How River Records Is Transforming Medical Documentation With AI and Problem-Oriented Charting

Welcome to a brand new episode of The Uprising Show! In this episode, host Vivek Nanda sits down with Dr. Jacob Kantrowitz, internal medicine physician, entrepreneur, and co-founder of River Records. Dr. Kantrowitz shares his journey from an early fascination with computer science at Milton Academy to pursuing both medicine and technology through an MD/PhD program at Boston University. Together, they unpack the genesis of River Records, a healthcare tech startup on a mission to transform how clinicians manage and access patient information using natural language processing and AI.

Dr. Kantrowitz dives into the complexity of healthcare information systems, explaining how current electronic health records often fall short for physicians and how River Records is flipping the script to build truly clinician-friendly workflows. He talks candidly about the challenges of bringing new tech to such a regulated, tradition-bound industry and why starting with smaller practices, rather than giant health systems, is a smarter path for disruptive startups.

The discussion also takes a forward-looking turn as Dr. Kantrowitz and Vivek explore the future of medical education in the age of AI, the changing role of physicians, and how new technology can empower, rather than replace, human connection in patient care. Dr. Kantrowitz even shares a few lighter personal insights, including his passion for bread baking and his favorite college squash memories.

Tune in for a thought-provoking conversation about medicine, entrepreneurship, and the human side of healthcare innovation!

Timestamps:

00:00 Inquisitive Family Man

06:10 Automating Clinical Data Summarization

08:24 Startup Pursuing Medical Data Solutions

12:26 Diverse Clinician Support Vital

14:53 Creating Generalized Clinical Tools

19:23 Streamlining Patient Records by Problem

23:47 Flaws in Problem-Oriented Charting

27:59 EHR: Challenges in Patient Engagement

30:17 "Communication Failure in Health Records"

32:15 Healthcare Data Management Challenge

36:24 Improving Patient Communication System

39:17 Evolving Medical Knowledge Evaluation

44:29 AI in Medicine: Human Touch Essential

46:11 "Guiding Medical Trainees with AI"

50:09 College Squash Varsity Experience

Unlocking the Future of Medical Records: Insights from Dr. Jacob Kantrowitz of River Records

On a recent episode of The Uprising Show, host Vivek sat down with Dr. Jacob Kantrowitz, internal medicine physician, entrepreneur, and co-founder of River Records, to discuss some of the most pressing challenges and opportunities at the intersection of healthcare, technology, and artificial intelligence.

Dr. Kantrowitz’s unique background as both a clinician and technologist gives him firsthand insight into the complexities clinicians face managing electronic health records (EHRs). Here’s what we learned from this enlightening conversation:

1. Medical Records Are Broken - and Doctors
Know It

Dr. Kantrowitz’s journey began at Boston University, where, while completing his MD/PhD, he encountered the everyday frustration of "chart biopsy", digging through countless notes and scattered data in EHRs just to find a patient’s relevant history. According to Dr. Kantrowitz, the current system is less a useful tool and more a filing cabinet: “EHRs capture data, but they’re terrible at making it accessible and actionable in real clinician workflows.”

Medical records are packed with valuable data, but the way they are organized, which is often by date, note, or data type, leads to “information scatter.” This means, for example, that a doctor trying to track a patient's hypertension history must look through dozens of notes, rather than finding a clear problem-oriented summary.

2. Solving Information Chaos with AI and NLP

River Records was born out of a desire to build technology that reimagines medical data organization. By harnessing natural language processing (NLP) and AI, Dr. Kantrowitz and his team built solutions that not only summarize and structure historical notes but also enable clinicians to capture and organize new information at the point of care.

Their flagship product, Stream, acts as an “AI medical scribe,” transcribing and arranging medical notes by clinical problem, not just visit date. This approach aligns with the way clinicians think, problem-oriented, rather than encounter-oriented, and empowers them to make better, faster decisions without getting bogged down in irrelevant data.

3. Why Startups Can Out-Innovate Legacy EHR Systems

You might wonder: can’t the big EHR vendors just add these AI features themselves? Dr. Kantrowitz argues that this is much easier said than done. “EHRs were designed decades ago, adding new layers or modules isn’t enough,” he explains. “Changing the data model and workflow is a massive engineering and user experience challenge.”

That’s why River Records is focused on serving small physician groups and private practices first, where nimble adoption and direct clinician feedback help refine their tools. Over time, the goal is to demonstrate real-world value and scalability, making it possible to influence even larger health systems.

4. The Hidden Challenge: Changing Clinical Workflows

Tech hurdles aren’t the only barrier. Clinicians have learned to trust their own workflows, and introducing a new tool means it must save time, reduce risk, and fit seamlessly into existing routines. “It’s not enough to automate notes; we need to give immediate, tangible benefits and avoid adding complexity or uncertainty,” says Dr. Kantrowitz. This human-centric design philosophy is how River Records aims to win clinician trust.

5. What’s Next for Medical Documentation?

Dr. Kantrowitz sees a future where clinical information is not just captured, but transformed almost instantly into actionable insights, reminders, and patient communications, across all care settings. As AI continues to evolve, physicians will become more like supervisors of AI agents, focusing their time on guiding, educating, and connecting with patients rather than just data entry.

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