In this episode of HealthTech Remedy, hosts Dr. Tim Showalter, Dr. Paul Gerrard, and Dr. Trevor Royce dive into one of the most persistent frustrations in modern medicine: the burden of the Electronic Health Record (EHR). We sit down with Craig Limoli, Co-founder and CEO of Wellsheet, to discuss how his company is tackling the dreaded "pajama time" - the hours physicians spend charting late at night - not by replacing the EHR, but by fixing how clinicians interact with it. If you’ve ever felt buried under thirty open tabs while trying to find a single lab result, this conversation is for you.
Craig breaks down Wellsheet’s unique approach as an intelligent "layer" that sits on top of existing systems like Epic and Cerner. We explore how their predictive workflow technology consolidates fragmented patient data into a single, intuitive view, and discuss their game-changing partnership with UpToDate that brings clinical guidelines directly into the decision-making process. The discussion also covers their latest AI advancements, including an agent that allows doctors to "chat" with a patient's chart to retrieve data instantly and features that automate inpatient documentation to save hours of manual work.
Finally, we look ahead to the "healthcare utopia of 2030." We discuss why smarter collaboration tools are essential for solving the looming clinical workforce shortage and how responsible AI can reduce burnout while improving patient safety. Whether you are a healthcare executive, a practicing clinician, or a tech enthusiast, this episode offers a pragmatic look at how intelligent workflows are reshaping the future of care delivery.
Episode Resources:
Introduction and Hosts
Dr. Tim Showalter: Good afternoon.
Dr. Paul Gerrard: Hey.
Dr. Trevor Royce: Hey, guys. It's good to see you. It's a great time of year. College Hoops is in full swing.
Dr. Tim Showalter: Yeah, UVA is having an unexpectedly good year this year.
Dr. Paul Gerrard: And I just wanted to say, Riverside put me in the chat at the same time, put the rest of you guys this time.
Dr. Tim Showalter: Oh, man. You're actually on time. That's amazing. I don't know how you got there from basketball, but that's fine.
Dr. Paul Gerrard: I was just so excited.
Dr. Trevor Royce: It was a first time for everything.
Dr. Tim Showalter: It was like the slam dunk of podcasting.
Dr. Paul Gerrard: Technology works.
Dr. Trevor Royce: That's how we pass the ball around here.
Dr. Tim Showalter: Yeah. How about I alley-oop to you, Paul, for a closing line?
Dr. Paul Gerrard: Well, we're about to talk about a company that spends its time trying to fix a problem that I think the three of us ran away from, medical charting.
Dr. Trevor Royce: I can't wait to talk about Wellsheet. Definitely going to dunk on Paul in this one. Welcome to HealthTech Remedy, the show where three physician leaders in health technology tell the stories of new and established companies and interview leaders from the industry. I'm Trevor Royce, radiation oncologist and a researcher with experience in real-world evidence, informatics, and AI diagnostics.
Dr. Paul Gerrard: And I'm Paul Gerrard. I started off as a physical medicine and rehabilitation physician before focusing on reimbursement policy, molecular diagnostics, and market access for AI products.
Dr. Tim Showalter: And I'm Tim Showalter, a radiation oncologist and prior med device entrepreneur who is now focused on bringing AI advances to cancer patients.
The Burden of Electronic Health Records (EHR)
Dr. Trevor Royce: Today, we're going to be talking about a company that has been making a real dent in one of the hardest problems in healthcare, and that's clinician workflow and documenting that workflow. This is not about just another, quote, dashboard workflow. This is an actual workflow. Painful reality that clinicians live every day, navigating the EHR, where you've got 30 tabs open, you have six different systems, your PACS system, your EHR, your scan documents for your EHR, your lab system, and you're trying to pull it all together to tell the story of the patient that you are getting ready for or have just seen. And these guys are trying to solve that riddle.
Dr. Paul Gerrard: I don't know how it has been for you guys, but I was rounding and you're thinking, hey, can you just pull up the CT from last month? Sure, if you're in the radiology suite already in the PACS system, logged into the patient, it's easy. But when you're out on the floor, that's when you have to start bargaining with the universe. So we're looking at a company trying to solve that.
Dr. Tim Showalter: Well, Paul, I will tell you, as a radiation oncologist, your first mistake was going into a specialty where you actually had to round. We have the luxury of staying in the outpatient center, but the pain is also there for us. I think there's a lot of switching across medical records for me in particular, seeing patients who have a long history that may be buried in various corners of the medical record. And that's a real pain point and source of frustration and frankly, burnout as well. Today, I think we're all excited to talk about Wellsheet, founded by Craig Limoli, who will be joining us later for the main interview. I think it'd be good for us to sit down now and chat a little bit about the company and just give our listeners a little bit of a preview for what they'll hear from Craig.
Dr. Trevor Royce: We've covered a little bit of this, but starting with the problem that they're trying to solve. The average clinician is spending an incredible amount of hours with the EHR. In fact, you hear stats like two to four times as much time is spent staring at the computer than actually interacting with a patient. A lot of this is obviously the documentation or charting or searching in the chart about a patient than it is actually dealing with a patient in front of you. There's a lot of thought that that contributes to things like burnout, dissatisfaction, and removing the human element in healthcare, which is why most providers have entered to get that human satisfaction. It depends on the specialty. Some specialties have this even more so than others.
Dr. Tim Showalter: Well, the metric people use, Trevor, is pajama time. That is so the metric people use, Trevor, is pajama time. That is so depressing. People talk about how much pajama time they're saving for charts, but the fact that that is even such a reality in healthcare that it exists as a term is just frankly depressing.
Dr. Trevor Royce: Absolutely. Sounds like a great way to scare aspiring physicians to a profession by acknowledging that you're going to be spending all your time staring at a computer screen, not talking to a patient.
Dr. Paul Gerrard: When I was in medical school in residency and even when I started practice, I was at some places that were making the transition from paper charting to EHRs. To this day, I have never used an EHR that was as fast as paper charting. One hospital I worked, everything came out in paper. I had my own little mini EHR and Word documents and Excel files. I was lightning fast doing things that way. And then we started implementing EHRs. And that's when pajama time became an issue. The EHR implemented this new thing, this new way of structuring information that might be great for somebody, but it sure slows you down when you're trying to actually get through medical reasoning, following up on information, seeing patients. It's just not organized in a way that is really helpful to doctors, at least in my experience.
Wellsheet: A Seamless Layer for Action
Dr. Tim Showalter: That is so true. I think EMRs became the repository for simply having a place where data could be read, first of all, because in that area, doctor's handwriting is famously illegible. And so it's accessible. If you need to share information with the payer to document care, you need to transfer it to another specialist. Obviously, there are some advantages to the EMR. But as we know, there are a whole lot of disadvantages for it. I think what's so exciting about Wellsheet is thinking about not really replacing the EHR. They're still treating it as sort of the system of record where a lot of important data lives. They're not trying to build a competitor to the major EHR players. But they're taking the data that's there, reorganizing it, and trying to build a system of action. They are really having a single user interface for care providers that is much more purpose-built for the actual practice of medicine.
Dr. Trevor Royce: I think this is a good reflection of the fallacy that technology innovations will make our life easier overnight. The EHR is a good example of that, where you adopt an EHR and all of a sudden it's actually more powerful to document and it actually takes more time. Eventually you get to a point where it becomes seamless and tools have caught up with the technology and you can actually see more patients and do more. I feel like Wellsheet is sitting right in that where you're transitioning from this massive burden in the HR to hopefully something a little smarter.
The Role of Interoperability and Policy
Dr. Tim Showalter: Yeah. So for all the medical students out there and the residents, health technology and AI is going to cure the ills of medicine. I genuinely, I'm saying that in jest, but I genuinely do think we're entering the golden age of modern medicine. We're going to have these solutions to help address some of the pain points for documentation and billing and all of the things that cause physicians to spend time up at night working on their notes from the day. Paul, I'm curious what you think about the timing. Where have we been? I'm curious your thoughts on the policy standpoint and the technical standpoint for what's kind of set the stage for this. It's not just AI, it's like some of the other trends.
Dr. Paul Gerrard: I think things like calls for interoperability and standards development for EHRs and in general for health technology systems to communicate with each other has been an important piece of this. It's probably the emergence of things like cloud services as well and things that can make it easy to deploy. Back in the early bad old days of the EHR, the hospital got the EHR system, but when they got it, just deploying it was a massive pain. Building anything on top of it was a massive pain. Professional programmers, a whole IT development staff in-house if you wanted to do anything that was remotely creative. We've advanced to a point where we are starting to see infrastructure in place that there can be some out-of-the-box implementation starting. It still requires a lot of back-end work, though.
Dr. Trevor Royce: I think a lot of people forget or don't realize, particularly with newer doctors, that the transition to EHR was effectively done through government fiat, where systems were forced to adopt an EHR. Of course, it took a while to catch up to make this technology useful because it wasn't necessarily an organic adoption of the EHR. But now you have these APIs and SMART on FHIR, these sort of plug and play solutions are actually becoming more effective and can be used.
Reimagining Clinician Workflow and Collaboration
Dr. Tim Showalter: What's unique about Wellsheet's approach in particular? I think it's kind of set up overall for the collaboration of the team. Trevor, what are your thoughts on how responsive this is to how care is actually delivered these days? To me, the things that are obvious are we have a lot of different pathways where care has to happen in a lot of different environments across specialties. We've got a lot of different divisions, different clinics, different specialists involved. You need to have something that's portable and has already set up for that patient journey. Other thoughts you might have?
Dr. Trevor Royce: What I like about what Wellsheet has built based on what I've seen on product videos is that you can stay in the same environment and it goes and pulls information for you. One that particularly struck me was gathering labs. Even in Epic, there are smart phrases to pull labs in, but to actually go and look at the labs in the labs tab, you leave your note and it's a very clunky kind of onerous process. If there's a way to actually have an application that pulls those labs in for you, you can review them and choose what you put in your note, or even when you're prepping for the patient beforehand. Then you take that same concept, apply it to things like pathology reports, radiology reports, but being able to stay in that same interface, that actually sounds pretty appealing to me.
Dr. Tim Showalter: Of course, there's the side of how the physician is going to use things. I think you're spot on that the fact that a lot of the relevant information is already pre-populated in the note, some of the pathways that are relevant for that patient start to populate orders, and you can even have collaboration for discharge planning. Those are some of the features that resonate with me. But I do think ultimately, if these tools are able to streamline a lot of the coordination across groups, I get the sense that you probably can move the needle in terms of ROI for the health system when talking to healthcare administrators. Something would be good to hear Craig's comments on to see what sort of outcomes they're seeing improved.
Dr. Trevor Royce: That's always an interesting question. What are the actual metrics of success here for something like this? How do you measure that physicians are happier doing their work because you have less documentation burden? Is it reducing things like length of stay or time spent in the EHR? There are a lot of different ways to slice it. We'll have to hear from Craig about that.
Dr. Paul Gerrard: Well, I think this captures an important part of the dynamic of EHRs. The hospitals are incurring the cost for the EHRs, but the physicians who are not incurring the cost for the EHRs are the end users. Nurses and other staff use it too. Sometimes the goals of the purchaser are not aligned with the user. We'll just put it that way. I guess they probably have to be these things where a better experience for the user somehow results in a material advantage for the purchaser too to get market traction.
Dr. Trevor Royce: There are a lot of layers to this because the joke is that the EHR is actually a billing tool, not a documentation tool. A lot of these challenges are a reflection that the EHR is doing a lot more than just telling the patient's story.
Dr. Tim Showalter: I'm just thinking about if I were a healthcare administrator. I would hope that I'd be thoughtful enough to think about some of these long-term workforce shortages and burnout and number of hours. But of course, there are the hard business metrics, the revenue metrics. Length of stay would really resonate, amount of time in the emergency room, and the accelerating transfers from the ER into inpatient beds for the patients who need that. Those are questions we should probably steer Craig towards to see what sort of hard numbers they have.
Dr. Paul Gerrard: One thing I think that's really unique about Wellsheet is they talk about the future isn't just more tech, it's smarter collaboration. We sound like a bunch of old curmudgeons griping about technology. All three of us work for healthcare AI companies. We're pro-technology people. The issue is it needs to be technology that is facilitating human decision-making in better ways. I think that's what Wellsheet really talks about is not just doing more tech, but using technology to enable smarter collaboration. They're not just adding more buttons and more bells and whistles. They're really trying to streamline things and remove friction. Getting one view for the whole care team, built-in decision support like lab interpretation, auto pulling things in, pre-populating the document, shared discharge planning, those kinds of things. The technology is used to make it look like technology is not there.
Interview with Craig Limoli: The Founding of Wellsheet
Dr. Tim Showalter: Up next, Craig Limoli, co-founder and CEO of Wellsheet. He's going to join us to talk about how they're rethinking the clinician workflow and building that intelligent layer that so much of us really wish the EHRs already had in place.
Dr. Trevor Royce: Looking forward to hearing from Craig. Let's do it.
Dr. Tim Showalter: Craig, welcome to HealthTech Remedy. Thanks for joining us.
Craig Limoli: Glad to be here.
Dr. Tim Showalter: We are really excited for this conversation. I think you're solving one of the most important and stubborn problems in healthcare, clinician workflow inside the EHR. So really excited to cover some territory with you.
Craig Limoli: Yeah, appreciate that. We're excited about the outcomes we're seeing in the market.
Dr. Trevor Royce: Having personally firsthand experienced the pain of the traditional EHR systems, I was very excited to see all the work that you guys have been doing and what you built. I guess we should start from the beginning, as any good story does. We'd love to hear how you made your transition into this really challenging problem of making a useful EHR, how your career in consulting at IBM led to this, and basically what motivated you to go down this path.
Craig Limoli: I founded Wellsheet after working at IBM in their Watson Health division. I was a strategy consultant there. My job was to go on site at hospitals and health systems and talk to clinicians as well as the executives of those systems, understand their problems and basically find the right IBM solution to those problems. My overall assessment was that IBM didn't have what they needed. So I went out to build it myself. And that's really where Wellsheet was born.
Dr. Tim Showalter: I'm guessing that's probably a founding story for a lot of people, not specifically IBM. I'm just saying for health technology founders that the reality is the solutions that are being made available to healthcare leaders are just not really what they need.
Craig Limoli: Absolutely. I had consulted in a number of industries prior to getting into the Watson Health Division, focusing on healthcare. It was very incremental in terms of the improvements that other industries needed, as opposed to in healthcare, it was drastic. The frustration that clinicians faced with existing technologies was palpable. That just didn't sit well with me for arguably the most important function in our society to have to be dealing with antiquated technologies that slowed them down so frequently. So that's really what called me into this journey.
Dr. Paul Gerrard: I'll say my own background as a physician is I often joke, maybe I'm not joking, which EHR is the least problematic. That comes from my own experience in medical school and residency where I was at some places that were manual, some that were on EHRs. Pretty consistently, I saw the EHRs produce problems. I should add, I love computers. Going back to you, it sounds like you have experienced the same thing, and you've probably seen this at a much greater scale than I have, just looking at my own personal life. Was there kind of a moment where you said, going out, making these calls, seeing workflow, there's a problem here, and there's a way that we can solve it? Was there that eureka moment?
Craig Limoli: Yes, absolutely. I distinctly remember a nursing leader breaking down into tears over her inability to get access to the data she needed to treat patients, to make the right clinical decision for patients. That really woke me up to the severity of this challenge of really bringing all of the information that clinicians need together for treatment decisions. That's really what Wellsheet was founded around, our mission to synthesize all relevant data for clinical decision making. Obviously, that starts with the EHR, and that's where we started to the points that you've made about the challenges there. That's absolutely core to clinical decision making, understanding that patient's medical record. But it doesn't stop there. Over the years, we've expanded the data sources that we integrate with to enhance clinical workflows beyond the EHR, both in terms of patient data, whether that's coming from multiple EHRs or HIEs or other systems, as well as clinical content to guide decision making. We combine the patient context with the latest in research and guidelines to help ensure that decisions are optimized for patients and that workflows are as efficient as possible for clinicians. Our mission at Wellsheet is to put everything a clinician needs into a single sheet. That's where the name Wellsheet comes from. We've been iterating on that over time to be able to reach the point we are at today.
Building an Integration Layer on Existing Systems
Dr. Paul Gerrard: That's a great concept.
Dr. Tim Showalter: Great. And follow up question to Paul's eureka moment question is, I've heard people say we should just go make a new HR. Let's just get rid of this whole thing and start from scratch. I think you had an insight that rather than starting from scratch and reinventing the entire system, it's really sort of a layer on top of the EHR. I'm guessing there's some wisdom and insight in that approach. Can you shed some insight for our listeners for why you chose that strategy and what are the market understandings that fueled that?
Craig Limoli: Our technology is easily implementable on top of existing EHRs. We typically go live in a month and a half. It takes hours of work for the health system to install. The switching costs are infinitesimal in comparison to a massive EHR integration or implementation effort. That allows us to be able to support many different EHRs, the existing landscape, very quickly and easily, as well as bring together data from multiple sources, which isn't something that any individual EHR can do effectively. By not being the system of record designed to ensure the set of patients' medical histories in a system of record type way, we can much more easily integrate multiple sources of data into a single view and provide a more comprehensive picture of that patient's medical history. It's both a speed advantage and just the nature of the product that enables us to provide a more superior experience for our users. That's what really drew us into doing it this way. We had built this incredibly sophisticated synchronization ingestion system to be able to bring in the entire patient medical record into our system and do so in a way that loads instantaneously for doctors, which is not an easy engineering feat, but is absolutely required for doctors to interact with our system. No amount of load time is acceptable to a busy physician. That was a big engineering feat. We were very fortunate that having all of that data then enabled us to very quickly capitalize as AI matured and brought new capabilities, being able to leverage that data for much more powerful purposes in the past two or three years. That's tremendously accelerated our ability to provide value for our users and our clients on top of that back-end data integration and synchronization system.
Product Deep Dive: Contextual Summary and Automation
Dr. Trevor Royce: This might be a good moment to take a bit of a deeper dive in the actual product to expand on what you just mentioned. It sounds pretty great. I remember I graduated medical school and I started intern year at the Harvard hospitals thinking I was going to walk into this incredible state-of-the-art EHR. Lo and behold, when I'm placing orders, it's on a MS-DOS type text-based command line system. It's kind of depressing because on the other hand, you've got an iPhone in your pocket. It's the most powerful handheld computer in human history. Tell me a little bit about what your product does for the physician. Compare it to what the EHR is like without it and what the EHR is with it and what goes on under the hood a little bit.
Craig Limoli: You can imagine the EHR as being almost a digitized version of the file cabinets of patient records that existed decades ago. They don't adapt to the user's needs and preferences, the actual context of what that particular user specialty is. They tend to interact with data. They are very static instead of dynamic from that perspective. Further, that particular patient in front of you provides a lot of context that you can optimize the display of information. That has been a big part of our ability to provide a superior user experience is really contextualizing the display of information to bring in all the relevant information for that particular physician based on their specialty and practice patterns and that particular patient that they're seeing, their set of diagnoses and reason for visit. We've been able to create this highly contextualized, optimized clinical summary. We were doing that before the AI models that we know today came into existence. Large language models and generative AI really became tools that we could leverage, and there are no more powerful tools than those for summarization. Leveraging those tools, we were able to take the experience of bringing together all the relevant information to a single view vastly into the future around summarizing that patient data in ways that tremendously reduce the amount of time that physicians have to spend reading through the patient's medical history and digging into individual notes. We can bring all of that salient information together in these summary views. Beyond that, help them with documentation as well. One of the features that we've released this year that has been an incredible boon for our users and driven a ton of adoption and efficiencies has been the ability to automatically generate inpatient documentation with Wellsheet. With the click of a button, you can generate your hospital course and effectively write your discharge summary in an automated way. Because we have access to all of the data in the chart, our AI can review all that information and produce these summaries that effectively write your documentation for you. This is akin to what you see on the outpatient side with scribes and listening to the patient conversation, but we like to say our AI reads the patient chart and produces this documentation for clinicians in an automated way. That's one example of how we've been able to leverage AI to advance the product and the efficiency we've been able to provide our users really substantially. We have some other new features that are being launched as we speak to clients around the country that are really cutting edge that I'd love to talk about as well.
Strategic Partnerships and Advanced AI Features
Dr. Paul Gerrard: You call things Wellsheet because the idea is that everything the clinician needs is really all on one sheet. It's summarizing what's in the patient's medical record, but then potentially also pulling in information about the best science out there on what to do about this patient. I think that really sounds like the motivation behind this partnership with UpToDate. We'd love for you to talk to us about how did that partnership happen? Where do things stand now? And are there other exciting features like this that you're bringing into Wellsheet?
Craig Limoli: Great question. We've been working with UpToDate for a little over a year now integrating their content into clinical workflows. The really powerful thing about this is that we can contextualize that content, that guidance that they have. It's an incredible treasure trove of practice guidelines that physicians depend on to make the optimal treatment decisions for patients. They're largely outside the workflow. They are not contextually aware of the patient. Wellsheet is really the only organization that I'm aware of that's effectively bringing together the entire patient chart and these clinical guidelines in a contextual way that actually can give direct guidance to clinicians on what to do about the patient in front of them. This is all embedded seamlessly within the existing EHR. You get this full, comprehensive tool, giving you all of the relevant patient data summarized, supports your documentation workflows, and this guidance from third parties like UpToDate. We've started to partner with others as well that we'll be announcing soon in that same space. That's been incredibly powerful for our users. It really brings a level of clinical intelligence that would otherwise require a lot of manual effort from physicians to have to navigate through. Taking that to the next level, we have two really exciting new features that are building on top of those integrations that we're really excited about. One is the ability to communicate with the chart in a chat-based interface. Effectively, an AI agent that can answer any questions you have on the patient's medical history in a narrative format. You can ask, for example, what was the patient's baseline creatinine? It will give you all of the values and the baseline. You can ask it to summarize the latest note for the patient. It'll give you the gist of the latest note and reference the note as well. You can ask it if a certain condition was mentioned in any previous notes. The possibilities are endless. We've been able to connect this with decision support resources as well. You could actually ask the agent, what do you recommend for next steps for this patient? It will go to the references and provide the relevant guidelines for that particular patient's situation based on our integrations that we have with these CDS vendors. And so this is akin to OpenEvidence, but contextually aware to the patient chart. It adds an incredible amount of value on top of that, where you're actually able to have a tool that knows your patient. We've heard from physicians that they often miss things in that process of having to navigate between these tools. So having that all in a single experience really changes the game for them in terms of the utility of those tools. Similarly, we're also launching a pathways feature, which takes into account the clinical pathways that are relevant to that patient and actually uses AI to autocomplete them. our AI reads through the chart, answers the questions in the pathway all the way through the decision-free down to the recommendation automatically by reading the chart and assessing the patient, and then provides full transparency and visibility to the physician to be able to go through that decision logic, make any adjustments as they see fit, placing orders that flow into the EHR based on the pathways recommendation. These are some really exciting, cutting-edge applications of leveraging these three key pillars of our product: this really robust data integration engine, bringing in the entire patient record, integrations with these decision-supported resources, and AI all coming together in this cohesive experience for our users that we think is really transformational. That's what we're seeing on the ground from our users.
Market Positioning and Competitive Differentiation
Dr. Tim Showalter: That's fantastic. Craig, I'm just, as a clinician, imagining that potentially fits very seamlessly into the workflow. By being integrated with the EHR, you mentioned the clinical context, but also perhaps it's auto-prompting some queries to highlight some of this information. One question that I'm sure every successful health technology CEO gets is how strong the moat is around the technology that you've built with respect to the behemoth, which shall not be named in this discussion, that could theoretically do much of this in their own market dominating EHR. Obviously, there is room for innovation. I'm just curious how you would respond to that query, because I'm sure you get it all the time.
Craig Limoli: We think about that a lot, and we certainly don't take it lightly. Our strategy is and has been around these extra EHR integrations that we don't feel any particular EHR is positioned well to achieve effectively for our users. Effectively, sitting across multiple EHRs, other sources of data on the patient that the TEFCA networks, etc., to provide a more comprehensive view of the patient's medical history that extends beyond any individual EHR, as well as bringing together this content in a way that's contextualized and really relevant to the user is something that the EHRs, I don't think, are well positioned to do. It really requires this ability to bridge across these systems in a way that, as I mentioned before, you're constrained as the system of record as an EHR. That's a big part of why we decided not to go down that path is because the data rigidity that comes along with that requirement makes it harder to achieve these cross-system integrations in a way that ultimately is ideal for the user, for clinicians accessing this patient information and clinical content for treatment decisions. We definitely are focused on ensuring we have sustainable, defensible differentiation from the EHRs. I think our cross-platform model has enabled us to do that effectively.
Dr. Trevor Royce: Related to that, and this is a bit of a pie in the sky question, big picture, who is your core customer? Who are you optimizing for? Who are you selling to? Is it the healthcare executive, the clinician, the patient? I assume it's a combination of these, but can you reflect on your learnings of having a product, a workflow software product in the healthcare and hospital ecosystem and how you approach that on the business side?
Craig Limoli: It's evolved over time in terms of our user base in particular. It has always been a combination of clinicians and system executives being able to balance their needs and serve both parties effectively. We started as a company very heavily focused on physicians and their workflows, and in particular, hospitalists, residents, kind of inpatient medical specialties as our core user group. But that has expanded really significantly, especially in the past couple of years beyond doctors into nursing, case management, pharmacy, really the entire hospital. Everyone who's accessing patient records for the most part uses Wellsheet to do so. We've developed more dedicated functionality for those different user groups over time as well that has really made it easy for them to adopt the technology and also cooperate with one another. Big challenge in hospital settings is care team collaboration, hand-off, discharge planning, multidisciplinary rounding. All of these interdisciplinary workflow steps require better technologies to coordinate across these different user groups. That's something that we've been able to really deliver in the past few years in a really effective way that has enabled us to really bridge across those user groups. From a health system executive perspective, we work with generally CIOs, CMIOs, CMOs as well, and really help advance their priorities around quality of care, patient throughput. Operational metrics are all impacted through the use of Wellsheet in these different settings. That's really the palace that we have, engaging these wide sets of users. We have health systems that have tens of thousands of users on Wellsheet in a single client environment, some of the largest health systems in the country. That speaks to the breadth of adoption across these different groups.
Addressing AI Reliability and Safety
Dr. Paul Gerrard: When we step back and look at the EHR world, it had some benefits, it had some downsides. One of the big downsides people talked about was note cloning, an issue that is still struggled with to this day. As we start to introduce AI into things, AI can make mistakes. There are issues like confabulation, potential problems I can't even think of. What kind of guardrails do you have or what are you thinking about to make sure that as your AI gets implemented, it helps to solve some of the existing problems or at least avoids creating new problems?
Craig Limoli: I think this is where our ability to tap into the entire patient record—all of the discrete data alongside the unstructured clinical notes and summarizing those effectively—is really powerful. This provides a few advantages. One, we can have a human in the loop, a retrieval augmented generation process where we actually look at the patient data alongside the unstructured documentation notes that we summarize in our views to ensure that there is a level of accuracy around what is being presented to the physician. This is both in terms of having automated checks on our end, as well as a clinical team that reviews any potential gaps that could arise based on these types of confabulations. Beyond that, we also, in our views, display that underlying clinical data. We are both providing the summary and the actual discrete data from the charts. Physicians can on the front lines ensure, and this builds confidence in the summaries as they see the discrete data side by side with the narrative summaries that we're providing with AI. It makes them much more confident that AI is being accurate for them. We empower users to have access to the underlying data very quickly and easily as well. Even when you think about things like the AI trap that I described or the pathways, our emphasis is always really strongly on providing the sources of where any of those clinical logic decisions come from. As a physician, you can very quickly and easily delve into the underlying data in the chart to be able to assess the veracity of AI's conclusions from that perspective. This is something that we have painstakingly ensured that there's full transparency. There's no black box. It's all very clear for the physician to be able to understand where this logic is emerging from.
The Future of Healthcare and Workforce Productivity
Dr. Trevor Royce: Can you reflect a little bit on what the future looks like? The healthcare utopia of 2030. How does Wellsheet sit in the middle of that? What does that team operating look like? What's sort of the vision there?
Craig Limoli: I think there is a real imperative for health systems to address the clinical workforce productivity problem. There is a shortage of physicians, nurses. Over time it's growing larger and becoming exacerbated given labor shortages across those groups. AI applications like Wellsheet are a really necessary part of that shift. Students need to achieve to be able to provide the same level of quality to patients and hopefully a much greater level of quality, leveraging these technologies effectively. Solving that workforce productivity challenge is really critical. If you can utilize tools effectively like Wellsheet in workflows that not only make physicians and other clinical staff more efficient, but also provide them with higher quality data for treatment decisions, you can ultimately improve outcomes for patients in a really substantial way. That is incredibly important to our healthcare system as a whole, ensuring that the cost curve can be bent in a positive direction and that the outcomes our healthcare system achieves start to become more commensurate with the resources that are put into this in this country. I really feel like this is both an imperative and an opportunity. The time is really now for health systems to get on the journey towards this transformation to be able to thrive in the years to come.
Dr. Tim Showalter: Craig, I think that's such a great spot for us to end on because I love the way you phrase that it's a positive direction we're heading in and now is the moment to get moving. We sort of have to prepare our healthcare system and landscape for that. Thank you for your comments. Thanks for running over. I know this is a little bit later than we scheduled. I really appreciate you taking the time to sit down and share your thoughts with us.
Craig Limoli: Absolutely. Thank you so much for having me.
Dr. Tim Showalter: Thanks so much. That'll wrap us up for this episode of HealthTech Remedy.
