[HN Gopher] Launch HN: WorkDone (YC X25) - AI Audit of Medical C...
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Launch HN: WorkDone (YC X25) - AI Audit of Medical Charts
Hey HN! We're Dmitry, Sergey, and Alex, co-founders of WorkDone
(https://www.wrkdn.com/). In one sentence: we built an AI product
that audits medical documentation in real time to catch and fix
errors before they turn into treatment mistakes or denied insurance
claims. We got interested in this problem when we saw how often
small documentation slip-ups can snowball into huge financial,
legal, and even life-threatening outcomes. Sometimes it's just a
mistyped medication time or a missing discharge note - basic stuff
- but when you're dealing with claims and regulatory rules, a minor
error can trigger an automatic denial. Wrong copy-pasting on a
discharge note will be uncovered by the insurance provider and will
cost stressful appeal. By the time an overworked clinical or
compliance team discovers it, it's usually too late to just fix it.
Our own experiences hit close to home: Dmitry's family member faced
grave consequences from a misread lab result, and Sergey comes from
a full medical family that's battled these issues up close. Here's
our demo if you'd be interested to take a look -
https://www.loom.com/share/add16021bb29432eba7f3254dd5e9a75 Our
solution is a set of AI agents that plug directly into a clinic or
hospital EHR/EMR system. As clinicians go about their daily
routines, WorkDone continuously monitors the records. If it spots
something that looks off-like a missing signature or a suspicious
timestamp- it asks the responsible staff member to double-check and
correct it on the spot. We want to prevent errors from becoming big
headaches and wasted hours down the road. Technically, this
involves running a secure event listener on top of EHR APIs and
applying a group of coordinated AI agents that's been loaded with
clinical protocols, payor rules, and finetuned on historical claim
denials and regulatory guidelines. The moment the model flags a
potential error, an agent nudges the user to clarify or confirm. If
it's a genuine mistake, we request correction approval from the
provider and fix it right away and store an audit trail for
compliance. We are extending the approach to finding conflicting
medication or prescribed treatments. What's different about our
approach from AI tools for hospital revenue management is this
focus on near-real-time intervention. Most tools detect errors
after the claim has already been submitted, so compliance teams end
up firefighting. We think the best place to fix something is in the
flow of work itself. One common question about the use of AI in the
medical/health field is: what if the AI hallucinates or gets
something wrong? In our case, since the tool is flagging possible
errors and its primary effect is to get extra human review, there's
no impact on anything health-critical like treatments. Rather the
risk is that too many false positives could waste staff members'
valuable time. For pilots, we are starting with read-only mode in
which we use API only to retrieve the data, and we are able to see
that the QA we built into the agent orchestration layer does a
pretty good job for spotting common documentation mistakes even in
lengthy charts (for instance, multi-day hospital stay). We're in
the early stages of refining our system, and we'd love feedback
from the community. If you have ideas on integrating with EHRs,
experiences with compliance tools, or just general insights about
working in healthcare environments, we're all ears. We're also on
the lookout for early users - particularly rehabs, small clinics
and hospitals - willing to give our AI a try and tell us where it
needs improvement. Thanks for reading, and let us know what you
think!
Author : digitaltzar
Score : 49 points
Date : 2025-05-22 15:23 UTC (7 hours ago)
| candiddevmike wrote:
| Congrats on the launch, but no link to your website? What EHRs do
| you integrate with, and why did you choose those to start with?
| Do physicians need to leave the EHR to use your app? In my
| experience, that ends up being a non-starter/huge impediment to
| usage.
| digitaltzar wrote:
| Thank you! We are at wrkdn.com
|
| To start, we integrate with Kipu and Athena, just happened that
| our first clients are rehabs and clinics that use these 2.
|
| Good point on the desire to stay in HR for the review workflow,
| this is our vision that could be achieved with widgets in
| specific EHRs but this is down the road. Once mistake is
| identified, we notify clinical professionals via standard
| communication like emails and also keep a dashboard with the
| list of 'topics' inside our portal.
| dang wrote:
| > no link to your website?
|
| Oops - it's my job to catch that as the editor. I've added it
| above now. Thanks for the heads-up!
| abelanger wrote:
| Congrats on the launch! I have a few questions (though I know
| very little about this space):
|
| 1. How often is the cause of a denied insurance claim a
| documentation error vs an intentional denial from an insurance
| company (either an automated system or medical reviewer)?
|
| 2. This feels very conceptually similar to an AI review bot, but
| the threshold for false positives feels higher. What does the
| process look like for double checking a false positive in the
| agent orchestration layer?
| digitaltzar wrote:
| Thank you!
|
| 1. It really depends on the clinical specialty, but the average
| is around 25% (e.g. 250M claims denied a year because of
| documentation mistakes). We work with rehabs where this ratio
| is above 50%
|
| 2. It's triple checking -tun the analysis twice and then verify
| the conclusion, 3+ separate agent calls
| bradly wrote:
| > We work with rehabs where this ratio is above 50%
|
| Medical offices where more than 50% of the denied claims are
| because of documentation mistakes? I'm confused why they are
| still operating. Is this not malpractice of some kind?
| digitaltzar wrote:
| For them it's a cost of doing business. Many of those
| claims will be paid after resubmissions (upon fixes the
| mistakes if it is possible) but the office operates with
| higher amount of working capital in this case
| bradly wrote:
| > For them it's a cost of doing business
|
| "a cost of doing business" reads like they do not care
| that over half their denials are not real. You are
| working with business that do not care about humans and
| will use your tool to more extract profit. I'd rather
| them go out of business if they cannot get 50% of their
| claims done in a way that doesn't get them auto rejected.
| nradov wrote:
| Be careful what you wish for. We already have a shortage
| of healthcare providers. Do you want to make it harder to
| get an appointment? There's nothing wrong with billing at
| the maximum level legally and contractually allowed.
| bradly wrote:
| > There's nothing wrong with billing at the maximum level
| legally and contractually allowed.
|
| I completely disagree with that statement. By nothing
| wrong, do you mean it isn't illegal?
|
| It is horrible that some health care providers are
| denying more than half their claims incorrectly. A
| strawman argument about making it harder to get an
| appointment does not change that.
| nradov wrote:
| Medical malpractice only applies to patient care, not
| administration. In other words, a provider can't be found
| liable for malpractice just because there's an error in the
| patient chart: there has to be some evidence of patient
| harm as well. Claim denials aren't a legal issue unless
| there is some sort of fraud or contact violation involved.
| digitaltzar wrote:
| Now I understand your question. I can provide and example
| where a small documentation error may cause patient harm
| - wrong copy-pasting in a discharge note, copying from
| other personal medical record and accidentally pulling
| their diagnosis into the record, and then factoring this
| diagnosis by the other doctor in their treatment plan
| bradly wrote:
| I don't know then, gross negligence? ianal, but why is
| this an acceptable and profitable way to operate is
| beyond me.
| nradov wrote:
| Errors on a medical chart by themselves wouldn't legally
| constitute gross negligence (or even regular negligence).
| But if there was some sort of preventable patient harm
| then such errors could be evidence for establishing
| malpractice liability and/or professional sanctions.
|
| In general patients should always check their own chart
| notes for errors. Most providers now make those available
| online for free through a secure patient portal.
| hooverd wrote:
| What was integrating with PowerChart and Epic like? Maybe they've
| improved in the last ten years, but the interfaces for both still
| seemed pretty awful.
| digitaltzar wrote:
| It's a rough journey, we are exploring how MCP makes it easier.
| Haven't met anyone who say that they like their EHR interface
| yet.
| trollied wrote:
| You answered that as if you haven't done it yet?
| digitaltzar wrote:
| Not with Epic, we work with Kipu and Athena for now
| SergeyYudovskiy wrote:
| To whom should it be wandering - TS website is
| https://www.wrkdn.com/
| dang wrote:
| Added above now. Thanks!
| Trugelnovatch wrote:
| Looks awesome, congrats guys.
| arkmm wrote:
| Very cool to see an early stage company doing this! I always hear
| that healthcare has a lot of red tape to handle so it's hard for
| startups to operate without tons of VC funding.
|
| How'd you guys find your initial users and figure out rehab
| clinics were a good place to start?
| digitaltzar wrote:
| Great questions, indeed this is a kingdom of red tape. We
| realized that our fist users likely will be small providers but
| who currently lose $$ on denied/delayed claims. Talked to the
| first cohort of them - rehabs, allergy clinic, men's health
| clinic, nursing home, etc. We signed the first rehab just 2
| weeks after meeting them because we offered to solve their
| problem in the same way as their 3rd party billing provider
| does (manually finds mistakes and circles them back to
| clinicians) for 2x lower price tag. Then we realize this is
| common situation for many rehabs.
| WesleyJohnson wrote:
| My FIL ran his own prosthetics and orthotics business for a
| couple decades and then had to shutter his doors due to all
| the insurance provider red tape. If all the Ts weren't
| crossed, or Is not dotted - denied. And the
| appeals/resubmission process was, IMHO, deliberately drawn
| out to deter anyone from doing it. US healthcare and
| insurance is such a shit show, but I digress. He now works
| for the VA, making much less - but at least he's still
| helping people and working in his field.
|
| Glad to see something like that taking shape, and hopefully
| helping other small businesses (and larger too) get a leg up
| on these insurance companies. As well, of course, avoiding
| real-world medical dangers as you've mentioned.
|
| Kudos on launching.
| digitaltzar wrote:
| Thank you, human stories like this made us passionate about
| solving this issue! Talked today to a behavioral health
| clinic that has 65 different payors, all with own set of
| billing rules and documentation standards!
| sigmaisaletter wrote:
| Cool idea. This seems US-only, unless I missed something.
|
| Is this even possible in the EU with the GDPR and its stricter
| rules on medical data?
| digitaltzar wrote:
| Not only US, e.g. the whole clinical world is now moving into
| AI-powered scribing of doctor visits, it really depends on the
| deployment model - where are LLMs, how they comply with local
| regulations. But access of AI to medical charts is a solved
| questions in general.
| agcat wrote:
| Congrats on the launch!
| 1oooqooq wrote:
| congrats on the launch, but how dystopic society have become is
| unbelievable.
| w10-1 wrote:
| Respect for the work, but recommend a pivot to Epic IT
| integrators as your target customer...
|
| (1) Don't confuse medical errors with claims errors. Your claims-
| amplifying customers don't really care about medical errors;
| they're mainly just optimizing their extraction from government
| and insurance payment systems. (And the vast majority of medical
| errors take significant skill to detect - beyond even complicated
| decision support systems.)
|
| For claims errors, I would rather the system provided feedback to
| the EHR Epic engineers than trying to block providers. The Epic
| IT should be getting regular reports that prompt them to fix
| their UI issues.
|
| But then I care more about fixing the Epic UI than claims.
|
| (2) Epic/EHR's are an epic UI failure (not surprising since it
| was not driven by user need but via top-down requirements). It
| has random and super-complicated form UI's forcing users into
| complicated multi-step workflows to say something trivial.
|
| Today in medicine the logistics of interfacing with Epic and
| other EHR's takes longer than the actual care. (Just imagine
| having to use a compiler that took longer than you did to write
| the code.) It's the scourge of medical care today.
|
| In that context, imagine: you want to build a system that argues
| with providers when they're done, based on AI logic completely
| separate from the Epic system logic? It's hard to imagine a
| better way to make a bad situation worse.
|
| What would be huge benefit instead is an AI tester for Epic.
| Something where you could generate all the ways users might see
| their UI and need to use it, and quantify all the
| confusing+unnecessary visuals and steps, to actually measure
| usability. Think user modeling and fuzzing coupled with
| progressive pruning for workflows, with actual metrics of system
| and workflow complexity.
|
| That usability testing would probably be useful in other domains,
| too. But starting with Epic would be good because it has so many
| UI errors (high signal to noise) and saving time for highly-paid,
| highly-blocked users translates directly to dollars. You could
| sell it to every Epic integrator in the US. Those customers are
| easy find and target, they have strong needs, they can work with
| you as your technology evolves (and filter the inaccuracies). By
| giving them objective measures of usability/complexity, you
| simplify their design space and give them a clean way to measure
| system improvement, reducing the level of politics they endure.
|
| Along the way you would build AI models over user interaction
| (instead of tokens). Then you could build interactive auto-
| completing UI's that work based on session observation and voice
| alone.
|
| Unless I'm searching or researching, I don't want AI to replicate
| what's been said. I want AI to anticipate what I'm doing, and
| afford me the choices I need to make. That's exactly the model of
| diagnosis and treatment.
| digitaltzar wrote:
| Very insightful, thank you! A comment on claim-amplifying
| customers - optimizing for the insurance payouts actually
| forces providers to adopt certain standards of compliance for
| medical records - here we are not talking about mistakes but
| about depth of CPT coding (the biggest for value-based care
| providers), etc. And it is not about claim but the underlying
| documentation of care
| nradov wrote:
| Most of that seems rather pointless. Epic is the worst EHR --
| except for all the others. There aren't a lot of Epic IT
| integrators out there as potential customers: Epic does most
| customer implementation and support in house. They do offer an
| extensive set of APIs for third-party developers including
| SMART on FHIR but there aren't many IT integrators focused on
| that either.
|
| As for usability feedback to Epic engineers, they generally
| aren't interested in what you have to say. I mean Epic does
| make product changes based on customer feedback but they don't
| listen to input from random other companies and they certainly
| don't pay for it. Their culture is more that they know the
| correct way to do things and customers should change their
| processes to fit the software.
|
| https://www.acquired.fm/episodes/epic-systems-mychart
| digitaltzar wrote:
| My friend who works now as an engineer at Apple interviewed
| with Epic 6 years ago - he got a guidance from a fellow to
| make a few mistakes in test tasks to increase chance of
| getting a job offer, and it worked - he got the offer
| nradov wrote:
| Whatever Epic has been doing from a hiring perspective
| seems to work pretty well. They are highly profitable, have
| a near zero customer churn rate, and many employees have
| been there for decades. The software might not be ideal
| from a usability or interoperability perspective but it's
| reliable, secure, and gets the job done. We could all learn
| something from how they operate.
| ttcbj wrote:
| My wife is a doctor at a major university. They are under
| pressure right now and are looking to increase revenue. Changing
| the way they document cases can substantially alter the billing
| outcome. Note that these are not errors, they are omissions of
| work done in the note that prevents the downstream billing
| experts from using higher paying codes.
|
| They have been aware for a few years that many clinicians aren't
| documenting their work in the best way for billing. The current
| solution is to have an annual talk given by the one billing
| expert in their department pointing out where people often lose
| revenue due to poor documentation.
|
| Not all the doctors attend this talk. There is no internal
| process for measuring subsequent improvements quantitatively.
| There are 85 doctors in her group.
|
| Anyway, this is just to say that something automated to help
| doctors document their work in a billing friendly way seems
| powerful. But for my wife's group, the issue doesn't seem to be
| denied claims or "errors" per se. More omissions/sub optimal
| documentation due to lack of knowledge. Or lack of follow through
| on knowledge which is only occasionally communicated.
| digitaltzar wrote:
| Thank you for the insights, I believe the challenge they have
| is related to CPT coding - not mistakes or errors, but the
| completeness' of clinical picture fro m the billing/insurance
| standpoint. A lot of this coding knowledge is tribal and
| resides in the head of clinicians. We can help, would greatly
| appreciate an introduction to your wife's colleagues at
| dmitry.k@wrkdn.com (Dmitry Karpov), thank you!
| cco wrote:
| I am not trying to be antagonistic, just earnestly trying to
| clarify.
|
| The goal here of your wife's hospital is to try to increase
| revenue and the outcome, either AI assisted or not, is more
| accurate visit notes which leads to more accurate billing,
| which would lead to higher costs to the patient for the same
| medical care.
|
| If that's right, I suppose a truer reflection of the medical
| care provided is a good unto itself, but I have to say I don't
| love the outcome as someone who's a patient and not a
| shareholder (401k notwithstanding).
| digitaltzar wrote:
| Thank you for these thoughts. I think billing inefficiencies
| caused by documentation make both hospitals and insures lose
| - one will get paid later, one will pay anyway, but the
| process is costly for patients who finance both, in the end
| of the day :(
| realo wrote:
| Avoid the healthcare loto ... come live in Canada and be
| happy!
| digitaltzar wrote:
| :)
| the__alchemist wrote:
| Time to prosecute the hospital administrators who encourage
| this. I've heard the same from friends.
|
| This is fraud.
| aerhardt wrote:
| Are agents all LLM-based or do you use other AI/ML techniques?
| digitaltzar wrote:
| The agents are LLM-based but for orchestration we use other ML
| methods
| whitten wrote:
| If you are interested in interfacing with an open source EHR/EMR,
| World VistA is available.
|
| I have extensive experience with it and am willing to help.
|
| information is at https://worldvista.org and https://hardhats.org
| and https://va.gov/vdl
| digitaltzar wrote:
| Thank you so much! Lets explore! Could you please ping me at
| dmitry.k@wrkdn.com or let me know what is the best way to
| connect
| vasusen wrote:
| Congratulations on the launch!
|
| How do you get the medical professionals to see a "diff" of the
| changes to approve? Is there versioning in the EHR tools?
| shcheklein wrote:
| Congratulations on the launch! Amazing work, it would be great to
| see how it evolves into a bigger story, work related agents
| beyond healthcare.
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