The Real-World Impact Of AI In Healthcare Documentation with Pat Williams, co-founder and CEO of iScribeHealth

[00:00:01] This podcast is produced by Outcomes Rocket, your healthcare exclusive digital marketing agency. Outcomes Rocket exists to help healthcare organizations like yours to maximize their impact and accelerate growth. Visit outcomesrocket.com or text us at 312-224-9945.

[00:00:30] Hey, everyone. Welcome back to the Outcomes Rocket recorded live here at Vive in Nashville, Tennessee. I've got the privilege of hosting Pat Williams today. He is the co-founder and chief executive officer at iScribe. Pat, welcome to the podcast. Thank you, Saul. Thanks for having me. Good to be here. Hey, it's such a pleasure and good to be in your hometown. Absolutely. Yeah, it's great to have one of these in the backyard. It's kind of strange to drive to one of these events, but even in the snow of Nashville, it's nice.

[00:00:59] Like snowing outside and I'm looking out the window and I see a guy with a leaf blower trying to blow snow. Yeah, we don't get snow very often. So yeah, we haven't been able to invest, I guess, in the equipment we need to deal with it. But yeah, kids are out of school and everybody's having fun. That's awesome, man. Well, it's a great city. And how's the meeting been for you? It's been really good, really exciting. I think eye-opening in a lot of ways, just how fast the industry is moving and evolving. Obviously, AI is everywhere.

[00:01:27] And yeah, just what a moment to be the local. We're sort of Nashville's own generative AI company, and we're proud to represent that in our hometown and backyard. That's awesome, man. That's awesome. Well, look, I want to get right into it, Pat. Tell us about your business. What do you guys do? How is it different? And why does it matter? Absolutely. I like to tell our story Netflix-style in three distinct seasons that we have, right? And first of all, who we are.

[00:01:51] We're a generative AI documentation company that allows physicians to show up, be their best selves, treat patients rather than computer screens and documentation headaches, right? Those are the things that we combat each and every day. How we got to where we are, it's all about the history. Season one of our story started with two men and an idea, as these things often do. Myself and my co-founder, Justin Hipps, who grew up within the EHR, EMR space, implementation sales roles at Greenway.

[00:02:20] I worked for a variety of healthcare, large, medium, small technology businesses as well. We both had this, again, just growing up in the industry experience, selling software and services to physicians, seeing the problem firsthand that they were dealing with. We felt like we contributed to the problem. Felt compelled to go to help solve it, right? And yeah, mid-late 2015, we set out with the industry backdrop in season one was obviously EHRs had reached this sort of boiling point, vein of every physician's existence, as they still are today.

[00:02:48] Transition from human-based transcription to voice recognition was a big trend. And then you had the iPhone was only a couple of years old, probably six-ish years old. So we saw this opportunity to create a consumer-esque feeling mobile app that could plug and play into various EHRs that are very clunky, difficult to manage. And so that was the founding thesis, right? Make EHRs easier to use with a combination of beautifully designed consumer feeling mobile app with voice recognition, but also a lot of functionality.

[00:03:17] Really, truly let the physician close the laptop, get away from it, input orders, diagnoses, billing codes, all the required documentation using just their thumb and their voice. And we built that on top of Greenway initially. We then pivoted into Athena Health Marketplace, who's been a tremendous partner. I'm happy to talk more about that. That got us started. So the first three years, we built a good base of early customers. We got our first million bucks in ARR in that season and got established. That was the origin story.

[00:03:45] And the transition from season one to season two started late 18, early 19 with the backdrop of the rise of the human scribe, right? So we were starting to have success, particularly with busy orthopedic practices. That became a real sweet spot for us. As we're out talking to these busy orthopedic groups in particular, every single one was either interested in, it was evaluating or had already deployed human scribes, right?

[00:04:08] The awkward person who might have worked at Best Buy last week, who's now sitting in the corner feverishly typing and awkwardly just because these high volume, high production docs, right? It was the economics did not support them doing any sort of point and click and they refused to do it. And so we saw the writing on the wall. You hear that 10 times in a row being the nimble entrepreneurs with who were like probably something to the scribing thing. We thought we had built the perfect app to replace scribing. So we started to offer that.

[00:04:36] We started to offer human-based virtual scribing as an option in the same mobile app that we built in season one. And this really worked well in that season of allowing us to go in as we were sitting around the table with five decision-maker physicians. One wants a new and improved Dragon voice recognition experience. One wants a hybrid point and click speech-to-text. Some wants their legacy transcription service to stay in place. And the other wants full-blown scribe. We could meet all physicians where they were in those scenarios.

[00:05:06] We could consolidate three or four vendors in one. And it was unique. It was this very versatile choose-your-own-adventure product that, however, with the human-in-the-loop scribing, worked really well. Worked a little too well. This was all during the COVID era as well. We grew that virtual scribing business up to about 120-plus people. So we inherited the problems that a lot of our customers were dealing with, a lot of turnover, a lot of just HR management, right? And so we found ourselves in this funky foot in two canoes.

[00:05:35] One is a pure technology business. One is a sort of a staffing for gig economy scribing business. And it was just a tough business to manage. We always, of course, wanted to be the lean and mean, pure SaaS business that we are today, happy to say. But it just was difficult to get there. And then lo and behold, season three, mid-2023, the AI UFO, as I like to say, landed on planet Earth. We- I love that. And it was one of the things where we were confident.

[00:06:04] There was a lot of hype around AI early. We, of course, were paying a lot of attention to it. We had partnered with some companies, many of which have big booths here, that were trying to help us get there. The technology was not ready yet. And then once the technology did get to a point where it was truly commercially viable in a clinical setting, we rapidly moved that human-based scribing business to fully automated. We took the 120 to zero over the course of 90 days. A million bucks off the P&L. Never looked back.

[00:06:32] And 2024 was just a transformative year. It's just we, again, a 10-year overnight success, as I like to say. And now we're in season four. 2025 is the newest addition. We're expanding the platform. We've got a lot of exciting things coming down the pike. Autonomous coding, denial management, impact on prior authorization, because now we feel like it can really start to merge, which has always been difficult.

[00:06:56] The documentation side in the exam room with the back office and billing office, because if the documentation is getting done immediately, all of these things can start to happen in more real time at the point of care. So we're thrilled with where we are. So you have to sort of appreciate that history, right, to understand why we're having the success. Oh, totally. Yeah, no. And I love the story. I really enjoyed hearing about each episode, or what did you call them? Season? Yeah, the Netflix seasons. The seasons, yeah. I like the seasons.

[00:07:23] And congrats on the evolution of the business. Thank you. Yeah. Again, it's a great team who's stayed very nimble. I think it's a testament to my co-founder and the whole team for staying. We stay very close to the customer, the market, right? We're always curious and interested of emerging technologies and trends. And that's, I think, the reason we've been able to make this incredible pivot. That's great.

[00:07:46] And look, while you have shed the human labor, all the nuance that you have come to understand and appreciate is still with the organization. Exactly. Yeah, so that's super valuable. Exactly. Yeah, I think that's a great point. That's why, again, another reason why we are where we are, right? That human-based scribing season was critical. We learned a lot. We had a great team, many of which, by the way, we kept on. And they're now prompt engineers.

[00:08:15] They're now clinical documentation integrity experts. So we really leveraged that expertise and subject matter, which you have to be able to do. Because the physician acceptance bar, the dirty little secret, which I think a lot of people are figuring out the hard way in this industry, is the physician acceptance bar is high. This is not just a flip on the microphone, turn it loose, and then everything happens magically from a formatting preferences perspective.

[00:08:41] You really have to serve this stuff up in a very bespoke way per physician. You walk into a 100-doc busy orthopedic practice, you're going to get 100 different requirements for how they want their notes to look. And so that's what we learned, again, through that period. And it just helped us really set a high bar internally for where we knew output preferences from day one needed to be. And I think that's why we are where we are again. That's awesome, man.

[00:09:10] Well, congrats on that. And look, just to be clear, I want to ask, what end customer do you serve in the healthcare ecosystem? Yeah, we, again, are ambulatory, non-hospital, non-health system, proudly focused today. And again, that's nothing against health systems. We certainly would love to eventually work with them one day. I think to be successful in this industry, though, you have to stay focused. That's been our key. And we've remained focused from day one on the independent ambulatory clinic setting.

[00:09:38] And that ranges, orthopedics is a specialty. You've heard me say that now many times. We service, I think, 13 or 14 different specialties. Primary care, now thanks to AI, is starting to really take off. We've got several hundred primary care physicians on the platform. Expect that to expand significantly this year. But we're also going to continue to stay focused on the specialists because that's a booming market. You're seeing a ton of consolidation in that space in particular.

[00:10:05] A lot of our customers that were 100-ish physicians when we started are now 300-plus statewide in states like Florida and Georgia and Texas. And so we're benefiting from those industry tailwinds. That's awesome. Man, that's really great, Pat. Thanks for the clarity. And it's just as important to know who you serve and who you don't. I remember I used to work at Metronic. And I remember listening to the CEO. And he spent, he had like 20 minutes on a panel.

[00:10:32] He spent like 10 telling people what we didn't do. Just because it's super important. And you did just that. So I think it's an important leadership quality to have that focus. And glad that all of our listeners know that now. That's right. So what's one thing most people don't know about the problem you solve? Yeah. I think, again, I think there's a misnomer that generative AI is sort of the silver bullet, right? That's just a powerful tool that has to be utilized correctly.

[00:11:01] I like to compare it to a power saw, right? Like it's all kinds of amazing power tools or pick your example that you really have to know how to use that, how to deploy it correctly. It takes the right support team and other tools to use these things correctly. And I think that's what we understand as well as anyone. I'll give you a walkie through a quick example of that in orthopedics. It's not just either about the in-room exam, exam conversation. That's not where the whole visit takes place, right? There's an intake component.

[00:11:31] You've got to be able to serve up everything that happens at that, at that during that intake and triage process. So the physician knows exactly why the patient's there and what's going on before they go in the room. Also, before they go in the room, the physician's going to be standing in front of typically a x-ray MRI reading machine. They need to be able to dictate in a verbatim fashion very explicit information for billing purposes about that image. They need to be able to state whether or not that image was captured on site. They need to state how many views of the image were captured.

[00:12:00] Again, this is not an ambient conversation. It's really thinking of it more of a real-time transcription. Then when they go in the room, that's when it gets – things can go off the rails. It gets a lot more organic, just like the conversation we're having now. Sometimes it's two people. Sometimes there's a spouse in the room. Sometimes there's an interpreter in the room. There's a lot going on in that room. Oh, by the way, the recording is just running from when they started out at the x-ray. Then they're going to fly out of the room when they're done with the in-room component because they're going to see 60 patients in that day. So these are very fast, quick interactions.

[00:12:31] And then outside the room, they're going to go back into more of that verbatim mode of barking orders at the AI, telling it, okay, this is exactly what we want to do next from an assessment plan perspective, what the next steps are, orders that need to be captured. And then they're also going to throw in a few normals or macros, which are standard exams with often variables in those macros, if there's any abnormals that need to be changed within the macro itself.

[00:12:57] So all of that has to get captured, is sent to the cloud, is processed, and then has to show up in very explicit, discreet areas in the EHR in 20, 25 seconds. And that's what we're able to do with great accuracy, consistency, quality for these busy, high volume, high production environments. And that's just, that is not an easy thing to do. And we, again, myself and my co-founder, we stay very close to these customers. We're involved in implementations and go live still because that's where we learn.

[00:13:26] That's where we get the insights. We really understand what's working and what's not. We hold ourselves to a high standard to that. Well, that's a nuance that those are nuances that really help you appreciate the depth and the richness of the experience that you and the iScribe team has. So thank you for sharing that. Sure. Well, we like to learn from successful people, Pat. So what would you say is your favorite business resource or business hack that you'd recommend to our listeners and why? Yeah, that's a great question.

[00:13:55] I think if I had to pick the one thing that's really served us well over the years, and we've started this about five years ago, about three years into our journey, we settled on a framework for running and managing our business called EOS, which is the Entrepreneur Operating System. And it's just been a game changer for us. I mean, in terms of just organizing everyone, shared vision, shared mission and goals, objectives, there's an annual, quarterly, weekly meeting cadence.

[00:14:22] But the most powerful part of EOS is the rock setting. So you're divvying up your annual goals into 90-day rocks. You're really living in these quarterly or 90-day windows where it's like you're just laser focused on moving and achieving these rocks departmentally. Everyone has them. I have my own 90-day rocks. The whole executive leadership team does, as well as everyone, all the other teams in support of that, all aimed at the same overarching company objectives that we're trying to achieve. And so it becomes this common language.

[00:14:52] It becomes this common framework that everyone has high visibility and is dialed into, and it just keeps us on track. We meet weekly as a team that are called L10 meetings, and these are where we go through, which 90% of the time is focused on what's called IDSing, identifying, discussing, and solving issues. Like, that's all that matters. We don't just drown ourselves in repetitive information. It's like the scoreboard is there. We review it quickly. Then we jump into what's the most important issue of the day.

[00:15:20] We try to solve as many of those issues as we can with all the leadership teams sitting around the table, and anything that doesn't get solved gets bumped to the next week. And then at the end, which is cool, the reason why it's called an L10 meeting is everyone rates the meeting. So it's 1 out of 10. So if somebody thinks the meeting sucks, then they have the freedom and flexibility to say it sucks. As we all know, a lot of meetings can suck. And if it's a 4 or some weeks. But you've got to say why, though, right? Like, you can't just give a number. Totally. Yeah. And believe me, we have meetings that suck sometimes.

[00:15:49] And it's usually because we're distracted or we're not focused. We go down rabbit holes. And I think we hold ourselves accountable on that, which is easy to do, depending on the issue of the day. Oh, yeah. For sure. But more often than not, I would say we average nines and tens because we've gotten better at the... We've grown in the process a lot. Early on, we have a lot of fours and fives and sixes. But, yeah, I would say... That's great, man. No, and there was a book that I read, and it was about the integrator. Yeah. And the... There's the Traction book, probably. Traction. That's the one.

[00:16:19] That's the one. That's the one. So that's usually the relationship between the visionary, which I... Right, wrong, or indifferent. I've been dubbed the visionary, which I still... It's kind of a weird... But, yeah, I'm a born-without-a-break pedal, ready-fire-aim guy. And luckily, my co-founder, Justin, he is truly an integrator, has the... That's really great. Oh, yeah. We complement each other very well. Very well. Yeah. I love it. If you guys haven't read that book, definitely recommend it. But also... And we'll link it up in the show notes. But the EO framework sounds really interesting. Yeah.

[00:16:48] Definitely have heard about it before. Yeah. And I love frameworks. So definitely one that we should all look into. So thanks for that, Pat. Absolutely. Look, we're here at the end, man. This has been a lot of fun to connect with you and chat. Can you give us a closing thought? And then the best place where the listeners can get in touch with you and the team? Yeah. Closing thought is thank you for having me on. This has been fun. This market is, again, my takeaway from this week at Vive is just how massive this market

[00:17:15] is and just how amazing the next three to five years are going to be in particular. Like there's going to be just a lot of just continued rapid change. And we're super grateful just to be in the mix, right? To have this opportunity is just a lot of fun. And it only took 10 years to get here. And yeah, iScribeHealth.com is the best place, our website. And then yeah, feel free to look me up on LinkedIn. Pat Williams, iScribeHealth. Shoot me a note. Happy to connect. Love it. Pat, thank you very much.

[00:17:43] And folks, check out the show notes where you'll see the ways to get in touch with Pat on LinkedIn. Check out his website to meet him and his team. Now's the time. You heard the different series of the business and their depth of expertise. So I think this is a company and team you're going to want to sync up on if you want to do scribing within your practice. So check them out. And Pat, thanks for joining us. Thank you, Saul. Appreciate it.

[00:18:18] This podcast is produced by Outcomes Rocket, your healthcare exclusive digital marketing agency. Outcomes Rocket exists to help healthcare organizations like yours to maximize their impact and accelerate growth. Visit OutcomesRocket.com or text us at 312-224-9945.