We seed funded a company late last year called Abridge and the company went public yesterday with their iOS and Android apps. Naomi wrote about the investment on the USV blog.

I want to focus on the product because I think it is a game changer for all of us that access the health care system regularly.

The Abridge mobile app (get it here) allows anyone to record a medical visit with a doctor, a nurse, or any other health care professional.

It works like this:

You open the app to see your visit history:

You tell the doctor, nurse, etc that you are going to record the session and hit the record button:

Then you record the session.

When you are done Abridge saves the audio recording of the session and also immediately (in way less than a minute) provides a transcript of the session with the key medical terms called out in bold.

That is me making stuff up this morning. I sure hope I don’t need a knee replacement any time soon.

This is one of those ideas that is so simple and so obvious that you wonder why nobody has done it before.

The team is a combination of physicians and machine learning people from University of Pittsburgh and Carnegie Mellon. It’s a combination of domain experts and technologists who are extremely well suited to make this work and work simply and elegantly.

I would encourage everyone who sees doctors regularly or has a loved one that does to get Abridge on your phones and their phones.

I think it’s a game changer for how we access and understand the medicine in our lives.

#hacking healthcare

Comments (Archived):

  1. pointsnfigures

    one of the interesting things about healthcare is that often people don’t know what questions to ask. i notice this with older people (like my parents). Part of it is generational; the prior generation had the utmost respect for doctors who were help up on a pedestal and revered. You don’t question someone like that. However, medicine has certainly changed and especially for people on Medicare. The economic incentive is to see more patients, and manage pain not necessarily cure or prevent anything. As they build a database, I wonder if they could use AI to help generate some questions for patients to ask doctors to get deeper answers and understanding of what’s going on inside their bodies?

    1. Susan Rubinsky

      Great point.

  2. Tom Labus

    As a fair skinned guy who was out in the Sun a lot a s a kid, I make a regular trek to a dermatologist. No matter how good a relationship I have with the Doc, I always have to remind myself that I’m revenue to him too. Docs can refuse to allow a recording?

    1. fredwilson

      I don’t think they can

      1. Matt A. Myers

        Might be useful for you to know for sure as an investor what ground your investment is standing on?

      1. Tom Labus


  3. bobmonsour

    It’s hard to overstate how timely this is. I am helping my brother navigate the start of his battle with recently diagnosed pancreatic cancer. We have 5 or 6 appointments and procedures taking place starting Monday. I plan to record as much as I can. I’ve been going to appointments with him and taking notes, yet we still seem to come away hearing different things or interpreting things differently. This will help immensely. Thanks, Fred.

    1. fredwilson

      I am so happy that you have some help as you go through this with your brother. I wish you and him the best with this

    2. JLM

      .Your brother is lucky to have you available to help him.Good luck, best wishes, and prayers.JLMwww.themusingsofthebigredca…

      1. bobmonsour

        Thanks, JKM. Navigating the decision process for entry to treatment has been difficult. At the same time, I feel privileged to be able to help him and his wife get it underway.

    3. Matt A. Myers

      And unfortunately you’re unlikely to find out what the actual leading knowledge and treatment is unless you dive into the internet, search and communities.

      1. bobmonsour

        Believe me, Mike, we’ve been diving all over the place. As with everything cancer, a lot depends on what the patient is willing to do and everyone is different on that count. There is a lot of “leading knowledge” and discovery going on in the form of clinical trials. However, that’s a far more complex bag than it appears. Time is often critical with an advanced cancer and the decisions have so many factors involved, with the primary one being what the patient (in this case, my brother) wants to pursue.

    4. Salt Shaker

      One of my closest childhood friends was diagnosed w/ pancreatic cancer 5 years ago. I just saw him perform a few weeks ago as the lead in an off-broadway show. Best wishes and prayers to you and your family.

      1. bobmonsour

        Thank you! While we feel that we must have hope, as you likely know, this is one nasty bastard of a cancer. I’ve been doing a ton of research, sharing what’s relevant to his decision making and keeping the darkest elements in my pocket. The emotional toll of the early stages of this knowledge can be too much.

        1. Salt Shaker

          Bob, I didn’t share in my earlier reply, but my family too is dealing with a bout of cancer. My nephew (27) was diagnosed with lymphoma 5-weeks ago. He just finished his first round of chemo (29 days) and the mass in his chest has almost dissipated. Doctors are very optimistic since he’s responded so well to treatment. I too have learned more about this insidious disease in the past few weeks than I thought possible. Yes, pancreatic is a tough one, but as I shared in my earlier reply, my friend seemingly at this stage has won the battle (if not the war). Cancer doesn’t discriminate and everyone responds differently. It’s horrible for the patient and the family, as you certainly know. An emotional rollercoaster. Again, wishing you all the best.

          1. bobmonsour

            Thanks for sharing your nephew’s story. It’s helpful to hear and to hope. It certainly is an emotional rollercoaster. I was talking to a social worker at one of the many non-profits that help families deal with new diagnoses of pancreatic cancer. I was telling her that I was good at compartmentalizing things so I was able to remain objective as we did a lot of research. Then I said (again) that I’m good at compartmentalizing, until I’m not. It was then that emotion washed over me. I’ve had some moments, but at the same time have to be someone who can dig in to the options and tasks as my brother and his wife are still processing what all this will mean for them. We’ve got his will and advanced directive in place, among other things. All doable, but none of it fun. All the best to you and your family.

    5. creative group

      bobmonsour:The stage of pancreatic cancer is as equally important as the next steps in winning the battle.–Cancer that begins in the organ lying behind the lower part of the stomach (pancreas).The pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars. If this type of cancer is detected late, it can spread rapidly.The Creator is in control we are only passengers in this life.All things are possible. Exercise every option and never ever give up.Captain Obvious!#UNEQUIVOCALLYUNAPOLOGETICALLYINDEPENDENT

    6. sonia gonzalez

      Sorry to hear about your brother. My father fought against pancreatic cancer. I sincerely wish you, your brother and your family the best. I recently heard about this study but I haven’t researched it much – https://www.nbcbayarea.com/

      1. bobmonsour

        Thanks, Sonia. I’ll take a look at the study. I know you understand how difficult it can be.

  4. awaldstein

    Simple answer to a huge issue and a platform that could grow significantly over time.Currently have an elderly extended family member that will be under care for a long while and tons of unknowns, hospitals, stresses, research, and the like.And an global extended family that needs to be kept up to date so just having a record to share with lets say a doctor who is a relative in Israel, or an Aunt wherever is a big deal. A huge time commitment researching, asking, then sharing, not to mention decision making.Some of this happens via phone so a phone recording option would be useful.Already sent it on for people to try.I thought about whether there is a cultural issue with people allowing themselves to be recorded but it will simply have to change.

  5. Anne Libby

    I love this!I’ve been recording/transcribing doctor visits for some of the older people I go to the doctor with. NB: in New York you can record a conversation without the other party’s permission. This is not true in some other states. And some doctors have looked askance at my request, and not granted this permission.However, the transcripts have shown us that sometimes even the patient and the advocate (i.e. me) did not hear what the doctor said.So hopefully the folks at Abridge will gain enough traction to get all doctors on board with the idea of recording visits.

    1. Richard

      The problem for the doctor is if she allows the device, she is required to authenticate the transcription. If the recording is inaccurate, the physician will have no way to prove otherwise in the future that negligence was in the transcription vs the verbal instruction. If the the EMR is not commensurate its an issue. Just too time intensive for the physician.

      1. F G

        Adding to your point, it’s not just the doctor at risk if the transcription is inaccurate, it’s the patient as well who might be following incorrect instructions. How does the app handle accented English? Is the accuracy rate of transcription equivalent for doctors with native English skills versus those with Chinese, Indian, Russian or Spanish accents? Is this another ML app with discrimination built in?I guess at some point the accuracy of the recording and transcription will be tested in court.

        1. Richard

          Some technologies add to the problem rather than fixing the problem. Overall the problem is how to improve the communication between the dr and the patient. And how to ensure the patient understands the actionable data. This is one of those ideas that sounds like it will solve these issues, but in the end will just add the complexity. Giving someone a transcript of a 45 minute appointment and having them pull actionable data from the record is simply not going to happen. Have you ever read a deposition transcript? There is a reason why they give you a week to review it.The accuracy is several dimensions – did the dr hear the question in the same way as it appears in the transcription, did the app hear the conversation correctly, if there are more than 2 people in room, did the app identify the speaker ? did the ML algo autocomplete correctly ? What was the body language? What are the effects on dr patient confidentiality ?The actionable data for and from the doctor is in the EHR, don’t reinvent the wheel by adding another wheel.

          1. F G

            Great point about the EHR. It would be more accurate to extract data from there and give it to the patient.Imagine a patient goes into the ER with an acute problem. The patient or friend/relative opens up the Abridge app and shows a transcript to the doctor. Should the doctor depend on this data, use it in their diagnosis/treatment, or ignore it(start a workup from scratch)?

          2. Richard

            Best practices are to ask for a printout of your EHR at the end of your appointment. Review it. Correct it – as needed – and bring it with you to your next visit. Most EHR in large practices are immediately viewable

    2. jason wright

      I was wondering about the legal position of making recordings. Thanks for the insight.

  6. William Mougayar

    Interesting where this can go.I don’t see why this can’t be used for therapy or chiropractic sessions too (anything paramedical, health wellness).How about during business meetings. I assume the algo can be tweaked to recognize business terms.Health wise, they could make correlations at the aggregate levels and connect similar patients together to discuss/share experiences without revealing confidential stuff of course.

  7. Joe Lazarus

    It will be interesting to see what parts of this become industry specific (ie. healthcare) and which parts become more generalized (ex. audio transcription apps for anything like Otter). I can picture Abridge going in a lot of other directions than transcription, so makes total sense for them to go deep in healthcare. Just wonder how things shake out across verticals.

    1. Susan Rubinsky

      Best way for a startup like this to “make it” it to go deep not wide, I think.

      1. Lawrence Brass

        I agree. Deep and wide is financial suicide, shallow and wide sometimes leads to not very good product(s). Deep single product with functional focus is perfect… but risky, because then product market fit is everything.

  8. curtissumpter

    Yeah. But what’s the privacy policy between Abridge and the patient/doctor? How is the data being collected (and I’m assuming it is) being used? And what’s the cost? Is the user the customer or the product?

    1. Matt A. Myers

      I’m sure they’ll figure that and decide as they go – making decisions based on what’s best for their business and not the consumers. Made me think of how Twitter opened up their API, and instead of embracing and building and supporting a much bigger integrated ecosystem – their anuses tightened in fear and they closed up integrations; left a large opportunity for them to be disrupted – but hey, they’ve made their money now, so the risk mostly on the general public holding the stock now.

  9. Mesh Lakhani

    This is amazing. When my fiancé was going through her treatment, we met with numerous oncologists, ENTs etc. I recorded everything over Voice Memos, and then would write notes in “Notes.” I wish we had this at the time. I will plan on using this moving forward.

  10. Matt A. Myers

    I can tell you exactly why this hasn’t existed yet – because most doctors give you 5-15 minutes at a time for even complex things, and 99% of them aren’t willing to read anything or listen to anything substantial. Perhaps it’s changing with younger generations. I believe recording audio and video should be mandatory in all health settings – health is a life and death situation, similar to the police who have authority over people – doctors have authority over what you get, when you get it via referring you or not, etc.

  11. Richard

    If the device is not hippa compliant, it’s a legal problem. See Amazon / Alexa – who is rolling out a hippa compliant version of this technology.

    1. Matt A. Myers

      I’m curious if they’re not claiming it as medical technology, and just as voice recording and transcribing.

      1. Richard

        HIPAA defines “covered entities” to include “healthcare clearing services”. The definition broadly construed would require compliance.

  12. Eli Hoffmann

    Fred, have they built their own voice-to-text solution or are they using third-party tools?

  13. JaredMermey

    Makes me want to ask “what next?.”A lot you can do with this data set at a macro and individual level to make doctor’s better and patients more informed.

  14. Susan Rubinsky

    I absolutely love this. As a daughter to two parents with a lot of medical needs, I can instantly see the value.Also, can’t wait to see what features roll out over time. For example, lists of medications — every time I take my Mom or Dad to the hospital we have to create the current medications list all over again. A way to combine it all in one app, with medical references would be really helpful.

  15. JLM

    .The clinic I go to — Austin Regional Clinic — did a pilot program with this for older patients (over 65). They picked this segment because they thought they had more time to deal with the idea.ARC is highly digital. All of your info — every bit of it — is in a digital file including lab test orders, lab test results, lists of medicines. Everything.It took them a long time to get where they are, but they are uber digital. It is very impressive.I think they tend to have younger docs, not exactly sure why.Every specialty you could imagine is under one roof.The result of the pilot came down to a single question — Where does the additional time come from to incorporate this?This question has to be considered in an environment of continuing decline of Medicare reimbursement. Doctors are being paid less and less from Medicare.It is not just the time to get it transcribed — get it that that can be automated — but for the doc to review it.One of the things I like about my personal physician is that he diligently reviews my file before I arrive and knows exactly what the issues are before we begin to talk.Everything in medicine has to become digital and transportable.JLMwww.themusingsofthebigredca…

    1. Matt A. Myers

      You’re either lucky with your doctor who reviews things beforehand and/or you don’t have much of anything complex going on. But how do you know they’re doing a good job, referring you to preventative, proactive treatments, practices, etc? You have no comparison tool or reference points do you?

      1. JLM

        .In the end, we get the medical treatment we demand. It is my job to know what is going on with my body.I have been proactive and I am able to operate Google.I get regular physicals and have a trend line on all data.I get a few more tests than the average bear — heart blockage cat scan, as an example.I intend to live to be 110.I will probably get hit by a car.JLMwww.themusingsofthebigredca…

      2. Pointsandfigures

        Over 65. No need for that new Face App

  16. Yuriy Blokhin

    This is such a simple and useful idea. Just shared this with my Dad who doesn’t speak English that well and often has to go see a doctor. Every visit a torture of anxiety for him since he’s worried (rightly) that he may miss something crucial and with the Canadian healthcare system it also means that it’ll be months until he can see the same specialist again because of the lineups. So this will make a very material impact on his levels of stress and quality of healthcare.

  17. Salt Shaker

    We unfortunately live in a litigious society and malpractice insurance is a huge expense for any practicing physician. I can see a physician’s reluctance in being audio taped, as a precise accounting of a consult can potentially be used against them. Audio transcripts miight even drive up the cost of malpractice insurance industry wide if it leads to increased litigation. (We all know how our legal system operates, and anyone can sue anyone, w/ or w/o cause.)All this is truly a shame, as from a patient and family standpoint the merits and value prop of a transcript are numerous. When a patient and their extended family are grappling with health issues, particularly serious health issues, clarity of thought isn’t always present.

    1. Matt A. Myers

      Fear because someone isn’t articulating something clearly or well enough should be seen as a positive in this setting, no? Won’t it incentivize a mechanism towards clarity, and of confidence of the doctor not being lazy, and being able to hold them accountable to the highest standards? It certainly will require doctors to be refined and brilliant, well-rounded individuals – and not simply those who can memorize and past tests in school.

      1. Salt Shaker

        Yes, I can see that, and I can also see a physician declining such a request, which is unfortunate cause that would potentially impede the trust between patient/doctor.

        1. Matt A. Myers

          Indeed – if they don’t trust themselves, then why would we trust them; and if it is the system, insurance and legal system etc., that they don’t trust – then they need to be forced to take a stand to fight the issues instead of trying to or being squeezed into whatever constraints it does.

    2. JLM

      .Medical malpractice is unlikely to be a relevant concern.The standard for seeking damages is “negligence.” Negligence standards have tightened up and require a physician to have violated a duty of care to the patient that results in actual harm to a patient.One could convincingly argue that a physician who allowed transcription is practicing a higher level of care.Damages can be economic/compensatory (cost of treatment, lost wages), non-economic (pain and suffering), and punitive.Many states have enacted caps on non-economic damages. Texas has a $250,000 cap on non-economic damages (pain and suffering) for each physician and each hospital.This bit of tort reform has resulted in an infinitely better care environment, less practice of defensive medicine, quicker settlements, and fewer ambulance chasing lawyers sprinting about.In most instances, this limits total non-economic damages to $500,000 assuming one physician and one hospital.Punitive damages can only be awarded if the conduct is “outrageous.” This rarely happens in the ordinary course of things.JLMwww.themusingsofthebigredca…

  18. Geoff

    Alas, not in the UK app store 🙁