AI-Enabled Scribes and Entrepreneurship with Ian Shakil (Augmedix)

On a recent episode of the AI Health Podcast, Augmedix Founder, Director, and Chief Strategy Officer Ian Shakil sat down to discuss how Augmedix is changing how electronic health records are generated, saving doctors time and improving patient experience. He also tells the story of how he founded Augmedix, and how his company differentiates itself in a competitive market.

Augmedix converts clinical conversations into documentation that is directly entered into the EHR system.

The Augmedix story is very much a story of Silicon Valley magic. Shakil was hanging out with some friends at a park in San Francisco. These friends happened to be working at Google and Google X, and they offered him the chance to experience Google Glass. “Have you ever thought about doctors and what they can do with this?” Shakil said. “I started forming Augmedix right then.”

In the first few months of Google’s soft launch of Google Glass, the company sent the devices to celebrities and they never used them. Augmedix bought the unused Glass devices and re-engineered them for enterprise applications. Eventually, Google got wind of what Augmedix was doing and that inspired them to pivot Glass to Glass at Work. “When we first started, we would put [Google Glass] on doctors and put scribes in other places in the building to prove the use case,” Shakil said.

Today, Augmedix gives providers Google Glass or smart phones they put on stands in the exam room. Augmedix runs on those devices, with the conversation live-streamed to a tech-enabled scribe who sits in a “cockpit” that allows AI to help scribes create sophisticated notes and even referrals. “From that, we produce beautiful EHR notes in real time. We produce documentation that’s better in every respect,” Shakil said. “Mind you, you’ve gotta have a human in the loop—it can’t be all AI” or the software simply becomes medical transcription.

Shakil said there are companies that use pure AI solutions, but they don’t make notes—it’s more of a dictation software to which doctors must talk in a really stilted way and the notes are transcribed word for word. With humans in the loop, body language such as nods and gestures can be captured by the scribe.

“Doctors don’t want transcription software, they want the relevant information to be captured,” Shakil said.

The training of Augmedix scribes includes use of EHR software. The majority of the company’s customers are primary care providers, but it also work with more than 20 different specialties. All notes are captured in draft status for doctors to edit as needed. Scribes also have the patient schedule for the day and “tee up” the patient’s previous history for the doctor to review before the visit. Scribes communicate with providers via text message.

Privacy is always a big concern in healthcare, and Augmedix protects patient privacy in several ways.

  • The practice tells patients about the remote scribe and tells them they can turn Augmedix off. But 98% of the time, patients accept the remote scribe.
  • Augmedix has workflows for anxiety and nudity to show that data is not being collected.
  • Everything is encrypted and HIPAA-compliant. Augmedix’s platform is the only software that runs on “scribe cockpit” computers, and the company has very high security protocols in place to ensure that protected health information doesn’t go beyond the EHR.

Despite—or perhaps because of—the pandemic, Augmedix is continually adding health system customers and doctors. Shakil says the company has substantially more clients than it did pre-pandemic. “We’re made for this world people live in,” he said. “The reality of the pandemic has forced doctors to let scribes go, so remote scribing has really been popular.”

Augmedix also works with telehealth. Through telemedicine visits on Zoom, the scribes are ambiently documenting the conversation. Shakil says Augmedix has a deep strategic integration with Zoom.

Most digital health startups need to gain traction with independent doctors before large health system customers get on board. That was the case for Augmedix: independent physicians can be up and running in weeks versus a sales cycle that takes quarters with big health systems. The company got rave reviews from the doctors who used it, and “today, 90% of our users are from enterprise clients like Dignity or Sutter, but we had to grow into those shoes.”

“We’re building the company strategically to be a stand-alone iconic company that spans various EHRs and across the country. We have designs to think of Augmedix as a platform business as well as an AI business,” Shakil said. “We will be unleashing platform capabilities and going beyond ambient documentation.” He said he expects the move to full automation to take some time, but the company doesn’t depend on that happening for its ultimate success.

“I think that’s very rational and conservative for us to have built a business that works in that way,” Shakil said. “We’re positioned to be the leader in this because we are collecting so much data, so much scale, and so much workflow mastery.”

Listen to the full podcast here.