In the next five years, we see Augnito as the voice interface driving software in hospitals across the country: Rustom Lawyer

Rustom Lawyer, CEO and co-founder, Augnito and Scribetech gives details to Viveka Roychowdhury on how with Augnito, doctors can produce twice the number of reports in the same time with close to 100 per cent accuracy, which allows them to focus more on patient care and has a direct impact on the bottom line

The world over, doctors are finding less time to deal with patients. Is this a factor of a poor doctor-patient ratio or the use of more technology as medical practice goes digital and doctors have to document patient history for Electronic Medical Record (EMR) systems etc? How does Scribetech, and now Augnito, which you started in 2001, address this issue?

This is actually an outcome of both the factors you mentioned. In developing countries such as ours, the doctor to patient ratio is very low and doctors are under immense pressure to service large number of patients every day which obviously reduces the time they can spend with each patient.

In developed countries with more advanced healthcare systems, where the doctor patient ratio is manageable, doctors have to document and capture every detail of patient care in the EMRs which allows those healthcare systems to actually thrive and provide better service. Having comprehensive and detailed information at the right time available to the correct person across the Continuum of Care drives better clinical outcomes in healthcare systems. But the downside of it is that it leads to “EMR fatigue” or “physician burnout” where doctors end up spending as much time inputting patient data as they do in patient consultation.

Augnito is an advanced speech recognition AI built to address this pain point. We are focused on the India market as it is evident that for our healthcare system to scale and support a billion plus population, we need widespread adoption of EMR systems and our technology is a great enabler. Augnito eases the effort required to input data in the EMR through an intelligent voice driven user interface, which is a net positive for the patient and the healthcare system.

Medical documentation systems require greater precision than transcribing software in other sectors, because patient lives depend on the accuracy of the transcript. How does the software deal with this requirement? Are there feedback loops from using clinicians and hospital administrators, etc?

With Augnito, our vision was to transform our two decades of clinical documentation knowledge and expertise in quality systems, security, and the criticality of turnaround times in hospital environments; and package this into a powerful AI that is a first of its kind in our country which is easily accessible to every doctor. The quality of documentation signifies quality healthcare and is a representation of the service a patient receives.

Augnito is precisely customised for the healthcare ecosystem. It has been built using the latest deep neural networks and can understand any accent highly accurately out of the box. It has the entire language of medicine built into it which covers 50+ specialities and sub-specialities. It is also updated with all popular generic and brand drug names. We have about 99 per cent accuracy right out of the box and we are constantly training our language models to further improve our accuracy.

What is the company’s USP over other such services in the domain area?

Augnito is a product truly “made in India” for the Indian market. We have used Human Centred Design principles to understand the needs and challenges of doctors which are very unique to the Indian context and design solutions around them. As this technology took extremely long to build, in fact it took us seven years of R&D to achieve the level of accuracy required for healthcare domain. The competitive landscape is quite blue sky at the moment and the potential use cases are very exciting. We are the only company in India providing such an advanced voice technology in the healthcare domain.

Simply put, our biggest USP is our out-of-the-box accuracy which has been tested and proven against the voice engines of global technology leaders, which is the reason leading hospital systems in our country are adopting Augnito. Mobility is a key differentiator. Being a cloud based service with availability across different OS and devices, Augnito is available for the doctor everywhere. You can efficiently make your reports, with your saved preferences, from any workstation be it at the hospital or home or even on your mobile.

Coming from a service background, we have leveraged our best practices of being an international BPO to design a seamless onboarding and support experience.

What are the regulations that need to be followed in terms of medical documentation standards, etc?

We have been dealing with medical documentation for close to two decades now. Compliances and security are core to our company. We are ISO 270001 certified by the BSI, and we are also GDPR (Global Data Protection Rules) compliant. We use military grade encryption for secure transfer and retrieval of information and we are Cyber Essentials Plus certified. In terms of documentation standards, we follow the NABH guidelines in India.

What is the revenue model followed by Scribetech and Augnito? Is the company able to get better realisations from the private healthcare sector than public health systems?

Augnito offers a suite of products and services in voice technology with a SaaS based revenue model. Our Clinical Speech Recognition application offers subscription based licenses for individual professionals, small teams and enterprises which can be paid annually or monthly. Our Speech API which is used to power EMRs is on a pay-as-you go model with a usage based pricing. Our product provides 10x the value of the cost of the software and hence it is cost effective for both private and public health systems.

What are the documented cost benefits of using such systems? And impact on patient care?

Clinical documentation has always been critical for healthcare professionals for billing, insurance, medico-legal purposes and analytics to achieve better patient care. With Augnito, doctors can produce twice the number of reports in the same time with close to 100 per cent accuracy, which allows them to focus more on patient care and has a direct impact on the bottom line. A product like this can make other clinical staff like nurses and medical secretarial staff also more efficient.

Renowned hospitals, like the Jaslok Hospital in Mumbai, have boosted the turnaround time of their discharge summary process through the successful adoption of Augnito. Generally, we work with the hospital finance departments and take them through our Value Calculator which makes the cost benefits very transparent. For example, a large healthcare group of 2000 beds could save potentially Rs 20-30 crore a year with the adoption of Augnito.

How did your company start collaborating with UK’s NHS and what is the extent of this partnership? How has Brexit and the aftermath impacted the NHS’ spend on such systems?

We are the pioneers of healthcare documentation BPO in the NHS and have been selected as a leading supplier on three consecutive national framework contracts which lasts about five years each and gives us the ability to provide software and services through this extensive tendering process to the single largest healthcare organisation in the world, the NHS. We have longstanding clients such as Chelsea and Westminster Hospital, University Hospital Birmingham, Kingston University Trust and many more.

Brexit has only accelerated the need in this market for leaner processes and systems, and we are also integrating our voice technology into this advanced health system which is helping drive down costs which is the need of the hour.

What have been the latest product/software launches from the company and what are the user trends driving development of such products?

Our product and service innovation is driven by Design Thinking wherein we spend a significant amount of time working and observing our customers using our products in real environments. In this process, we discovered this unmet need for mobility for healthcare professionals. Augnito Everywhere was launched to combine the power of voice with the ease of mobility and also with its multi-platform availability.

What has been a big hit in this community is our Augnito App which we have only just launched a few weeks back exclusively for radiology and we already have close to 1000 radiologists using it daily to make their reports on mobile phones. It’s a game changer for doctors to be able to create your reports accurately on the go wherever you are. India is one of the largest growing markets for smartphones, so the move to mobile-first solutions is definitely on target for us.

It’s been nearly two decades since the launch of Scribetech. Operations today span the UK, US and India. What has been the revenue growth over these two decades? And revenue share between these countries? How would this translate into number of doctors, facilities served and patient lives impacted?

Scribetech has an office in US, and our key markets include NHS UK, and now India.

Our BPO revenue growth has been strong till the last few years when it started flattening out due to the push for increased automation over manual processes and we had the realisation that we needed to disrupt our own business model and invest our profits into developing Augnito.

Currently, the vast majority of our revenue is from the UK healthcare market from our BPO business as we have only very recently launched Augnito in India. What gives us huge confidence is that Augnito is being actively purchased and we have landed contracts with leading hospitals and healthcare organisations even during this COVID crisis.

In the UK, we have provided services to more than 15 trusts which have collectively produced clinical documentations to millions of patients over the years. In India, we already have doctors in 24/28 states producing medical reports using Augnito and have marquee clients which include Breach Candy Hospitals, Jaslok Hospitals and NM Medical. This trend points to rapid growth over the next few years.

Tell us about Scribetech’s launch and journey in India (through Augnito). Is the company partnering with India’s public health systems like the NHS or with the private healthcare sector?

At a Stanford class, with my professor Baba Shiv, I had very long discussions about how a market like India was ready for a technology like this. Further to this, on my return, we got into this process of Human Centered Design where we interviewed and observed healthcare professionals, built and tested multiple MVPs (Minimum Viable Products) and tested our hypothesis rapidly and often.  We were convinced scientifically that we were on to something important. We landed our first client at a cutting edge 500 bed hospital in Mathura last October and the product started picking up steam from there. We have received a very positive reaction from the healthcare community which has for years been in the need of a software like this.

COVID-19 has forced organisations to think leaner and adapt to the new normal. Healthcare providers now require highly efficient systems for medical reporting so as to minimise the need for human contact and allow doctors to have dynamic working hours with the ability to work from home as well. Augnito successfully fulfils this emerging demand of the new normal. Leading hospitals and diagnostic centres such as Breach Candy Hospital and NM Medical have all been able to streamline their operations during this time with the power of our Speech Recognition AI.

“It’s making a huge difference. It’s increasing our turnaround time tremendously. It’s changed my life and it will change every radiologist’s life, believe me!” – Dr Anirudh Kohli, Head of Imaging, Breach Candy Hospital & Trust (in a recent youtube interview)

As mentioned before, we believe that the ROI of this software makes it cost efficient for both public and private healthcare systems. The private healthcare systems have been more receptive to this technology but we are seeing an increased interest for Augnito from public health systems as well as they are recognising the value this can provide.

What is the distribution of your team’s headcount across these three countries?

We have our engineering team in Manchester, and sales office in London and we have our product design, software engineering, India sales and BPO operations based out of Mumbai and Bangalore with a split of 15:85 in UK and India.

What is Scribetech’s presence in other geographies?

There is clearly a transformation happening in the digital health ecosystem in India and we believe Augnito will be a very important enabler to power this transformation. We are therefore focused on the Indian market. We are also successfully growing our international operations for Augnito, leveraging our existing market in the UK.

What are your plans for the next five years in terms of evolving user needs, new products/services, expansion to other countries, new partnership/revenue models, etc?

We are in very exciting times in terms of evolution of speech recognition and natural language processing. We have recently been awarded the Abdul Kalam Fellowship from Government of India as the industrial partner for advanced research in the healthcare space along with Professor Pushpak Bhattacharya of IIT Bombay who is one of the leading scientists in AI in the country.

In the next five years, we see Augnito as the voice interface driving software in hospitals across the country – it’s a bit like “Intel inside”. We now have an illustrious strategic advisory board with the likes of Ishaat Hussain (former finance director of Tata Sons and chairman and board member of many Tata companies like TCS) and Maciej Kraus (Venture Investor and Stanford Lecturer).

We believe India will be one of the best laboratories for AI because we have a massive market and a young, dynamic population of computer scientists, engineers and designers who have the confidence to build world class software products made in India for the world. We are just getting started!

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