Munjal Shah is a 5-foot-something man with a mega vision that involves, yes, you guessed it — generative AI in healthcare. His ability to tell a story while being supremely convincing is a skill that would likely make most entrepreneurs green with envy. There is both bravado and sincerity.
No doubt those skills played a big role in winning $50 million in seed funding from General Catalyst and Andreessen Horowitz to build what he bills as a safe, large language model specifically for healthcare. That announcement came in May when the Palo Alto, California startup — Hippocratic AI — emerged from stealth. The idea was apparently rooted in a conversation between Shah and Hemant Taneja, the prominent venture capitalist in General Catalyst’s healthcare team. The two talked about how ChatGPT had consumed the world and brainstormed about whether there were applications of LLMs in healthcare.
Turns out that there are. In my roughly 40-minute interview with him at the HLTH conference on Tuesday, Shah engaged in a bewitching narrative of how LLMs can be a force for immense good. Imagine if every chronic disease patient in the United States got the same level of high-quality care as if they had one chronic disease nurse specialist devoted solely to them. Imagine if heath systems could achieve this level of care without hiring an army of humans — which is impossible anyway given prohibitive costs and a nursing shortage in general.
That is the future Shah is creating, or more accurately attempting to create. His first healthcare venture crashed and burned, and he is currently battling a lawsuit, but more on that later.
Solving the staffing crisis
Shah is very clear about what his LLMs are not going to do.
“In fact, we explicitly are not even going to allow people to try to use it to do diagnoses,” Shah insists. “I don’t think it’s safe, honestly.”
Nor is he interested in leveraging AI to make more sense of the electronic medical record and relieve administrative burden.
“Everybody’s out there saying, ‘Let’s do EMR summarization or let’s write drafts in baskets in Epic, or let’s write pre-authorization letters to the insurance companies.’ ” he said of the conventional thinking about the best ways to apply generative AI in healthcare. “I think … maybe that’ll make doctors 10% more efficient.”
And it’s just too low of a bar for efficiency for Hippocratic AI, implies Shah. What he is interested in is solving the staffing crisis in healthcare.
“We’re focused on low risk activities that can still give huge leverage in healthcare,” he declared. “They drive huge costs in healthcare and can improve outcomes a lot.”
So what are those applications? A voice-enabled AI nurse trained to take care of very specific healthcare conditions and able to manage a conversation with a human battling those conditions.
Where is the trust?
Trust is the core of building any business but a fledgling one that is pushing AI as a fundamentally transformative tool has to be bathed in it. And that is where Shah has a problem. In an excellent article that followed Hippocratic AI’s splashy launch, Forbes’ Katie Jennings enumerated how Shah’s previous company Health IQ is “facing allegations of millions in unpaid invoices, tens of millions in debt” with one lawsuit is “alleging fraud.”
Health IQ was a Medicare brokerage startup that Shah co-founded and was CEO of. It is currently in Chapter 7 bankruptcy proceedings.
When asked how folks can trust Shah’s new venture given this history, there is a noticeable change in his demeanor. He is surprised that the issue was raised at all but to his credit doesn’t shy away from addressing it. Gone is the bravado, the self-assuredness of knowing that he likely has the tools to can solve a really intractable problem in healthcare. In its place, there’s almost a look of sheepishness.
“I would say that, look, I built that business and really focused on trying to ensure we built a good business serving seniors. In building that business we took on a lot of debt to grow it,” he explained. “And the debt was cheap when debt was cheap. And then as the interest rates went up, we really struggled to make the debt payments.”
He added that he spent his entire Christmas of 2022 trying to raise fresh capital from 50 investors. He added that some creditors didn’t understand that certain senior lenders were secure and when the company folded through a Chapter 7, they would get paid first. Which meant others wouldn’t be paid at all.
“As the waterfall trickles down. there’s less and less to share,” he said. “I lost huge amounts of money personally in it. But in the end, when a company runs out of money, companies run out of money and not everybody can get paid.”
Shah built three companies before. The two before Health IQ weren’t in healthcare. Like so many tech entrepreneurs that have rushed in hoping to improve healthcare delivery and efficiency while reaping millions, he encountered an inhospitable terrain.
“I did not realize how difficult some parts of healthcare were to be,” he conceded. “I’ll try to get my redemption through Hippocratic and try to do something good.”
Meanwhile, many of the vendor lawsuits filed against Health IQ are on administrative stay pending the resolution of its bankruptcy filing. A class action lawsuit filed by employees is also pending.
Photo: Sylverarts, Getty Images