces handwriting and what have you. But it sounds like more recently there's been a big transition in a company or just tell me about the broader transition.
- [02:27]
Janie
Yeah. So from a transition perspective, we really think about our journey as how do we, you know, first chapter was, first act was how do we help save time? And that's where a lot of that original product was.
- [02:37]
Host 1
Which like, by the way, one of those interesting stats on your landing page was like, people spend, doctors spend like time after hours.
- [02:43]
Janie
They call it pajama time.
- [02:45]
Host 1
Okay, why is that? Pajama time?
- [02:46]
Janie
Doctors after work in their pajamas at home are just writing and catching up on their notes every day. And you know, I think some of our favorite customer love stories, we have a Slack channel called Love Stories. We have clinicians telling us abridged has helped us, you know, from retiring earlier. We're now finally able to go home and eat dinner with our kids for the first time, save the marriage.
- [03:09]
Host 1
And yeah, one of your quotes was like, we're not divorcing anymore. Like, why? Because you're working too much, I guess.
- [03:16]
Chai
Yeah.
- [03:16]
Janie
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 we think 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 actually improve patient outcomes and probably one of the most important workflows and problems to be going after right now.
- [04:04]
Host 2
I mean, I think one thing that's interesting, Chai, is obviously you came over to a bridge from Glean and I think about clinical decisions support, which is, you know, for our listeners, is basically, you know, 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. Right. Of 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 problem set you're going after now and what feels different now that you're in healthcare.
- [04:33]
Chai
Yeah, very similar. And I think taking a step back, I think 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 Crowd based products look the same. And I think seeing that's 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 actually puts them to work. So I see it in a lot of ways, a lot of similarities, and this is a healthcare coded version of Glean. But I think the differences are really interesting. A couple things that come to mind. First and foremost, the rigor at which in the setting we are in, the downside risk is extremely high here. In healthcare, it can actually be fatal in some cases, you prescribe something that the patient is allergic to, for example, whereas at Glean it's like, 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 kind of go into there. Second thing that comes to mind is like vertical versus horizontal. In both cases there's a large variance, but when Glean is 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 and it lets you go after them much more easily. And especially in healthcare, where so many problems were solved with labor and process, that's actually extremely ripe for AI to keep helping augment and enable. And then the final thing that I think that's really interesting, Bridge, specifically compared to many other companies in the AI area, is the modality we started with. We're ambient and we're always listening in the background. And I think many more AI products will go that way. But it's actually how we started. And I think that's actually the greatest form of AI we can create. AI that's actually seamless. You're not actually 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 I actually think Abridge very much started from the opportunity and continues to go that way.
- [06:57]
Host 2
Yeah. And one thing I think 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 do you kind of break the wall almost and like say, hey, clinician, like, you might not have thought about X or whatever it is that you want to do. And obviously, I think in healthcare traditionally there's been this idea of alert fatigue and just like 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 like the right way to intervene or to pop up in a doctor visit?
- [07:26]
Janie
Yeah, it's such a good question. I think alerts are notorious in healthcare specifically. I think over 90% of alerts are ignored. I think 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 maybe if, and if there is something that has great clinical risk and we, we're acutely aware that intervening now and not later is incredibly important, we should decide to act. But I think 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 actually 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 a bridge will summarize all of the most recent contacts 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 actually going into that conversation prepped rather than walking in cold to that patient visit and then having this product interrupt you five or ten times throughout the visit. And there might actually 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 I think 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 a bridge. We might choose to actually 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 Shawn 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 because we have all the context. But these two last criteria, if you can address with Shawn before he leaves the room, we could actually guarantee that your MRI is approved before you leave. And so when you think about clinical usefulness impact to the patient, I think 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, you kind of get to check all of those boxes. But when doctors have 15 minutes between visits, we have to be really, really thoughtful about when it actually matters.
- [10:23]
Chai
I think there's this interesting product opportunity that AI can have is reduced latency in the world. For example, prioritization is an example of where care gets delayed. And so great AI can reduce that. And I think 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 Jenny said, and really high quality models, then I think you can create a whole other game.
- [10:53]
Janie
Yeah, and I really like that experience because I think it kind of starts to tease apart like what makes this so hard and unique. I think like one, to make that prior authorization example possible, think about all the data that you need to have. You need to integrate within 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 actually 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.
- [11:31]
Host 2
I thought this episode was to make sure we didn't scare people from health
- [11:33]
Janie
care, but I think when you think about the things that make it hard, it also gives you the moat. And then I think the second is the AI and the model quality. We need to be able to hang our Hat on. And so the bar I think similarly when I worked at Opendoor I worked on pricing models like every outlier wiped out the margins of 30. And so similarly here in health care, 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 kind of like 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 two minutes or real time. And I think it's where healthcare is both very difficult but also extremely rewarding if you can crack it.
- [12:36]
Host 1
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 a bridge in? Is there a bridge room set up where it's just always on?
- [12:55]
Host 2
I don't know, a bridge podcast studio.
- [12:58]
Janie
Primary form factor is mobile and desktop. Usually clinicians are walking in and out of rooms with mobile, but at the end of the day when they're closing, 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 what is the power of multimodality and even more data. As you think about all of the what is today not captured context really, really 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. Starting on a bridge 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 beg really, really interesting and fun questions.
- [13:55]
Host 1
Like the way in tech companies we have all these Google Meet their things. We might as well set up entire rooms with just a bridge tech very much.
- [14:03]
Chai
And I also think similarly about actually also AR glasses and so forth. I think is also quite relevant where part of it is how do we bring it in a way without a screen, but also bring the information to the clinician in real time but also let them focus on the patient.
- [14:19]
Host 1
Do you think they want that? I'm just very. I tend to Be skeptical ar, but I'm curious what you've tried.
- [14:26]
Chai
You know, admittedly it's not a near term product roadmap by any means. And I'm here being far fetched sick
- [14:32]
Host 2
AR stuff for surgeries actually. People are trying to visualize like the, you know, you're about to make an incision, but you want to see like what the cut might look or what the body might look like inside. And they can basically layer in imaging.
- [14:43]
Host 1
Yeah, that's cool.
- [14:44]
Host 2
Yeah.
- [14:45]
Chai
Some point in the future.
- [14:47]
Janie
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, I think unlocks a lot of product capabilities.
- [14:58]
Host 2
Yeah.
- [14:58]
Host 1
And just to establish the terminology. Sorry. And I know I'm like, I'm asking basic questions somewhat for myself, but also for the audience who might be less integrated. When you say health systems, it's like the Johns Hopkins, the Kaiser Permanente Kaisers. These are your customers. Right. And the outcome that you deliver for them is happier. Doctors reduce whatever cost, I guess of processing, reduce mistakes. I think it's weird in a sense that I feel like there's also a secondary customer, like the customer of the customer. And I don't know if you think about it that way.
- [15:29]
Janie
Yeah, I think the other interesting and complex part of building product is we have our buyers who are the chief medical information officers, 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 are we building for, who's the secondary user? And what does that mean either in terms of experience, security, compliance, ROI that we have to make tangible. And so like you said, like 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 a bridge, because you have more compliant documentation or because you have fewer queries coming from your billing team, we actually save or add real dollars to your bottom line or top line, I think are things that we're constantly thinking about because of the dynamic across all three sets of users.
- [16:32]
Chai
And I think there's a whole other axis too with the payers and pharma as well and connecting all these three big stakeholders in healthcare.
- [16:40]
Host 1
Do the payers ever see your data? Sorry, the payers mean the insurers, right?
- [16:44]
Chai
Yes.
- [16:45]
Host 1
They also see abridged data.
- [16:49]
Chai
They wouldn't see the raw abridged data. But when you're working together on something like prior authorization, whatever information they need, we'd communicate to them.
- [16:58]
Host 2
Oh, right, yeah, that's cool. I guess I would love to dig into just obviously you guys solve 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 a bridge today?
- [17:12]
Chai
To make things simple, let's take building off the prior auth example. So one thing Janie talked about is like, 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, really, really hard about this problem is actually doing it real time in the conversation. So, you know, 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 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 I think a lot of clever engineering goes actually. It's like, 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 actually make this problem tractable? And of course the Pareto frontier is always changing. But we're also trying to do this now.
- [18:26]
Host 1
Yeah.
- [18:27]
Host 2
What implications has that had for what you take off the shelf and say, you know 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 like, no, this is where we spend most of our time focused on.
- [18:38]
Chai
Yeah, this is the fun challenge in AI, right? 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 I feel that when you talk about AI models, we're like, the models are just going to get infinitely better. But I don't think maybe in the grandness of time you could say that. But actually 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 so we have to think about where are the things that unique data that we're uniquely training on or actually to step back a little like where is a proprietary model bringing an 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 80 million or hundreds of millions actually now getting close to medical conversation. 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 actually have these traces at scale, as in like 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 actually train better agents on certain use cases, whether it's your transcription, diarization use cases or so on, or like node 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 kind of 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 you know that the model providers, because a large class of the consumer model providers is healthcare queries, you know, that they actually might optimize to train a lot of healthcare data to actually encode the knowledge in its weights. And I think this is just a great thing for us as well where the off the shelf models can keep 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.
- [21:07]
Host 2
Yeah, and obviously you have like overall capabilities improving. I'm curious, like as these models get better, is there something you look at and you're like three months ago we really couldn't do that, but God, the latest models really allow us to do it.
- [21:19]
Chai
So here's something interesting that I've been toying with. All models are, this wasn't super, 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 a storage of all this information. It's actually a lot of information there. They 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 actually 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 actually very directly benefits us.
- [22:10]
Host 1
Yeah, 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 real time basically just batches of every one minute, every five minutes. Is that how we actually do it or is there some more native genuinely real time in the sense that OpenAI has a real time API or Gemini as a real time API?
- [22:35]
Chai
Yeah. So today it is more on the batch basis, but there's interesting prototypes that we have that we're still not full time voice in, text out in that sense, but actually can you trigger your models, your agents or agentic workflows depending on actually the right times in the conversation. So you can imagine, you know, different techniques to bring this latency down and like, you know, 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.
- [23:16]
Host 1
Do people don't want voice in, voice out.
- [23:19]
Chai
Right now we aren't creating experiences that are like kind of during the conversation, kind of. It's almost like might be too disruptive, too, too disruptive until like, 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 I think that change is much more gradual and it's more text focused, text out anything.
- [23:42]
Janie
So much of currently what our product is trying to do is allow a clinician to focus on their patient. And I think maybe at some point, but I think 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.
- [24:02]
Host 1
Yeah.
- [24:03]
Host 2
Jenny, one thing I'm curious about is how you think about personalization of the product. I imagine every doctor is a special snowflake in their own way, has their own way, they like to do things. There's 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 you actually deliver on that?
- [24:21]
Janie
Yeah, 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. 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 I think 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 I think the tricky part is how do you make sure that stylistic preferences don't actually 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, very different from a dermatologist workflow.
- [25:33]
Host 2
I assume cardiology notes are the highest stakes for you guys, given your CEO
- [25:36]
Janie
as a cardiologist, it's like, yeah, shiv or 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. But specialties require a lot of personalization, both in terms of what does the product actually look like. And so we make sure that as new users onboard, we catch that and the product kind of proportionally reflects that, but also on the back end, like evals at the specialty level, they are hard earned to actually calibrate and get right. What does a really great dermatology note look like, what actually 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 like, but on the back end, tuning and really, really deepening our understanding. For the specialists, what does great output look like? And that's obviously 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 actually inform clinicians before, during or after a visit what best practices should look like? And I think as you think about like deepening moats as well, when health systems trust us with that data, allow us to kind of productize it directly into the clinical workflow, I think makes us a really, really great partner to health systems who want to build something that truly meets their needs, their practicing guidelines.
- [27:24]
Chai
And I want to add on to that for the clinical documentation problem. It's very similar to like AI writing, 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 actually one of these new systems records almost.
- [27:51]
Janie
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, really powerful as a mechanism to just going deeper in personalization.
- [28:04]
Chai
Yeah, bounds.
- [28:05]
Host 2
It's so 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 an AI tool. And so it seems like you all are really doing that very effectively.
- [28:24]
Janie
Yeah, we're now starting to have our customers ask what are other customers doing and how are they doing it? And I think 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.
- [28:41]
Host 1
I'm just kind of curious. 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?
- [28:52]
Chai
I think 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 like, 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 actually what. Of course that shapes the context and the decisions you make.
- [29:16]
Host 1
Yeah. And this all goes into the context engine and it might affect the notes,
- [29:20]
Chai
but maybe not for these local pathways. We're definitely thinking about it a little more for clinical decisions for per product,
- [29:27]
Host 1
which is your stuff.
- [29:28]
Janie
Yeah.
- [29:29]
Host 1
Okay. 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.
- [29:38]
Chai
Yeah, there's of course many different ways you could do memory where it's like, okay, can you actually bake it into the model weights or can you do it in some external store? I think 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 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 like a separate store for memory where you actually have, for example, like a memory subagent that's like 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 you have background jobs that are running that are collating these memories, similar to sleep, of course, and what other patterns products do as well. Learning over all the action data we have again, like no edits, the conversations they did in the actual transcripts.
- [30:41]
Host 2
What about evals? How in the world do you like this is such a complex product service 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 kind of learnings along the
- [30:50]
Janie
way from an evals perspective? I think 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 actually becomes something that can be billable, which is obviously very, 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.
- [31:41]
Chai
Yeah, that's why I was smiling. I was like, is JD gonna mention what it stands for?
- [31:47]
Host 2
That does not. It's like a million acronyms on myself supposed to know that I don't. So I was like, oh, yeah, of course. Like an lfd.
- [31:51]
Janie
I've never heard of lfds.
- [31:54]
Chai
It's a bridge.
- [31:56]
Janie
I think I got through three days and then I had to ask someone. I thought it was just me that didn't know, but it's our original.
- [32:02]
Host 1
I look at the data as a meme in ML because you tend to not look at it. You just want to look at number go up.
- [32:07]
Chai
Exactly.
- [32:08]
Janie
Yeah, 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 I think 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? I think this takes a lot of domain expertise and to be frank, lots of mistakes and errors in figuring that out. And so I think as much of it is an ML problem, so much of it has also been operational gains that I think are hugely, hugely important. Where domain specific expertise is everything.
- [33:23]
Host 2
Yeah. But it's funny, people talk about healthcare like it's one giant market. And the reality is it's like dozens and dozens of sub markets. And so it feels like in your evals you obviously have to build that up across the board.
- [33:34]
Host 1
And is specialization the primary cardinality? That's the word that comes to mind
- [33:40]
Janie
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, really aimed at making the document or the output a lot more billable. And so we'll actually want to work with coding teams and not necessary clinicians.
- [34:05]
Host 1
And so what are you meaning healthcare?
- [34:06]
Janie
Yes, yes, yes, yes.
- [34:07]
Chai
I see other kinds.
- [34:09]
Janie
Yeah. But is this output proportional to the work that was actually 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 I think is where a lot of our operational investments have gone into
- [34:36]
Chai
and I think I view a lot of analogies to self driving cars here where part of it is we actually really want progressive rollout of features to actually 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 G8 the next week because I'm like go move fast, ship and whatnot. But the mentality is 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 actually match real life distribution. And over time by rolling out early, I actually think similar to Waymo has a tagline, the world's most experienced driver. I actually think another thing that can actually at least linearly increase for us is both the size of our evaluation offline and online. And it all feeds back.
- [35:26]
Janie
I think some thing 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 I think what is more exciting over the last call, it few quarters has been a subset of our customers have said we actually want to innovate with you, we trust you. And we have a pretty decent chunk of our customers who say we'll actually 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, way before ga. I think 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 right. The bar is still quite high for iterative rollout, but I think because of the trust we've earned, we're able to learn at pretty high volume very quickly.
- [36:45]
Host 1
Yeah, I mean your scale is still pretty huge. We were going to go into scale in a sec. One thing I wanted to follow up on, evals 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 HIPAA elements of this. I have zero experience in that. What do you have to do? What is actually surprisingly not that bad.
- [37:07]
Chai
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 the basis of online eval sets are learning from. And so you have to. And there's like actually very clear government guidelines like what counts as phi. And so we've actually even have built models that can take for example, a clinical transcript and actually 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. Right. And prove that out because you know now you have like multiple probabilistic systems on top of each other. But once you have that, then you can actually train on it, use it for evaluation, 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.
- [37:58]
Host 1
Is the anonymization one way, like once it's done, you cannot undo it or is there someone who holds the master key that can? Yeah, okay, so it's one way. Yeah, yeah, I guess. I mean, I guess that's how it works. I just wanted to, because like, you know, there's a lot of these, like learning from feedback and everything that like you would want to debug more but you can't because you just physically don't allow yourself to.
- [38:18]
Janie
Well, 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 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 quality, we can still use it.
- [38:50]
Host 2
Yeah, but it'll be fascinating to see how that space evolves. Right. 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 ask the average cancer patient like, hey, do you want people, do you want other patients to be able to learn from your experience? Take it all, they're like, please, I'd love nothing more than for other people to be able to learn from the experience that I had. And so obviously in the past it was a lot harder to do that kind of learning. But I think with this technology that actually might really be practical. And so it'll be fascinating to see how that continues to evolve.
- [39:22]
Chai
There's so much in our Data set of 100 million conversations. 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 because you have 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 trace.
- [39:46]
Host 2
Yeah, I guess 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 do our listeners have to look forward to if they ever get to this level of scale?
- [40:06]
Chai
I think larger in scale. So of course there's a general infrastructure in any given startup. You're kind of building the plane while it's flying. So there's some notion of that. But I think what gets interesting on the AI and ML side for sure is this is you get more and more scale. So one, you have the data to first and foremost do this, but you actually start thinking about costs or infrastructure in a whole different way at scale versus a prototype. You can use the most expensive model, you can burn as many tokens as you want. But when you're doing 100 million conversations.
- [40:42]
Host 2
Yeah, token max. And leaderboards are less exciting in that context.
- [40:45]
Chai
Right. When you're doing that. And so that comes for. We have the data and we also have the team that's able to actually post train based on this. And you can actually 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 get that way. Such that you want to do efficiency maximization in terms of compute and tokens.
- [41:08]
Host 2
Yeah, I mean, 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 like, 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 kind of optimizations.
- [41:22]
Chai
Yeah, it's a natural trajectory where it's like 0 to 1. We're not talking about any of these optimizations, but when maybe we're in the 1 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 0 to 1 that lets you do this.
- [41:36]
Host 2
That's fascinating. I mean, I feel like there's one thing that's so interesting about the abridged footprint is like you're in the doctor patient visit in real time. There's probably, I would say there's probably 50 years worth of product you could build on top of that. What gets each of you like, 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?
- [41:53]
Janie
I think 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 like, 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 actually a good candidate for this clinical trial that I'm about to run? And I think 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 like separate, very expensive, complex systems that serve each one of these stakeholders in very different ways, start to kind of collapse all of that into a singular platform that enables not just more efficiency across the board, but Also better outcomes for everyone. And I think all of us experience healthcare in probably very painful ways. And I think knowing that there is a world in which we can simplify a lot is really exciting to me. And it all starts at the conversation.
- [43:16]
Chai
You know, it's interesting. I think 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 huge in healthcare.
- [43:28]
Host 2
And they call it the triple aim
- [43:29]
Chai
in healthcare, but very similarly 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 as soon as the lab value gets updated. Do you have a background agent that kicks off and uses all the context to be like, oh hey, actually the patient should do this next, for example, and 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 build a bridge to all of these things? Very cool.
- [44:11]
Host 1
I think 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?
- [44:30]
Janie
Yeah, I think 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 pool and push all of the data into the right places is like not only table stakes. If we can't do that, health systems don't want to use us. I think 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, very close partnerships with some of the largest electronic health records that allowed us to pull and push data with, you know, APIs that weren't ready out of the box. And clinicians want to save clicks. Anytime we introduce a new product that, you know, adds two clicks for them in their day, they're like, we're not going to use it. You know, they have 15 minute back to back appointments with their patients. They're spending, you know, hours during pajama time doing documentation like every second and every minute counts. And so we really think about being deeply integrated into the EHR as also table stakes to actually getting real usage and adoption. And I think 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 I think 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.
- [46:01]
Chai
Strategically, to your point, it's like what does EHR Want to Own vs. EHRs are really focused on the clinical workflows and so forth. But some of the things that we're talking about here, at least traditionally, are outside of the domain where it's like oh, connecting payers and providers together with provider policies or the clinical trial matching as Janie brought up. And so these are like entirely. We position ourselves as building this entirely new intelligence, clinical intelligence layer across again providers, pharma and payers. And so it's a whole different ballgame that we try to play.
- [46:37]
Host 1
Yeah, it's like a different layer of scope.
- [46:39]
Host 2
Yeah. I'm curious. You obviously are both relatively newcomers to health care. People have these like, you know, there's lots of futuristic health care AI takes of everything will look different. You know, now that you've been in health care for a bit, you obviously live at the edge of AI. What have you like changed your mind on around this? You know, as you think about what health care looks like in 10, 20 years? I mean any, any updates to, to your mental model from the time actually being close to the problems.
- [47:03]
Chai
One thing that I was hesitant about before, and actually it's a common thing when I'm trying to recruit engineers that people ask me around is definitely like, 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 I actually think that surprised me how much is coming to the companies actually there's a lot of really favorable regulatory tailwinds as well. Where you think about government actually really wants interoperability between all these systems that we talked about and so agents can access this information. The government actually 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 2022 that required you to have mention all these options and do all these other things. But actually it's a very forward looking way. And so I think for me what's been really cool to work on is I think 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.
- [48:05]
Janie
I think one thing I would call out is I think for the very reasons things are higher stakes or potentially considered more difficult in healthcare, I think it's where some of the hardest AI problems will get solved first just because the bar is so high. I think when I first joined I was like, oh, this is where we'll be on the tail end of where all of the AI innovation will actually be able to be applied. But when you think about zero error evals or multi step workflows that have really, really low tolerance, I actually think a lot of the innovation will happen here just because we have to or else we can't ship.
- [48:43]
Host 2
Yeah, because like in other domains you'd much rather just solve the 80% as good enough.
- [48:46]
Janie
Yeah, 80, 20 doesn't work here.
- [48:49]
Chai
Building off that, I think traditionally I think there was a bit of stigma that oh, healthcare companies are not that interesting from a technical perspective or I' seen that or faced that myself. But these are actually really, really hard and fun problems from a pure technical perspective. Beyond just the impact, like how do you bring the latency of this thing down and make it really high quality?
- [49:08]
Host 1
How do you bring the latency of things down?
- [49:11]
Chai
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 really your bottleneck in a lot of workflows. Sometimes it's the model itself. And so that's where 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 like, okay, on top of that, if you use a constellation of different models, can you first use kind of 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, and so forth and so all these clever tricks to make it work. And by the way, we also realize that the Pareto frontier is changing and so these tricks 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.
- [50:12]
Host 2
Should we go to Quickfire or you want to ask more about a bridge we can stuff everything that's not a bridge into the, into the quickfire.
- [50:16]
Host 1
But I don't mind. I mean, I was just, I think, I feel like Janie was on the topic of more long tail stuff, which is not the 8020 thing and that really matters. And if you have any tips or cool stories or just general approaches that have worked for you, that's interesting to dig into.
- [50:32]
Janie
Yeah, I mean, I think one of them is even just how we staff our teams looks different than a traditional software engineering team. I'd say we have a bunch of folks with different roles who are clinicians. And so we have this role called the clinician scientist. And I think 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 basically a full stack engineer all the way to extremely, extremely scrappy prompter. But having each of these people embedded within our teams instantly raises the par for everything that we build because not only are they determining like is this product clinically useful, but they're deeply, deeply embedded in our whole evals process. And so when we talk about LFDs, when we talk about what is our actual evaluation criteria, like you don't want Chai or me creating what those are because we don't have clinical background. But I think that is probably unique to a bridge, but has been game changing. And when you think about where the puck is going, you have people with clinical backgrounds who are technical and where AI tools are going, they just become more and more critical and the killers of the team. And so I think that's one and then I think 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 really, 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 I think that's also been something we've had to tune over time.
- [52:28]
Host 1
And you have partners who basically opted in to give you those evals.
- [52:32]
Janie
Yeah, so we work either internally or with third party for offline evals and then we have customers who agreed to give us, whether it's thumbs up, thumbs down to choose this or that, a lot of data to get us to what is as close to fully confident as possible.
- [52:51]
Host 1
Yeah, the term that comes to Mind is kind of like active learning on things where you know you're weak. I feel like it's kind of a lost art. But is a lot of the polish that comes into doing something like this really?
- [53:03]
Chai
Yeah, 100%.
- [53:05]
Host 2
I mean, maybe on a totally unrelated note, like Chai, you obviously had a very storied run at Glean before heading over to Abridged. And so I'm curious, that obviously was one of the early AI app success stories. It's reflecting back on that experience. What do you think Glean got most right, maybe most wrong? Yeah. Curious for your reflections.
- [53:25]
Chai
I think I attribute Glean's success really to very, very strong technical foundations that have really stood the test of time. And so it started with the known problem and like finding information work is hard. The best technology at the time was to build really, really high quality search. I think a lot of times enterprise search startups failed because the quality wasn't great enough. But the learning that people took away from that is, oh, enterprise search is not good enough. And so like quality I think really changes the game of like, if something can be useful or not. It's like similarly, people may have taken it that way, like, oh, Alexa voice assistants are not that useful. But when you have quality, things can change the game. And so I think Glean's early foundations, by bringing people who had built search at Google, the best place to have ever built search, and being really creative and having a very concrete problem to solve, but with the right technical backgrounds, laid the foundation for all of its success for the many, many, many years to come. And I think what's interesting is always figuring out, hey, how does the company adapt in this? As we all know and we've talked many times in this changing landscape. And so for gleam, like, how do you put this context layer to the use has been the thing that we've really the last few years has been the fun from the challenge where you could say that's been the opportunity for the company as well as the challenge as well.
- [54:46]
Host 2
Yeah, definitely a competitive market. It feels like one at the epicenter of the foundation model and big hyperscalers. It'll be interesting to see how it
- [54:53]
Chai
all plays out when you think about can you build something that helps everyone at knowledge work as well is a massive opportunity.
- [55:02]
Host 2
Yeah. My mental model is there's a few markets that are like the foundation model. Companies have to win or big enough to go after and it's probably consumer code and that. So definitely be interesting to see how it plays out. I guess one Thing we often think about on the investing side is the pace of, of progress in models changes so fast and so the building patterns adjust so fast. And it's always hard to figure out what pieces of the way people are building today the infrastructure tools they use are going to prove persistent versus okay, six months later we're doing something completely different because models have improved. I'm curious of the stuff you use today, how do you think about the pieces of AI infrastructure software that feel a little bit more persistent?
- [55:40]
Chai
Okay, so generally if you take the thesis that the models are going to be more and more agentic, I think before we had to build a lot of scaffolding around that in previous games we made our own DSL effectively. And you can view the. Because the models were not capable enough so you needed to simplify things. And you can view it similar to other agent frameworks. But over time if the models become more and more agentic and can use the similar tools that we already have, where it's like computer use writing code itself in sandbox, I think much more around, I think far more about what are the right context layers and the tools to give agents. And then I think the other things that I think about are actually how do you really build truly event driven real time systems and especially at a bridge, again where you're doing something real time in the conversation. And so I think there's a lot of event driven technology and by the way, stuff that we've always used in the past, whether it's Kafka, temporal sockets and so forth, how do you bring that together is I think actually also durable or thinking about patterns in which humans collaborated with each other on Google Docs, how do you think about CRDT and so forth when you have conflicts, when you have multi agent systems? So all these things that we've built for, I actually think the things we've built for humans are actually the things that are going to continue to be
- [56:54]
Host 2
durable just with like a thousand times more of the scale of agents running at them.
- [56:58]
Chai
Yeah. So make sure that they scale of course, and fast and whatnot. Without a doubt, yes.
- [57:03]
Host 1
Does a bridge become more agentic over time then what is the next step more agentic version of that look like? Because you're already pretty proactive with the notifications, I guess.
- [57:15]
Chai
Yeah. And so I view that as like a piece of being agentic. But I also view maybe some of the things we mentioned before like, oh, reacting to labs or like you know, doing work in the background or doing even more capabilities on behalf of the clinician, who we believe has a super important role to play in terms of patient connection and so forth. Yeah.
- [57:35]
Host 2
I'm curious for both of you, like, what's one thing you've changed your mind on in AI in the past year?
- [57:39]
Janie
I think the one I flip flopped on, and this is much more product specific, is probably the hotter take is that prototypes are the end all, be all and that PRDs are dead. I think we've tried switching and kind of we continue to evolve the way product is developed and the products that we're building are extremely complicated and nuanced and it is very, very difficult for a prototype to capture the full complexity of what can we or can't we do with this data? Is this the actual right problem to be solving for in a world where software has become so cheap? Yes, this is a cool looking prototype, but should we be spending any of our precious hours here? If so, why? And how does this deepen our moat in a world of decreasing moats, does this require custom implementation from our customer to actually use? None of that gets captured in a prototype. And so I think we're continuously evolving the way that we develop product here. But even if not written in the same traditional ways as it was two years ago, I think as a team we've gotten pretty, I think high conviction that in a world of so much noise, like crisp written clarity is more important than ever. It might now live in a markdown file that more teams and systems can use as context, but that's probably one that is much more function specific to me.
- [59:08]
Host 1
But you're disagreeing with the consensus that purities are dead. And so you are like, we should
- [59:15]
Janie
partner with AI to create great documentation. But I think first, probably most important is strategically answering like, why is this problem the one our company and our product should solve? What happens if the next 20 competitors build this? What is our right to win? And does this help us differentiate in any way or are we just adding noise? I think it's important.
- [59:40]
Host 1
High bar. I don't know if I could answer that because a lot of the times the answer is there's let's do it first.
- [59:44]
Janie
And I think when the cost of doing it first is so expensive. We just talked through the process of getting something out to customers. I think you need to have a higher bar for as a business, should we invest here? And I think as all of our roles evolve, one of product or all of our jobs become like, should we do this thing? And I think that's something that is worth the Time spending up front on. And then as you think about prototypes, it's still really valuable to quickly show Here are the 20 ways we could do it. Clinician, I would love your feedback. Which one resonates more or as you get into deeper fidelity, you can also make the prototypes deeper fidelity and get it as close to production ready as possible. But beyond that to actually get it out to customers, there's a lot of implementation details, security compliance, edge cases, things that never get caught in a prototype that I think need to be written out somewhere and so they look different but I think still more important than ever.
- [60:53]
Host 2
Yeah, it's interesting. I imagine a lot of that also is given the context of the stage that it bridges at. I feel like for so many early stage companies, it's just a desperate race to you throw 30 things at the wall, you're like, please, something just resonate with my end buyer and you find something. And that's why the prototype first approach is so powerful. But for you all, it's like anything you're going to DO is across 200 systems, there's a whole implementation, change management side of things and you get a few big bullets to fire at what you want those systems to do. And so I think being really thoughtful about that makes a ton of sense. And maybe the prototype first takes one all grow into to your view of the world when they're. When they're a bit more scale.
- [61:33]
Janie
I think the weekend demo versus it works at the largest health systems is like a massive, massive gap. I don't think it means we can't go fast. Like I think this is the fastest I've built in my career right now. And I think the.
- [61:47]
Host 1
Compared to loom.
- [61:48]
Janie
Yeah, I think from like the complexity and the scale of the products we're trying to build and the problems we're trying to solve, I'd say yes, maybe I updated a flow or shipped a new feature pretty quickly. But if you think about some of the products we're building, we're trying to collapse prior authorization things that used to take 45 days across maybe 20 different touch points into one. I think I'm building faster than I ever have. And so I think the thoughtfulness actually allows us just to go fast at the right things. It sounds contradictory, but I think go
- [62:29]
Host 1
slow to go fast.
- [62:29]
Janie
Exactly.
- [62:30]
Chai
Yeah. It's interesting. I think when a lot of things are changing and in the AI discourse, I think sometimes we lose sight of things that always stood the test of time. Judgment and clarity always matter. As an engineer, sometimes I don't want a prototype, actually, I would like to see. I want the clarity that comes from writing and then we build that. And again, for some things, of course, where it's a small thing, like, yeah, just ship the prototype. That's why. Don't sweat the details. So I think the interesting thing, the nuance that gets lost sometimes in discussion is sometimes we need to recalibrate our judgment for sure, because the costs and gains have changed. But that doesn't mean we go all the way on one spectrum or the
- [63:09]
Host 1
other outside of your specific tool. I always like to ask this question, any other AI tools that you guys are enjoying?
- [63:17]
Chai
Claude code. But that feels like too basic of an answer.
- [63:21]
Host 1
Is all of rich engineering very pilled on cloud code?
- [63:23]
Chai
Yes, very much so. You know, no cursor. Oh, we also have cursor as well.
- [63:29]
Host 1
I'm just checking the boxes here.
- [63:30]
Chai
Yeah, many of the tools available, but it's like you look at just earlier today, you see an engineer screen, you see like six different clods running at it, sometimes the same person. I've seen them on the sofa now with the remote control as well, on the mobile, but. But like, very much so. Like, one of the interesting things for me is, like, as a relatively new person at the company, like, cloud code actually helps me onboard much faster. Or any of these. And like, I feel like I learned so much.
- [63:56]
Host 2
I do love the memes of, like, you know, Claude's going to do this. I'd like to see Claude. You know, the venture equivalent is like, I'd like to see Claude go do a company at a billion dollars pre revenue. Well, we always like to leave the last word in these conversations to you both. And so any place you want to point folks where they can go, learn more about Abridged, the work you're doing, any of the research you guys have done, whatever, the floor is yours.
- [64:19]
Chai
A couple places. On our Abridge website, we have a lot of our white papers where we've done a lot of interesting work, such as reducing hallucinations.
- [64:27]
Host 1
Very well presented, by the way. I liked it.
- [64:30]
Chai
Thank you. Our science team rigorously defined what actually is the problem. And one of the interesting things, by the way, at Abridge is we actually have multiple stats professors on staff as well. So in that specific white paper, Michael Oberst, who's a professor at jhu, and so we have multiple. And from that comes very high rigor. And then also our taste for design comes from really good presentation. But setting that aside, and we're going to have many more technical topics there. Please follow our Twitter account as well. Bridgehq. And then the other thing I'll plug a little is we have open house of deep diving deep into AI and healthcare. Coming up with Andreessen Horowitz.
- [65:08]
Host 2
Amazing. Well, thanks so much. This is super fun.
- [65:10]
Chai
All right, thank you.