Rehumanizing Doctor-Patient Relationships with Manny Krakaris, CEO, Augmedix

In a recent episode of the Cowen Insights podcast, Cowen’s healthcare technology analyst, Charles Rhyee, spoke with Augmedix CEO Manny Krakaris. They discussed the administrative burden of medical note documentation on providers today and how Augmedix’s offerings can increase productivity and prevent physician burnout.

Augmedix provides a remote scribe service that leverages technology such as AI, machine learning, and natural language processing to save clinicians an estimated 2-3 hours a day. The remote sessions are transcribed into notes that go into a patient’s chart, along with reminders about lab tests, prescriptions, and more.

We are currently experiencing unprecedented amounts of physician burnout—doctors leaving medical practice altogether—due to the destruction of work-life balance that was an unintended consequence of digitizing health records. The way doctors need to take notes for these EHR systems also diverts attention away from the patient, what they’re saying, and how they’re saying it, resulting in lower satisfaction among patients.

In an attempt to remedy this problem, doctors started dictating notes, but “this was more like typing with your mouth,” as Krakaris said. Dictation solutions are taking a back seat to technology such as that offered by Augmedix.

“There are four major categories of limitations existing solutions fall into,” Krakaris said, “One, they don’t save doctors enough time, so they’re not worth the effort. Two, they’re too rigid and don’t integrate easily into doctor workflows. Three, they’re not global, which is increasingly important today because doctors don’t always practice from a fixed location. And four, there are limitations which pertain to the most prevalent model or full-service solution, which is the in-person model. COVID exposed the limitations of that model, and healthcare systems are moving away from it.”

How does Augmedix differentiate itself from the other services that are offered today?

Augmedix starts with a live offering, where remote scribes listen in with the doctor through a tool such as a smartphone or Google Glass (with the patient’s permission) and take notes on the exam in real time. The company complemented that service with a non-real-time solution called Notes, which it released in 2020.

“Under the live service, we have a dedicated specialist who ensures delivery of complete, accurate notes shortly following the conclusion of the patient encounter. Moreover, because it’s delivered via a bidirectional, or synchronous, communication channel, our live service enables an exchange of information between Augmedix and its customers to ensure the highest quality notes by eliminating any ambiguities that might occur during the patient encounter,” Krakaris said. “It also enables us to deliver other services such as care reminders, coding suggestions, and pending orders. The value of these additional services is greatest when delivered in real time, which gives us a significant advantage of the non-real-time services that are out there.”

Augmedix currently has four of the top 10 and six of the top 20 health systems in the U.S. as customers. “Getting into large enterprises is not a trivial matter,” Krakaris said. “It requires a tremendous amount of data protection, so we not only have to comply with HIPAA standards in terms of data security, but we go well beyond that because the requirements of our big enterprise customers exceed the requirements of HIPAA.”

There are several companies that offer competing services, many of them on the premise that they can deliver complete, accurate, cogent medical notes without any human intervention. “As those propositions have been tested in the market, it’s been revealed that they really can’t deliver on that promise,” said Krakaris.

In terms of the limitations of the “pure AI” approach to documentation, the output is essentially unstructured data that may or may not capture all the discussion topics in the appointment or the context of that discussion. “No matter how good your algorithms are, it’s very difficult to convert unstructured data into an accurate and cogent medical note,” Krakaris said, “and the requirements for accuracy in our industry are very high because the consequences of mistakes can be devastating.” In addition, doctors and patients have to follow very rigid scripts to get a pure AI service to create good notes, and neither doctors nor patients want that.

“We don’t think technology should be inhibiting doctors from practicing medicine the way they want to practice medicine,” Krakaris said.

Listen to the full interview here.