Zach Lipton

They have to document a complete inventory of all the medications that the patient is on and what, if anything, has changed.

They have to write a patient facing after visit summary that is duplicative in its contents, but reformulated specifically to be the subset of things that are like, don't forget this and you must take these action items.

So those are part of the plan, but they're written a little bit differently and a slightly different maybe like tone and assumed level of like reading level or understanding of medical jargon.

So doctors, they also have to enter the medication orders.

They have to affix billing codes to particular problems.

And it have to be, if they attach a billing code because they're billing for treatment of a problem, they better have documented details for each one.

So it's this colossal tangle.

paperwork that the doctors are accountable for.

The idea of a scribe, a human scribe, in the first place is that you have someone in the office who is basically like your note taker.

And while you're attending to the patient and thinking a little bit more first principles, they are busily writing out all their notes and then digitizing them for you.

And very often, like in a teaching hospital, they might make, you know, when possible, make some of the trainees do some of the scribing for patients.

for the attending and more senior doctors, remote scribing services started as a sort of very, very often like a kind of like record the audio with a conversation.

And there's a human listening in a call center and basically trying to do the same thing, often with a much longer turnaround for the notes and maybe with lower quality.

They also have less signal because they have the audio signal, but they didn't see what was going on.

These services, they just wouldn't scale.

Doctors who could afford them, you know, you're very well paid, like, you know, you're kind of like highest compensated specialties, you know, to get that yoke of clerical work off their neck.

It might have been worth it, but the lion's share of doctors couldn't afford it.

We're talking like $20,000 per doctor per year.

It was a kind of extreme expense for these sort of like remote human-in-the-loop scribing services.

So they weren't, the vast majority of doctors never had the benefit of a scribe, even though like for the subset who did, it was kind of a big business.