The Birth of Ambient Documentation: How an ER Doctor and College Student Built a Healthcare Tech Revolution
In 2014, an emergency room doctor and a college pre-med student took a leap of faith that would transform healthcare documentation. Their startup, iScribes, eventually became Dragon Ambient eXperience (DAX), now a cornerstone product for Microsoft and Nuance. Here's their remarkable journey.
An Unlikely Partnership
It began in a Virginia emergency department, where pre-med student Christopher worked as a scribe for Dr. Jared Pelo. Christopher's endless curiosity about medicine caught Jared's attention – he kept asking questions about X-ray interpretations and clinical decisions instead of just taking notes.
When Jared approached Christopher with a business proposition, Christopher was deep into medical school applications. The choice was stark: continue on the safe path to medical school or join a risky startup venture. After a surprising conversation with his father, who told him "You can go to school anytime...the experience you'll get is invaluable," Christopher joined the iScribes mission.
Building from Nothing
The early days were characterized by bootstrap ingenuity:
- Working from an unheated house with Bitcoin miners providing warmth
- Hand-ironed company sweatshirts
- Minimum wage pay for dedicated employees
- Personal loans and retirement savings keeping the company afloat
Two pivotal moments shaped their success:
- A cold email to info@triangleortho.com led to their first customer and investor
- Meeting David Meisner, who brought crucial business and financial expertise
Culture as Foundation
Despite financial constraints, the founders prioritized building strong company culture:
- Weekly updates and celebrations
- Company sweatshirts after one year
- A mission-driven community
- Three core values consistently reinforced
The result? A loyal workforce of 250 employees who often felt guilty about leaving even for double the pay.
The Technology Bet
The team made a prescient decision to record and store all their documentation data, believing that someday AI could transform it into automated documentation. While their initial competitive moat was this massive dataset, the emergence of large language models changed the landscape. Nevertheless, DAX became a cornerstone product mentioned in Microsoft earnings calls.
Key Lessons
- Bias toward action: "Be wrong by trying, don't be wrong by hypothesizing and not going for it."
- Deep conviction matters: The level of commitment required means you need to truly believe in solving the problem.
- People first: Success came from improving life for doctors, patients, and employees alike.
- Build community: Strong culture creates resilience through hard times.
The iScribes story demonstrates how vision, persistence, and the right team can transform an industry. From a college student's curiosity to a product used by healthcare systems nationwide, it's a testament to the power of taking risks and believing in possibility.
Ten years later, both founders reflect on this journey with gratitude – for the lessons learned, the friendships forged, and the impact they've had on healthcare. As Christopher notes, "What a blessing to carry these lessons forward at 34." Their story continues to inspire entrepreneurs and innovators in healthcare technology.
Key Timestamps:
- 00:10 - Introduction and background
- 02:06 - Earliest days of iScribes conception
- 08:09 - The pivotal dinner meeting
- 14:22 - Early company milestones and strategy
- 15:34 - Key turning points: Triangle Ortho email and David Meisner
- 22:17 - Office space evolution and growth
- 27:43 - Building company culture
- 33:05 - Challenging moments and near-failures
- 36:27 - Personal sacrifices and financial risks
- 40:52 - Key lessons learned
- 43:51 - Impact on personal growth and relationships
