# Abridge moved from a consumer app to enterprise for scale

Markdown copy of https://realalpha.app/s/abridge-moved-from-a-consumer-app-to-enterprise-for-scale/ on Real Alpha, the best minutes from long interviews with the people building AI. Cite and link the page, not this copy.

- Speaker: [Shiv Rao](https://realalpha.app/builders/shiv-rao/) · Shiv Rao is cofounder and CEO of Abridge; practicing cardiologist. · Co-founded Abridge, which brings context and understanding to medical conversations, and practices as a UPMC cardiologist.
- Host: [Alex Konrad](https://realalpha.app/people/alex-konrad/) · Founder & editor, Upstarts Media · Ran Forbes' Midas List for ten years and co-created its Cloud 100 list; founded Upstarts in 2025.
- Show: Upstarts
- Episode: [Abridge’s Shiv Rao: Taking On Microsoft To Cure Doctor Burnout With AI](https://realalpha.app/v/W4_aRWsHogM/), Jul 23, 2026
- Moment: 17:00 to 20:14 of the episode (3 min), playing on https://realalpha.app/s/abridge-moved-from-a-consumer-app-to-enterprise-for-scale/; the episode from there: https://realalpha.app/v/W4_aRWsHogM/?t=1020

## Quote

> “we were able to rush into that moment and really sort of recognize that the **center of gravity** to really create scale here is the enterprise.”
> — [Shiv Rao](https://realalpha.app/builders/shiv-rao/) at [18:12](https://realalpha.app/v/W4_aRWsHogM/?t=1092) · Upstarts

## Takeaways

1. Abridge launched a direct-to-consumer app in 2019.
2. Generative AI helped the team refocus on enterprise.
3. Health systems became the route to broad clinical reach.

## About this segment

Abridge first launched a consumer app, then saw enterprise as the route to scale when generative AI arrived. Clinicians could then extend the service to patients.

From “Abridge’s Shiv Rao: Taking On Microsoft To Cure Doctor Burnout With AI”, Jul 23, 2026. [Watch the full episode](https://realalpha.app/v/W4_aRWsHogM/)

## Transcript

Transcribed by machine (Whisper) from the episode’s audio, so a word may be off here and there.

[17:05](https://realalpha.app/v/W4_aRWsHogM/?t=1025) When you guys started in 2018, what was the first version of the product? What was the wedge that you guys were providing? Yeah, totally. When we first put our seed deck together, there was one slide where there was a patient on one side of the slide and there was a doctor on the other side. And then there was our application in the middle. And the idea was we can serve both sides. And the barrier to entry on the doctor side, enterprise healthcare, not for the faint of heart.

[17:30](https://realalpha.app/v/W4_aRWsHogM/?t=1050) You have to go through a crazy idea maze. It's a labyrinth to sort of figure out how to get out there and actually get distribution and create value. So there was also a whole bunch of R&D sort of risk that we had to navigate as well. And we had the types of PhDs and professors and postdocs, and we had data sets that allowed us to sort of tackle that, but we didn't want to hold our breath on science challenge. And so we put a direct-to-consumer app out first in 2019, and that helped people all of us capture conversations with doctors with permission and the idea was to help them sort of be the healthiest versions of themselves help them understand what they talked about help them you know understand their condition but also understand their care plan and hopefully follow through on it but then in 2023 obviously the sky

[18:15](https://realalpha.app/v/W4_aRWsHogM/?t=1095) opened up on generative ai and we were able to rush into that moment and really sort of recognize that the center of gravity to really create scale here is the enterprise. And so now it's finally, you know, overnight success, I guess, like six or seven years in the making, but we go through the enterprise, we help clinicians, then the clinicians sort of extend to their patients and we can create impact at scale across a big swath of the country right now. What was the capability or the aha moment that was able to then unlock some of those first customers, you know, in the health systems?

[18:47](https://realalpha.app/v/W4_aRWsHogM/?t=1127) we were eating glass for many years and while we're eating glass like you just have to kiss a lot of frogs you have to a lot a lot of business models you have to like figure out a lot of go to markets there's that alex rompell quote startups get disruption when they get distribution faster than incumbents get innovation it's like every clayton christensen book and like one line and in health care finding a way to get distribution is is it's hard and so much of is like building trust and so much of it is finding a way to to de-risk this because it's such a risk averse industry so i'd say aha moments for us i don't know if there was one because there was like multiple years of us pre-selling and figuring out how to position ourselves and 2021 2022 especially 2022 we had the contours of a real product that could work that was pre-llm

[19:38](https://realalpha.app/v/W4_aRWsHogM/?t=1178) It was with all that, you know, all those annotations and fine-tuned models. And then GBT comes out and we recognize, like, what's about to happen. We very quickly refactored. And once everybody in healthcare as well had used ChatGPT and sort of understood, hey, there's something here we should take seriously. thankfully they called us back so all those calls that we made in 2020 2021 and 2022 like all that hard work ended up working out ended up paying off because we got to pilot once we piloted