Abridge's Shiv Rao: The Doctor Founder Taking On Microsoft In Healthcare AI

**Shiv Rao** (0:00)
My wife and I went through, she is the main character, me as the family member, three years of IVF with PGD.
I'd go to every single visit with her, I'd be there, and the doctor, the counselor would leave, and we'd look at each other and be like, what did they just say? Like, what are we supposed to do? And I'm a doctor.

**Alex Konrad** (0:16)
Doctors and clinicians are burned out, and their patients don't understand what they're being told, which means whatever it is, they're probably not going to do it. At the same time, the US healthcare system is drowning in paperwork. To the tune of $1.5 trillion in healthcare, the US healthcare system is going to have to spend $1.5 billion every year. Today, we're talking to a founder who's trying to bridge those two problems. His startup Abridge is building an AI operating system for healthcare, and in 2025, it was valued at $5.3 billion.
More recently, Abridge announced partnerships with Eli Lilly and Nvidia, and it works with more than 300 healthcare systems. Founder and CEO Shiv Rao is a practicing cardiologist even to stay. He says Abridge's values help define its positioning.

**Shiv Rao** (0:57)
All companies need to have one strong idea at least that they hold tightly to, and that's the North Star. Otherwise, especially in healthcare, you get blown in so many different directions. When you're at scale as we are, there's also so many opportunities. There's a lot of low-hanging dollars. We want to make sure that we're going after the dollars that build trust. We're not going to put ads into that workflow that sacrifice trust.
We are always going to be in service of delivering a better experience and a better clinical outcome. We want to be deflationary. We want to save time, save money, save lives.

**Alex Konrad** (1:29)
Today on The Upstarts Podcast, we're going to talk about how to position your startup against the Microsoft giant, the three phases of AI companies and health, and how to create a category, then compete as it gets crowded too. Plus, by finding scale in the healthcare system is like eating glass and kissing a bunch of frogs.
I'm Alex Konrad, founder and editor of Upstarts Media, and this is The Upstarts Podcast, our weekly show where we talk to startup founders who are punching above their weight to take on the status quo. Shiv, thanks for joining us on the show.

**Shiv Rao** (1:59)
Thank you, super excited to be here.

**Alex Konrad** (2:00)
Now, should I say Dr. Shiv Rao, because you are a practicing physician as well, right?

**Shiv Rao** (2:04)
Yeah, yeah, I guess so. Weekend of the month, not much.

**Alex Konrad** (2:06)
This episode is brought to you by Rippling AI, the only AI built to give you full visibility into your startup and the ability to take action across every department. So Shiv, in a nutshell, what is Abridge doing for doctors, patients, your customers?

**Shiv Rao** (2:20)
Yeah, we're using AI to bring doctors and patients closer together. That's it in a nutshell. We're trying to do all the work behind the scenes that would allow them to just focus on each other, and it allows us to save time, save money, and really save lives too. Healthcare is a huge industry. It's like 18 percent of GDP, and we are building the AI layer for healthcare. Where we've started is healthcare delivery, because when you think about the pain points there, clinicians are burning out, doctors, nurses don't want to be doctors anymore. Patients can't understand what's going on, much less follow through to be the healthiest versions of themselves.
We're wedging in to the moment, the sacrosanct moment between them, to help both sides of that room. Where we've started is that conversation. We believe that it's computable and that you can build a platform on top of it.
We started out helping clinicians with clerical work like notes, placing their orders, doing accounting, doing billing, what they call revenue cycle. But now, we're also helping with clinical intelligence, with decision support, so that they can practice at the top of their license, as they say, so they can not only deliver a better experience, but also hopefully deliver a better clinical outcome.

**Alex Konrad** (3:32)
Should we be thinking about Abridge as a software business, as some sort of operating system? I know you resist the idea of being an AI scribe, but how should people think about the output of what Abridge is doing?

**Shiv Rao** (3:44)
Yeah, I would think about us as an AI-native company for health care. All of us have probably seen the doctor, or we've had a family member who's seen a doctor at some point in the recent past, and you're in that room, and sometimes those doctors are stressed out, sometimes they're not making eye contact, their back is towards you because they're typing and doing all this other work that they're asked to do that actually distracts them from delivering the best possible care.