Shiv Rao, MD
Gary Barg: Dr. Shiv Rao, you have a very interesting background for an entrepreneur. Can you share it with us?
Dr. Shiv Rao: I first got into technology, then, the arts. Then, I became a cardiologist and that pivot came about, because when I was an undergraduate, I heard a story about an ophthalmologist who had given eyesight to millions of people using a clever innovation that helped him perform surgeries as a pay-as-you-can service. That had a huge impact on me to create technology to help many people.
So, now I aspire to live at the intersection of creativity, technology and healthcare. I also spent some time as a healthcare technology investor. My job was to find interesting companies doing good things for people and invest in them. I recently quit that job and my position as a cardiologist at a local academic hospital to focus on my new company called abridge.
Gary Barg: Why did you start your company and what is abridge?
Dr. Shiv Rao: In March of 2018, I saw a patient with a 10-year history of breast cancer and she was very anxious and nervous the whole visit. At the end of the encounter I asked her if there was something I did or said to make her so very anxious. She told me that since her initial diagnosis of breast cancer her husband has come to every single encounter. He would sit in the corner generally and take notes and he couldn’t be there that day. So, she was nervous and yet so very eloquent. She’s an English professor at the University of Pittsburgh and told me that it seems as if the whole hospital system has been designed to strip her and other patients of their dignity.
She told me that him taking notes meant she could feel liberated to be present in the conversation knowing that they could go home and research all of his notes, Google them, learn about all the different medical terminology that was discussed, and then rewrite their story in a different notebook in their own words with the idea that they could go to the next clinician feeling like the main characters of their health story as opposed to someone looking in from the outside.
Everything that her husband did in the corner of the room for her is what abridge is trying to automate for every patient by using cutting edge technology.
Gary Barg: So, this is actually a caregiving challenge that abridge is trying to help us with, as we sit in our doctor’s appointments trying to figure out what part of it we’re going to remember.
Dr. Shiv Rao: That’s exactly it. We want to help people remember the details, empower them and enable them to share them with others in their network. So much of healthcare is about understanding your story and staying on the same page with your caregivers and clinicians. We’re trying to help make that easier for people.
Gary Barg: How do caregivers use abridge?
Dr. Shiv Rao: With abridge, patients and caregivers can flip the script on the clinic. We can use the app on our phones to record our healthcare encounters.The technology automatically not only captures the audio but also creates a transcript which pulls out the most important medical moments from those conversations.
We tried to design this to be as simple as possible. You can just go to the App Store whether it’s IOS or Android and download the app. Then, there’s just one big button and to start recording, you press it. The technology will automatically pull out the key parts of the conversation because we learned in our research that few people will go back to a 30-minute encounter with a clinician and listen to all of it again.
We can all benefit from relistening to the moments that actually matter. All you have to do is tap on the part of the conversation—like the transcript—and you’ll immediately be able to listen to the associated audio. We can share that transcript—that audio—with our family members, caregivers, clinicians, and with everybody on our care team. So, that’s the app in a nutshell.
Gary Barg: I’m wondering if clinicians are comfortable with being recorded. As a doctor, you’re probably in the best position to tell us that.
abridge
Dr. Shiv Rao: I’ve been telling my patients to record for the last two years. We have a strong cadre of clinicians already who support recording and support putting the patient at the center. There are clinicians who will say, “Please just record the last few minutes” and we think that’s totally fine. In fact, we think letting the clinician know that you want to record bolsters trust between clinicians and consumers. But in the end, this app is about creating agency for caregivers and patients. It’s about autonomy. It’s about ownership and it’s about dignity.
Gary Barg: Dignity is the word. It levels the playing field when you’re sitting in that office with the doctor and you’re afraid to ask questions or you’re afraid to say you don’t understand.
Dr. Shiv Rao: That’s exactly right. I’ve had so many interactions with patients where I give them a new diagnosis and you can tell that they don’t hear anything after that moment. Of course, it’s human. You sort of go to a different place.
I write notes that go into the electronic medical records, but the overlap between what I document for billing purposes, and for communicating with other doctors, and what I say to my patient is actually very little. Abridge also helps clinicians ensure that the patients can have an ability to go back to what they recommended.
Gary Barg: Shiv, what is the one most important piece of information or advice you would like to share with family caregivers?
Dr. Shiv Rao: Keep sharing stories because stories connect us together and caregiving is so much about connection. I use the word “stories” also when we talk about healthcare encounters whether it’s recording and documentation because framing healthcare as about stories. And we think that can help transform our journeys from being about patient-hood or caregiver-hood into being about personhood.
And again, as we discussed, it’s really about dignity.