Augmedix: Taking a Look at Your Next Visit to the Doctor
Peering into a company using a new business and operating model to give Google Glass a second life.
Google Glass remains perhaps the most prominent example of an early innovation in the new frontier of the Internet of Things (IOT) that failed to live up to expectations. Google’s interactive eyewear product, launched in 2012, heralded a new era of wearable technology. [1] Despite generating a great deal of initial hype from tech enthusiasts, Sergey Brin’s spectacles, the first major product to come from Google’s X division, failed to find a foothold in the consumer market. A price-point of $1500 and Glass’s tendency to generate the perception of privacy violations and “Glassholes,” [2] led many industry analysts to write Google’s IOT experiment off as a failure. [3] While Google seems to have given up or at least delayed its ambition for a wide consumer rollout [4,5] the company has pivoted and partnered with nine other companies who are working hard to demonstrate new applications for the technology in industries ranging from manufacturing to the arts. [6]
A Glass Half Full?
One of the most innovative and potentially game-changing applications of Google Glass to date has been in healthcare, where a startup has taken the same product that fell flat in the consumer market and by applying new business and operating models has helped to change the outlook on Glass. Founded by Stanford GSB alum Ian Shakil, [7] Augmedix is a San Francisco based start-up with more than $36 million in venture backed capital, which has partnered with Google with the vision of making the physician-patient interaction more human and more efficient. [4] The company has built a client base of approximately 500 physicians across the country, who are using the technology to reduce the amount of time they spend on administrative tasks and more easily access notes, histories, and labs during patient visits.
Augmedix’s business model is founded on one of the many inefficiencies in modern healthcare. Physician time is among the most valuable resources in the industry, but recent research suggests that doctors spend a tremendous percentage of their time doing administrative tasks that do not directly drive improved health for patients. A recent time study, which was conducted on a sample of US family doctors, internists, cardiologists, and orthopedists found that “for every hour physicians provide direct clinical face time to patients, nearly two additional hours is spent on electronic health record (EHR) and desk work within the clinic day.” [8] Augmedix’s business model tries to circumvent this problem by using Google Glass as a way for physicians to both transcribe data during patient visits and access data from a patient’s file more readily. As a physician does an examination, she can dictate what she wants to put in her note, and one of Augmedix’s 200 scribes (many of whom are located in Bangalore, India) receives a live stream of the visit and transcribes what he sees. Augmedix claims that they can save physicians more than 2 hours a day, and improve patient interactions by reducing the need for physicians to enter information into a patient’s EHR during a visit. Beyond creating value by improving physician time utilization, Augmedix purports to improve documentation quality and to improve patient satisfaction and the patient experience. [9]
The Augmedix Value Proposition:
Staying Ahead of the Curve
In many ways, Augmedix is a prime example of a company adapting to the new digital landscape and crafting a coherent business and operational strategy to create and capture value. The company offers a fascinating example of how a product designed for one market may in fact generate more value with a revised business and operating model. And yet, while Augmedix has had some early success, it too will likely face business and operational model challenges as it attempts to grow.
While I was unable to find any details on the contractual agreement between Augmedix and Google, the relationship will drive a continuous business model challenge for the startup. As of now, Augmedix’s business model relies on Google’s glass technology and eco-system. Were Google to terminate the partnership or underinvest in continued product development, Augmedix’s business model will come under heavy pressure. As it prepares for the future, it should work to maximally align Google’s interests with its own to ensure the lynchpin of its strategy remains intact. Operationally, Augmedix is heavily reliant on its ability to hire scribes in low-cost labor environments. And yet, given that the role demands both near perfect accuracy and a high degree of familiarity with the practice of medicine, the company is likely to have difficulty scaling with its current operating model. As the company invests in building a pipeline to recruit, train, and retain scribes, it simultaneously must prepare for a future in which artificial intelligence will erode the value it can generate from those investments.
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Text References
[1] Bilton, Nick. “Why Google Glass Broke.” The New York Times, February 4, 2015.
[2] Oreskovic, Alexei, Sarah McBride, and Malathi Nayak “Google Glass Future Clouded as Some Early Believers Lose Faith.” Reuters, November 14, 2014 < http://www.reuters.com/article/us-google-glass-insight-idUSKCN0IY18E20141114>
[3] Altman, Ian. “Why Google Glass Failed And Why Apple Watch Could Too.” Forbes, April 28, 2015. <http://www.forbes.com/sites/ianaltman/2015/04/28/why-google-glass-failed-and-why-apple-watch-could-too/#7821c39858ec>
[4] Dwoskin, Elizabeth. “Coming to a Doctor’s Office Near You: Live-Streaming Your Exam with Google Glass.” The Washington Post, September 27, 2016.
[5] Google public note, “We’re Graduating from Google[x] Labs.” < https://plus.google.com/+GoogleGlass/posts/9uiwXY42tvc?e=-RedirectToSandbox>
[6] Google public note, “Glass at Work.” < https://developers.google.com/glass/distribute/glass-at-work>
[7] Ian Shakil Linkedin Page, <https://www.linkedin.com/in/ishakil>
[8] Sinsky, Christine, et al. “Allocation of Physician Time in Ambulatory Practice: A Time and
Motion Study in 4 Specialties.” Annals of Internal Medicine. September 6, 2016.
[9] Augmedix FAQ < http://www.augmedix.com/faq/>
Image References
Cover Image: https://healthinformatics.wikispaces.com/file/view/hc-pictures-using-google-glass-in-the-hospital-005.jpeg/470495088/354×259/hc-pictures-using-google-glass-in-the-hospital-005.jpeg
http://www.xconomy.com/wordpress/wp-content/images/2016/04/AugmedixDrRS-1100×734.jpg
Image 1: http://glass-apps.org/wp-content/uploads/2013/06/google-glass1.jpg
Image 2: http://healthstandards.com/wp-content/uploads/2013/03/Picture-41.png
Image 3: http://www.augmedix.com/
Applying Google Glass in healthcare is a reasonable idea. I agree doctors spend a lot of time on administrative and documentation requirement and any technology that saves time will add enormous value to doctors and hospitals. The Google Glass technology however may interfere with patient care by physically coming between doctors and patients. While this technology is promising, I don’t believe that it will save doctors time in the long run. Much more, it may actually decrease how effective doctors connect with their patients.
Thanks for the post, Hannah – exciting stuff. Unlike Robbie, I am confident that Glass can reduce time spent by physicians on administrative tasks like documentation and therefore improve patient satisfaction. Of course, this is contingent on the product being glitch-free and as minimally obtrusive in appearance as possible – two primary reasons Glass fell short for consumers, to my understanding. What worries me is documentation quality, privacy of patient information, and interoperability with other health information systems. Not only are the scribes remotely located, there’s a high likelihood that some portion of information gets mistranslated, either because scribes lack sufficient medical knowledge, aren’t perfectly fluent in the language of use, or there’s some technical hitch distorting info transfer. In healthcare, it is of utmost importance that the data captured in the EHR is accurate. Also, giving the scribe access to sensitive patient information sounds like murky territory as far as HIPAA is concerned. A potential solution is incorporating voice recognition in the Glass hardware, but at least from my experience, that is never 100% reliable either. My final concern around interoperability speaks to the ability to automatically sync data captured by Glass with existing data in the hospital’s information systems (e.g. its EHRs, op time / workflow, payments). I imagine there’ll be a need for close collaboration with health IT vendors like Epic or Cerner to ensure successful integration…
Thanks for this article. Its great to see technology playing a new role in the healthcare space. Aside from the Google-Augmedix relationship risk, privacy is the largest concern on my mind. I’d like to know how this technology gets around our HIPAA laws. Do patients sign away their medical information so that it can be transcribed have way around the world? Are they even being told where their information is being sent? This technology will likely help reduce administrative time, but Augmedix should set larger goals moving forward. Successful transcription services will remove dictation from the patient-doctor encounter. One day, information will be captured through various sensors in the exam room, interpreted, and documented without requiring the doctor to dictate a note. Doctors perceive that EMR systems are for billing purposes- the level of detail required in their notes goes beyond what is required for excellent patient care. While we’re not there yet, this is certainly the first step toward a patient focused future.
Thanks for sharing. Healthcare is one of the applications of augmented reality that I am most excited about. In your post, you mentioned the risk of Augmedix’s reliance on Google. While this would have been a major risk a few years ago, the risk of other players such as Facebook, Microsoft, and Snapchat in this space has reduced the severity of the risk. Facebook’s Oculus platform and Microsoft’s HoloLens can serve as alternatives to Google’s Glass product. The challenge that lies ahead of Facebook and Microsoft is the form factor of their products. The current design of Oculus and HoloLens would make it hard for physicians to use the products during in-person interactions, but it’s certainly possible to use it offline to execute administrative tasks and conduct research.