Ask any health-focused VC to name one of the top AI startups, and one name comes up again and again: a Pittsburgh-based company called Abridge. And it’s a startup that started before OpenAI became popular and LLMs entered the Valley’s common vocabulary.
In 2019, Shiv Rao, a practicing cardiologist, pitched Andy Weissman, general partner at Union Square Ventures, to a startup idea. Rao called it SoundCloud plus RapGenius for medicine.
While Weissman thought it was a little humorous to compare a nascent AI-powered medical notes app to hosting music and transcribing lyrics, the idea resonated with him.
Rao explained that doctors spend up to two hours a day—usually outside of normal work hours—typing notes that summarize what was discussed with their patients that day. Such administrative tasks have been burning out doctors for years, leading some to leave the profession altogether. Rao convinced Weissman that the latest innovations in artificial intelligence could dramatically reduce the time doctors spend on the ever-increasing burden of paperwork.
This was years before genetic AI took over the world and captured the imagination of VCs.
“It was a very strange idea. No one had done it before,” Weissman said.
But Weissman and other USV colleagues liked the fact that Rao was not only a doctor at the University of Pittsburgh Medical Center, but also spent half his time as a corporate entrepreneur for that health system, investing in health technology startups. Rao’s employees and advisors were also alumni and faculty at Carnegie Mellon, one of the top institutions in the country for engineering and artificial intelligence research.
“[Shiv] he had that rare combination of talents: an entrepreneur with a very ambitious vision, with a really interesting team,” Weissman said. “I felt unique.”
Abridge also had a basic transcription product that doctors could download for free to their smartphones and start using in their interactions with patients. Their use formed the basis of Abridge’s LLM.
A little more than five years after USV led a $5 million seed round in Rao’s startup Abridge, the company has become one of the most talked-about and fastest-growing AI healthcare businesses.
Although most companies are still very cautious about adopting AI tools, large medical systems are eager to sign contracts with Abridge.
“The sales cycle for [health systems] it could be 18 to 24 months,” Rao said. “When we started the company, we knew what we were in for.” But with a four-year lead on a virtual writing product trained on thousands of doctor-patient conversations, and now that artificial intelligence is booming, hospitals are suddenly buying Abridge at a rapid pace, in stark contrast to their typically protracted buying behavior. The company has announced a new health system client nearly every week since early 2024.
“We had built up all this momentum that became kinetic almost overnight in January,” Rao said. “University of Chicago, Sutter, Yale, Lee Health, Christus, Emory and the list goes on and on,” he said.
Major hospitals not only buy multi-thousand seat licenses of Abridge, but in many cases publish glowing reviews about how the health technology software is changing doctors’ lives. Hospital officials and doctors describe Abridge as “Life changes“, “magical,” and “one of the most significant paradigm shifts in our careers.”
One of the biggest criticisms of genetic AI is that it still has few meaningful business applications. But taking virtual medical notes appears to be a valuable application of the new technology.
Drowning in bureaucracy
“I have professional PTSD and war stories about seeing patients and then spending hours and hours at night writing notes and doing all this paperwork that really distracts from the most important thing, which is your patient, but and it takes away from your personal life,” Rao said.
With Abridge registration in the background, a physician can focus solely on the patient without having to worry about filling out specific fields in the medical record during the visit.
The payback of AI-powered medical scribes is very easy to measure, he says Dr. Lee Swam, chief digital health officer at Yale New Haven Medical System, an Abridge client. That’s why so many health systems are flocking to use them, especially Abridge. . “It’s one of the hottest products in the AI space right now,” he told TechCrunch.
As with many administrative things in health technology, when it comes to choosing a vendor, the most important considerations are price and integration with Epic, an EHR used by most major health systems in the US, Schwamm said. Abridge, which supports 14 foreign languages, including Haitian Creole, Brazilian Portuguese and Punjabi, is often the winner when health systems compare it to other AI-powered doctors, Schwamm said.
Earlier this year, Abridge acquired the right to be ibuilt into Epic. After Umbridge records a session and a doctor stops the recording, “there’s a note in English sitting inside Epic waiting for them to quickly verify it, edit it and adjust it as they see fit,” Rao said.
While Abridge appears to be ahead of its competitors, which, in addition to Microsoft-owned Nuance, include Ambiance, Nabla and Suki, Schwamm isn’t sure it will be able to maintain its lead in the long run.
“The big question is, do you need a specific medical LLM to succeed in this space?” asked. “Or will the giant foundation models, GPT-4o, Google and Meta, get so good that they could absorb an entire set of medical notes and start delivering similar performance?”
This line of research shows that these are still early days not just for virtual medical note taking, but for most AI companies being created. The pace of innovation is fast and furious, and today’s winners could easily lose their lead.
“Umbridge is well ahead, but it’s early in the race,” said Schwamm, “A horse can knee badly and stumble, or it can keep going further and further ahead.”
For now, most TechCrunch investors agree that Abridge is leading the AI medical scribe race. Because of this, money has fallen on the company.
In February, Abridge raised a $150 million series led by Lightspeed Ventures at a valuation of $850 million.
