Instead, Dr. Rao (or Shiv — as everyone from his inner circle to newest customers calls him) greets you with a calm, measured presence. His words are deliberate, each thought separated by a considered pause. It’s a demeanor that combines the bedside manner of a physician with the strategic vision of a founder, a blend that has become central to Abridge’s success.
Dr. Rao is a practicing cardiologist who has spent time on clinical documentation improvement committees (where he grew accustomed to physicians’ “thousand-yard stares”) and in hospital system innovation (he previously led the provider-facing investment portfolio for UPMC, where he invested in startups). He established Abridge in 2018, and the company has since emerged as a leader in generative AI for clinical documentation, a promising platform in a healthcare system struggling with clinician burnout, administrative burden, access problems, and increasingly the cost and complexity driven by incomplete, inaccurate and uncontextualized patient conversations.
Healthcare has long grappled with managing the low-value work that falls on clinicians. The American Medical Association calls its initiative to cut unnecessary tasks “Getting Rid of Stupid Stuff.” Physicians have their own term for the hours spent charting and closing notes at home, often in loungewear: “Pajama Time.” Despite well-meaning initiatives and heralded tech solutions, many health systems found that attempts to reduce physicians’ administrative burdens often just shifted the workload around instead of eliminating it. The result? The core problem persisted, with clinicians still weighed down by clerical demands.
Abridge offers a different outcome, with generative AI that listens to clinical conversations in real-time, automatically turning them into accurate, billable medical notes. “In this case, it actually didn’t shift any work anywhere,” Matt Kull, Chief Information and Digital Officer at Inova Health System, said. “It really just eliminated keystrokes from the actual clinician. There are no shifts in work. What we’re seeing is that this just makes the primary user more efficient.”
Inova is one of Abridge’s newest partners, underscoring the company’s growing reach as it transitioned from providing generative AI tutorials for health system executives just a few years ago to serving more than 100 health systems and their physicians, including Memorial Sloan Kettering Cancer Center, Mayo Clinic, Johns Hopkins Medicine, Duke Health, UNC Health, Christus Health, UChicago Medicine, Endeavor Health and Akron Children’s.
The company isn’t stopping there. While Abridge has ample opportunity to penetrate the physician market and significantly improve doctors’ workflows, it is also setting its sights on transforming documentation for nurses. Unlike physicians, who typically document in a narrative style, nurses rely on discrete forms, cells and flow sheets — a distinction that makes off-the-shelf solutions inadequate for their needs.
Since last summer, Abridge has been working with Mayo Clinic and Epic on a generative AI ambient documentation tool specifically tailored for nurses. Mayo Chief Nursing Officer Ryannon Frederick describes it as a rare example of technology designed not just to supplement nurses’ work, but to genuinely make their jobs easier.
“It’s hard for me to think of one piece of technology that actually made it easier for nurses to provide care for patients,” Ms. Frederick said. Many past solutions inadvertently shifted administrative burdens onto nurses, turning technology into just another task, but this collaboration took a fundamentally different approach. “It’s not Abridge building a tool that Mayo then tests,” she explained. “It’s Mayo nurses working side by side with Abridge and Epic,” ensuring the technology is built from the ground up to align with real-world nursing workflows.
Abridge’s work with nurses is a sign of its larger ambitions, which recently attracted a $250 million Series D funding round, underscoring investor confidence in the company’s vision and momentum. The capital, led by Elad Gil and IVP and boosting Abridge’s valuation to $2.75 billion, will fuel additional development of AI capabilities and commercial growth. The San Francisco-based company recently appointed Sagar Sanghvi, former CFO of Instacart, as CFO. He joins a leadership team with deep tech expertise both within and beyond healthcare. COO Julia Chou, Chief Product Officer Mario Queiroz and General Counsel Tim Hwang all share tenures at Google, while Chief Technology and Science Officer Zack Lipton, PhD, is also an associate professor at Carnegie Mellon University in Pittsburgh. Chief Commercial Officer Brian Wilson is a healthcare industry veteran.
“I think what our investors have perceived is that we’ve got a group of people who are really committed to this idea that we can make a profound difference in healthcare,” Dr. Rao said. “AI is just an incredible tool, and that what we’re building right now is really the most initial wedge into a much larger opportunity to improve experiences, to improve outcomes and to lower costs over time.”
Abridge is a company driven by rigor. Dr. Rao and his team welcome demanding pilots, high standards and candid feedback. With support for more than 28 languages and 50 specialties, they are fueled by seeing their technology excel in highly specialized settings, from pediatrics to oncology to behavioral health. The team is eager to work not just with large or academic health systems, but complex ones.
“Their focus on clinical rigor and long-term potential really set them apart,” said Justin Brueck, system vice president of innovation and research at Endeavor Health, based in Evanston, Ill.
This meticulous approach is shaped by a culture of persistence and “eating glass.” Early on, Abridgers joked about being ‘hope camels,’ surviving on a single drop of optimism through the next desert of challenges. Eating glass became their metaphor for building resilience by embracing difficulty. Dr. Rao recently reflected on a talk by Nvidia CEO Jensen Huang, who told Stanford University students he wished them “ample doses of pain and suffering” because adversity builds character and fosters resilience. “It’s a hilarious talk and so profound at the same time,” Dr. Rao said.
Dr. Rao’s dual roles as a CEO and practicing physician keep Abridge grounded in clinical realities. “I’m an end user myself. Just last night, I was on call at the hospital, and I still take a weekend shift every month,” he said. This perspective informs Abridge’s core philosophy: delivering technology that doesn’t just add to clinicians’ workloads but actively lightens them. “We’re not just building tools for healthcare; we’re building tools that I want to use myself,” Dr. Rao said.
This alignment of mission and execution is not lost on partners.
“His involvement has been incredible,” Mr. Kull with Inova noted. “There’s never been a moment that Shiv was not available to talk about a feature or function set or something that we wanted clarification on the roadmap or where his vision was going. He has not only a keen interest in his business, but he has a keen interest in physicians as a whole — he wants their lives to be better.”
At Inova, reducing “pajama time” was the key KPI in its head-to-head, six-month assessment of Abridge. Mr. Kull explained that the system operated on the principle that if pajama time went down, more benefits would follow. With Abridge now available to more than 1,000 physicians in its Virginia and Washington, D.C., service area, Inova is seeing more notes closed the same day and patient visits trending upward.
At Duke Health, which recently expanded Abridge to 5,000 clinicians, Chief Health Information Officer Eric Poon, MD, shared how the tool allowed him to leave the clinic with his documentation complete — something he hadn’t achieved in years.
Endeavor Health saw similar success. Initially, a small pilot with physicians was set to run for six months, but according to Mr. Brueck, the choice to scale came sooner. “Three months in, we were basically in a position to say, ‘We definitely think that there is an opportunity here to scale.'” Early surveys showed a 100% increase in clinicians’ ability to give patients undivided attention, with over 60% reporting improved work satisfaction. “That’s phenomenal,” Mr. Brueck said.
Abridge’s adoption at Akron Children’s has been particularly transformative in pediatrics, where patient interactions are often nuanced, noisy and involve multiple family members. The tool’s ability to filter out background noise, distinguish between voices, and focus on critical elements of clinical conversations has made a noticeable impact on the clinicians in Northeast Ohio.
“It’s like being able to make eye contact again,” said Akron Children’s CMIO Dr. Sarah Rush. The system had tried numerous solutions to lighten physicians’ administrative burdens, but most provided modest relief or only shifted the work around. “I went into this thinking perhaps [Abridge] was going to be somewhat different, but I don’t think myself or anybody on my team had the awareness that it was going to be as impactful as what we have seen,” Dr. Rush said.
Physicians at Akron Children’s also noted how the tool preserves the human aspects of care. “One of our GI doctors talked about being able to sing songs, and it doesn’t end up as part of the documentation, but it’s part of the visit,” Dr. Rush explained. “The tool recognizes the things that are part of what makes us human and how we interact, but doesn’t necessarily need to be part of the medical documentation.”
For many health system leaders, Abridge’s strongest appeal lies in its physician-first design. With the U.S. facing a looming capacity crisis from the “silver tsunami” of aging Baby Boomers, the administrative burden on physicians has become increasingly unsustainable. Abridge’s ambient AI tool offers a rare win-win: it not only lightens clinicians’ workloads but also enhances billing accuracy, creating a self-sustaining flywheel of efficiency and revenue generation.
The company’s new Contextual Reasoning Engine leverages clinical, payer, and revenue cycle data to generate documentation that is both clinically meaningful and billing-compliant. In an environment where nearly 37% of U.S. hospitals are operating at a loss, a tool that can optimize billing processes and reduce denials is not just advantageous — it’s critical. The engine ensures Abridge’s technology is as financially strategic as it is transformative for clinicians’ day-to-day work.
“This tool is really about allowing clinicians and their health systems to get full and accurate credit for the care that they delivered,” Dr. Rao explained, noting the engine works quietly in the background, preserving a physician-first approach. “When you compare the outputs with this type of technology in place versus the outputs without,” said Dr. Rao, “to the clinician’s eye, it might not — off the bat — look and feel very different. But to the coder or the auditor’s eye, it’s night and day.”
Dr. Rao connected the tool’s purpose to his own past experiences on clinical documentation integrity teams at a large health system. “We would go from department to department and do these lunch and learns, trying to teach doctors with PowerPoints and pizza how to write not just the clinically useful note, but the billable note — how to think about medical decision-making criteria for their level of service coding or how to think about HCCs in relation to risk adjustment if they’re a primary care clinician,” he recalled. “Every single one of those doctors would have a thousand-yard stare, because they just want to get back to delivering care for their patients.”
The financial implications are significant. At Endeavor Health, physicians who used Abridge for more than half of their documentation saw a 14% increase in work RVUs and nearly 20% reduction to time spent in notes per day.
“We often talk about the fact that this is not about making providers have to see more patients. This was actually, in many situations, just better documentation,” said Mr. Brueck. “If you can extrapolate that across the system, it’s a large opportunity to offset the cost of these technologies.” He noted that if at least 25% of physicians use Abridge, the system will be well-positioned to “more than recoup the cost” of implementing the technology.
At Inova Health, the financial benefits were equally clear, even though they were not the No. 1 driver for the tool. “I have data that shows that this was not an additive cost because of the backside benefit,” Mr. Kull said.
At Mayo Clinic, the system is rolling out the ambient AI documentation tool for nurses, live in seven units as of early March, with high rates of adoption so far and the intention to scale it wider. “We’re starting conversations about how we expand beyond the walls of Mayo Clinic,” Ms. Frederick, CNO of Mayo, said. “That was really important to me as we partnered with Abridge and Epic — I don’t want this tool to be a solution for Mayo Clinic nurses only. I really want this to be a solution for nurses.”
This broader ambition speaks to Abridge’s disciplined approach — one that favors depth and precision over quick wins. While AI has generated considerable hype across industries, often favoring style over substance, Abridge stands out for taking a meticulous and methodical path.
“There’s been a quote in my head these last few days by Charlie Munger,” Dr. Rao said. “He says, ‘Number one: take a basic idea, and Number two, take it very, very seriously.'”
Making clinical documentation smarter and easier is anything but basic, but it is everything to Abridge.
“We’re going millions of miles deep on this idea,” Dr. Rao said. “For us, precision, accuracy, trust — these aren’t just features. They’re existential. It means we won’t overpromise, we won’t pitch ahead of our skis, and we won’t tout product features we haven’t built and thoroughly tested. That approach, to me, is what I always wanted to see when I was on the other side.”