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About this episode

“We call ourselves a therapeutic scribe. We actually are using Deepgram to speak to the actual clinician to where they can have a conversation. It says, 'describe your session for me'. They'll go ahead and describe what happened in their session, how their client presented any assessments they did, and then the AI will actually ask questions, and then when they answer those, it'll take that information transcript again and do the same thing, create a note or a document.”

— Ross Young

Ross Young is the CEO of Clinical Notes AI, where he integrates AI to aid mental health care. Previously, Ross worked at Qoria, an AI child wellness organization, where he identified early signs of mental health issues. This experience inspired him to create Clinical Notes AI, which reduces administrative burdens on clinicians and streamlines insurance processes, combating burnout.

Ross has been featured on several podcasts and was a finalist for the Cybersecurity Stewardship Award by the San Diego Business Journal in 2020. He is an engaging speaker, having presented at events like the Riverside County SELPA Mental Health Symposium and the Colorado Psychology Association. Ross's leadership and expertise make him a sought-after speaker, advocating for AI's transformative potential in mental health. His forward-thinking approach offers valuable insights into the future of healthcare.

Listen to the episode on Spotify, Apple Podcast, Podcast addicts, Castbox. You can also watch this episode on YouTube.

In this episode of AIMinds, Ross Young discusses the journey of leveraging AI to revolutionize the field of behavioral health tech. Ross shares his transition from the cybersecurity sector to founding a company that is making a real difference in the lives of clinicians and patients.

Ross's journey began with a focus on online safety for children, leading him to the realization of the overwhelming administrative burdens faced by behavioral health clinicians. He saw an opportunity to apply AI to streamline clinical documentation processes, ultimately saving clinicians valuable time that can now be focused on providing care and building relationships with patients.

By introducing generative AI tools to the behavioral health space, Ross and his team at Clinical Notes AI have successfully developed a platform that significantly reduces the time clinicians spend on documentation. This not only enhances efficiency but also allows clinicians to see more patients and ultimately improve the quality of care provided.

Moreover, Ross's vision of AI for good shines through in the mission of Clinical Notes AI. By empowering clinicians with AI tools, the company is enabling them to focus on what truly matters - helping people in need. The impact of this technology goes beyond just efficiency; it is about enhancing human connection, empathy, and care in the healthcare industry.

As Ross shares his insights on scaling a company, fostering a culture of innovation, and the importance of customer obsession, it becomes evident that AI is not a threat to humanity but a powerful tool to empower individuals and transform industries for the better.

Fun Fact: Did you know that up to 40% of clinician’s time are spent on notes and documentation, so Clinical Notes AI helps them reduce that time by automating clinical documentation.

Show Notes:

00:00 Introduction to Ross Young and his background.
04:34 Customer obsession, problem alignment, and organizational preparedness.
09:49 AI tool detects early indicators of school violence.
12:10 Healthcare professionals create treatment plans and notes.
14:25 Expressing empathy for therapist's difficult situation.
18:15 Influencer's YouTube review led to product success.
22:35 Clinical Notes AI uses AI to document sessions.
24:18 Utilize text-to-speech partnership for privacy.
26:45 AI-aided efficiency frees time for family.

More Quotes from Ross:

“They started using it and said, 'where has this been my entire life? This is changing my life.' And then we knew that we found a problem that we could solve. So it was very exciting. The first day we rolled it out to them, we had 24 mental health clinicians sign up for it, and we were, I mean, jumping up, high fiving, excited. They started using the product, and then they started sharing it with their clinical friends that were outside of public sector.”

— Ross Young on the birth of Clinical Notes AI

“It's all about how do you get the AI, the data to be able to help you. We offer a live option to where the AI actually listens to the conversation live, and then takes that transcript that's built, submits it to one of our microservice, multi LLM infrastructure, and then from there it does the summarization, does a potential diagnosis, et cetera, and contextualizes things out of that transcript through a trained and fine tuned LLM that's designed to write clinical documentation that aligns with insurance reimbursement for them. So they talk about, hey, I got a new cat yesterday. That's not going to be in the conversation. It's only going to be what's clinically relevant.”

— Ross Young

“AI for good is such a good theme and hashtag. Frankly, I think we could go out and use our minds to create an application that uses AI to help you trade stocks better. And those are out there and those are great, but what's the purpose of, really, why we're here? And it's to really care about other people and to build relationships.”

— Ross Young

Transcript:

Demetrios:

Welcome to the AI Minds podcast. This is a podcast where we explore the companies of tomorrow being built. AI first. I'm your host, Demetrios, and this episode is brought to you by Deepgram, the number one speech to text and text to speech API on the Internet today. Trusted by the world's top conversational AI leaders, startups and enterprises like Spotify, Twilio, NASA and Citibank, we are joined by none other than the co founder and CEO of clinical notes AI, Ross. How you doing today, man?

Ross Young:

Great. Good morning.

Demetrios:

Well, I know you're on a whole different side of the globe. We were just talking about how you're in sunny San Diego right now and you got done with a workout. And so I appreciate you making time for me to chat a little bit more about your story and what you've gotten up to. You have a really fascinating journey, and it starts in the cybersecurity sector. Can you break down what you were doing there?

Ross Young:

Yeah, absolutely. So, you know, when the mortgage industry crashed back in 2008 and 2009, we said, what are we going to do? So essentially there was a little startup named Iboss out of San Diego, California. They had about six employees. And I came on really as the first salesperson there and got introduced to technology. So that's really where I got my journey started and got my taste of an IP network table and what the heck that was and what was active directory, that was quite a new world for me early on in my career.

Demetrios:

Excellent. And so then you said, all right, 2008, I'm going to try and get a sales job. I imagine that did well for you. You learned a lot about the tech and then you kept going deeper and deeper.

Ross Young:

Yeah, exactly. Well, I was so overwhelmed with what I didn't know that I really just dove in to learn how networks functioned, learn how cybersecurity worked, and we got into protecting kids online by blocking them from getting access to pornography at the network level. So that really started my journey into like, you know, behavioral health tech, but cybersecurity as well. So it was something that was quite interesting, that helped people but, and kept kids safe online, but also is technically very interesting.

Demetrios:

I'm sure there was a lot of very frustrated 16 year old boys out there because of what you were doing.

Ross Young:

People asked me, they said, what do you do? I said, I ruined 14 year old boys dreams.

Demetrios:

Poor guys. But it's also good. So break down this whole, like, behavioral tech idea and then where that took you.

Ross Young:

Yeah, absolutely. So we were pretty early on at iBoss, and within a couple of years, we became the market share leader in blocking students from getting to inappropriate content to keep them safe online. And ultimately that turned into even being able to see what kids could type in or typing into Google. And we started seeing children that were at risk from a self harm perspective. So it started to really go that direction. And then we took on some capital from Goldman Sachs and the company started to go more towards enterprise. And from there, I got a phone call from a little company out of Australia that was really focused on protecting kids online and giving parents the ability to have some control over how often their kids use the Internet, what applications they use, that type of a thing. And we started positioning that with schools.

Ross Young:

So that was a role where I led North America. I was actually the first employee in North America. And we grew that company from a million to a little over 100 million in five years in revenue. And that was quite a journey, to say the least. I learned a lot. We hired a lot, we acquired companies, we raised a bunch of capital. And I really cut my teeth at that particular role.

Demetrios:

So you saw the pains of scaling a company. What are some big takeaways that you now are implementing in your current role?

Ross Young:

Well, ultimately, being customers obsessed and problem obsessed. Right. As you see problems in the market, rather than coming up with our own ideas and pushing them out to the market, it's really about learning, learning exactly how your customer and ideal user lives their day, you know, their day to day inside of their particular role and what matters to them, and then really understanding their problems and aligning the technology there. You know, when you can do that and communicate that story, you're partnering with them, right? You're not really selling anything, if you will. And then while that's happening, preparing the organization for the level of scale, right. Taking the amount of having the big dream and the vision to dominating your market and solving the problem collectively for your entire space, and preparing your organization to say, hey, if we get 10 million users, what does that look like? Things that you do with a million users and 10 million users fundamentally have to be written in a different way. Really preparing the organization and being customer obsessed.

Demetrios:

Are there things that you recognize you needed to be focused on in different stages? I like this idea of really thinking big to try and expand the mind and expand the vision. But I imagine, like, on the organizational level, when you're at a million and you're the only person in the US, going from a million to 10 million has its unique challenges, then 10 million to 50 million has its unique challenges, and then 50 to 100 plus are whole different challenges and bottlenecks. So anything that stood out for you in each of these different phases. Yeah.

Ross Young:

To get to the next phase, right. As you're reaching up that cliff to grab onto that next rock and throw your leg over the branch and get up there, you have to do things that aren't scalable at first. Right. You know, you. You have to ultimately, you know, maybe lose on your first couple of deals to get there and really learn what that next level is like and set that expectation really with your customers as you grow. But also preparing your team. I think that's incredibly important to say, hey, we're rapidly growing. You may have to wear some hats that aren't in your exact and perfect job description, but that's part of the fun and really just smelling the roses along the journey, because you're going to trip and fall and scrape your elbow and preparing your customers, your team, your staff and letting them know it's okay to make a mistake so that because they're going to happen, they're going to learn from.

Ross Young:

But that really helps breed and set a culture of innovation across your organization. When people feel like they're okay to try things, right. As long as those expectations are there for your customers and your team, it's a really fun journey. And so that's, you know, that's it. Have fun and, you know, really try things that you know from the smart people that you've hired, allow them to make those decisions and try.

Demetrios:

I really like this idea of, on those first few deals that you're going for where you're trying to level up, you should be okay with losing as long as you're learning along the way. And it makes me instantly think, like, how do you have enough conviction in yourself or your product to know that, okay, it's, our product's good or whatever, we're learning along the way, we're tweaking it and we're making those changes, but we have the conviction in ourselves to be able to get to that next level.

Ross Young:

Right. Yeah, that's really exactly it. You know, we even, because we're transparent with that process. You know, when, when I was at linewise, which was the student safety company I was most recently at, you know, we got into the biggest deal that we had ever been at. I think it was 75,000 users, you know, at seven gigabits per second that they were on demand from a bandwidth perspective. And we struggled there. Right. But we learned a lot.

Ross Young:

We broke our appliance, we took their network town. And ultimately, we lost the proof of concept, but we built a relationship with that CIO. First of all, he said, I need to move to something a bit more stable. And that was fine, and we understood it. But he said, our support and our effort, our attention to detail was better than he's ever seen. And he ended up referring multiple other large organizations to us that we, you know, we took the learnings from his organization, applied him there, and ultimately, I think, you know, two and a half years later, we won him back as a customer. So, you know, you lived a fight another day. You take your lumps and you learn from those.

Ross Young:

Right? Builds character.

Demetrios:

Incredible. So then walk me through the next phase of your journey.

Ross Young:

Yeah. So one of the things we designed at linewise was an AI based tool that looked for early indicators, indicators of suicide, school violence, sexually abused children, substance use disorder in kids by monitoring network traffic. And what was going into the device where we found early indicators of that, we ranked them from an AI perspective. And then when there was a significant potential issue that was coming up, we would call the school counselor, call the school principal, et cetera. In some cases, we even forwarded some school violent events where weapons found in backpacks. So it was incredible now and very meaningful. Now, how did I get into clinical notes AI? Well, there is a problem with some school districts we work with. So, for example, we deployed that application to a large school district in southern California.

Ross Young:

And ultimately, after a month of a trial, they said, we're not buying. Turn it off. And we looked at our logs. We said, well, why? We thwarted four different suicidal events in children, and we're keeping kids safe in your district. And they said, look, our behavioral health staff is so overwhelmed that we cannot handle the amount of alerts that are coming in. So from a liability perspective, we cannot have these things sitting in our inbox. So turn it off. And that really kept me up at night, right? And as it kept me up at night, I thought about it and started interviewing some of those counselors, some of those principals, and talked to the CIO offline.

Ross Young:

He's like, if we would, we could. He's like, but our legal team said, we can't. So as I interviewed them, I asked them if I could to the clinicians. I said, if I could give you a magic wand and you could make one thing go away, what would it be? And they said, my notes and my documentation take up so much of my time. And as we estimated that we looked at it, started researching. It's about 30, anywhere from 20% to 35% average.

Demetrios:

31 of these notes and documentation, what does this look like? What is that like?

Ross Young:

Yeah. So every meeting that they have in certain schools and behavioral health departments, especially if they're billing insurance, they have to create a treatment plan. They have to create a progress note. They have to do an assessment on them, and then they have to do kind of a final discharge type of a document. So the treatment plans will take them 30 to 45 minutes, a kid or a patient. The progress notes, on average, is about 15 minutes after every single patient or student that they see. And if you think about the amount of time that adds up, if they're seeing six, seven, eight clients or students a day, which is about 30% of their time, how many more children could they help? Suicide is the number two cause of death for people under 24. It's horrible.

Ross Young:

And we have even internally have an experience with that. When I left my previous organization, we founded this. I founded this with the clinical psychologist out of Australia. Her name was Jordan Foster. She won business woman of the year in 2020. We had actually acquired her business in Australia, and she was a very dear friend to me and co founder in this business. And right before we actually launched our product, we actually lost her to mental health. So her legacy with us, and we're building this in her honor and in the honor for the mental health of behavioral health clinicians.

Ross Young:

Not a lot of people think about, how is my doctor's mental health? How is my therapist's mental health? Because they're helping me. They should be fine. Well, they're not. And a major burden for them is their administrative duties, and they're carrying everybody else's burdens as they're helping people as well. So it's a tough role, and most technology is built to give them more work. There's not a lot that's built to reduce the administrative burden on their plate to help them. So that's what we've built.

Demetrios:

Wow. So first off, really sorry to hear that. And it's a very difficult situation, as you mentioned, most of the time when we go to our therapist, it's like we. It's very much like, at least when I'm going, it's like me, me, me type of thing. I'm not sitting there asking my therapist, like, so, how you do it, right? And what. Tell me what's on your mind? And so I very see that what you're talking about. And it is like there is a weight that can be carried silently, because sometimes I imagine it's hard as a therapist to speak about this stuff, because you're the one who's supposed to be keeping everybody else up and making everybody else feel good. And so that's very rough to hear about.

Demetrios:

But you continued to interview people and you continued to say, what is it about this? Like, if we could get rid of this documentation and this writing that you need to do, and we could save you 15 minutes per kid that you see at the end of the day, if you tally that up, that's like a couple hours worth of documentation that they have to do. And so out of that, clinical notes was born. Is that how it.

Ross Young:

Yeah, absolutely. So with the magic wand statement, we said. We said, okay, generative AI was very new, and we knew the summarization capabilities of it, and we knew, you know, llama two had just come out, just released it. Open source hugging face was there. You know, there were some. Some models that were available, but also some off the shelf stuff, too. That was decent. So we ultimately built an mvp very small in the cloud in partnership with Deepgram, in partnership with OpenAI.

Ross Young:

I think everybody was touching that. And our own model really, as well. We put it together and pushed it out to the counselors at that particular school district, actually. And they started using it and said, where has this been my entire life? This is changing my life. And then we knew that we found a problem that we could solve. So it was very exciting. The first day we rolled it out to them, we had 24 mental health clinicians sign up for it, and we were, I mean, jumping up, high fiving, excited. They started using the product, and then they started sharing it with their clinical friends that were outside of public sector.

Ross Young:

So they started sharing it with other behavioral health clinics, and then they were reaching out to us and asking us if they could use it for free. And we're like, okay, this is starting to go well. Let's let this fire burn. So it really started to go viral in the southern California behavioral health kind of industry, if you will. And then we said, all right, well, let's build this puppy for scale. So, with our experience of previously building a company up to serving over 13 million daily average users, we started to build our infrastructure, and we can look around corners with some of that. So, yeah, that was how clinical notes AI was born. And we continued to get additional MVP's deployments and scale took us around four months to actually build the product until we were ready for GA.

Ross Young:

Then we added pricing and hooked it up to strike, created some automation there, and we actually launched the product GA on January 22, of 2024.

Demetrios:

And have you noticed that it is mainly word of mouth that's been the reason for the growth?

Ross Young:

Well, yes, and some influencers really, as well, which I guess is technically word of mouth, too. So essentially we had what, you know, what kicked us off, really, and we built a dual go to market model, which I'll get into in just a minute. But what kicked us off really, was an influencer on YouTube that only talks about clinical documentation for therapists. I mean, how perfect of a, of an influencer had found our product, reached out to us for a demo, and she said, by the way, I have a YouTube channel with 29,000 mental health, behavioral health specialists that I talk about notes with. Can I do a review on your product? What did I tell her? You think? Absolutely. I said, can we do a rev share or something? No, I do not take any type of compensation at all. I just want to review your product. So she did a review, and then boom, it exploded from there.

Ross Young:

And we created a referral program as well. And that's part of our individual and small group practitioner approach. But we have a dual go to market approach as well for the enterprise, which we're doing really well into.

Demetrios:

And is it, as you mentioned, there's been this time saving aspect. I imagine you're getting people that are reaching out to you saying, like, I'm able to see x amount of more students. Is that like the main value prop that you're saying, like, you can now see more patients because of all this paperwork that gets cut out?

Ross Young:

Well, here's the thing. In behavioral health, people get into it because they care about people. So that's instant problem. Not to mention the mental health of the clinicians, which we'll get into in a second. But then we go, okay, we show the demo, we talk about it, and we go, how much time do we think that AI could shave off of their note and documentation time? See, if I say it's suspect, if they say it's true, so they go, well, shoot, 40% usually is what they say. Our reports are showing about 60, but we go, okay, let's go with 40. All right, so if you're at 1.4 million, right, and it's 40, that's $600,000 plus a year. If you can shave that off.

Ross Young:

Well, what's the cost of our product? A little bit less than that. No. So the ROI is really there from a business sense perspective, and then just the lives of, of the people.

Demetrios:

Yeah, it's super clear. If you can put it in those types of numbers, because someone is like, and it's not like, as you mentioned, the clinician isn't stoked to be doing paperwork. I imagine there's not really a lot of people that get out of bed and think like, wow, I hope I can do more paperwork today than I did yesterday. Right? Yeah, there's, there's that whole side of it where you get to empower people to do what they do best and let the bureaucracy part of it kind of go under the hood. And so can you break down how exactly it works? Are people just recording conversations with their phone in the, in, in their, like, uh, what is it called when they see a patient? Or like, what, what does it actually look like to get the documentation done for you or, or have a copilot doing the documentation with you?

Ross Young:

So there's a couple of ways that we do capture. It's all about how do you get the AI, the data to be able to help you. We offer a live option to where the AI actually listens to the conversation live, and then takes that transcript that's built, submits it to one of our microservice, multi LLM infrastructure, and then from there it does the summarization, does a potential diagnosis, et cetera, and contextualizes things out of that transcript through a trained and fine tuned LLM that's designed to write clinical documentation that aligns with insurance reimbursement for them. So they talk about, hey, I got a new cat yesterday. That's not going to be in the conversation. It's only going to be what's clinically relevant. So that's option one. Option two is talk to your AI scribe.

Ross Young:

We call ourselves a therapeutic scribe. So we actually are using Deepgram to speak to the actual clinician to where they can have a conversation. It says, describe your session for me. They'll go ahead and describe what happened in their session, how their client presented any assessments they did, and then the AI will actually, AI will actually ask questions to them, and then when they answer those, it'll then take that information transcript again and do the same thing, create a note or a document. So really, in this space, it's all about informed consent and the client being aware that AI is being used to listen to the conversation. It's very sensitive information, even more so than medical Phi, right. You may not care if it gets out that somebody knows how many, what your t cell count is in your blood, but you're going to care if you tell somebody a very deep, dark, traumatic story of some level of abuse. You've experienced or a marital conflict or those types of things.

Ross Young:

So highly sensitive. So we give those different types of options to our customers.

Demetrios:

Yeah, that makes a lot of sense. And then, wow. So let me just try and summarize everything here because it feels like this is very cool. What you've been able to do is you said, okay, you have two options. You can have it there with you and then it will help whatever the paperwork is after the fact, or you can be prompted and then you, as the clinician can talk about what you just went through and what you were talking about and all of that fun stuff because I imagine some people aren't super excited to have their conversations being recorded when it is this sensitive.

Ross Young:

And that's a key factor and strategy we actually made. So we use the speech to text technology through partnering with Deepgram, and then from there, that audio is discarded immediately. It can't be subpoenaed, it can't be pulled. The transcript that we get out of that, we use just enough to create the document or the note, and then that is disassociated as well. So we put all of that in our privacy policy. We have scripts for clinicians to read to patients. There's, there's generally a fear of that upfront, but it's all about the delivery for them. And we get a lot of feedback from our customers that I'm surprised that all of my customers are okay with this and people are actually intrigued with that, you know, especially because it helps their clinician.

Demetrios:

Well, Ross, this is super cool to see, and I'm very excited for what you're doing. It is, as you mentioned, AI for good in a way. And so I wanted to talk a bit about that theme. And I think the narrative right now, the general narrative, is that AI is going to come. It's going to take our jobs, it's going to destroy everything. Feels like you've really found a way to leverage what we are capable of doing today. Not some far fetched story in the future, not some fantasy or Sci-Fi book that may or may not happen. You said, what can we do today to help people's lives be better? And let's do it.

Demetrios:

Let's put it into practice. Let's see how well it works and let's see how people respond to that.

Ross Young:

I mean, AI for good is such a good theme and hashtag, frankly. Right. I think we could go out and use our minds to create an application that uses AI to help you trade stocks better. And those are out there and those are great, but what's the purpose of, really, why we're here? And it's to really care about other people and to build relationships. So it actually does the opposite of, I think, what a lot of people think it does. It's going to take my job, people are going to be lazy, et cetera. That's not the case. Humans are tool builders, right? I think there was a study done back in the eighties, and I think it was unpopular mechanics, where it ranked the animals versus the humans.

Ross Young:

And the humans were ranked, I think, 9th or 10th in that particular study on their own, from speed, from efficiency, et cetera. But then they recalibrated that with a human on a bike, and the human on the bike was number one by far, right? We are tool builders. What we've done here with AI is build a tool to help humans be more efficient. Look at all the different medicines that can come out of this. Look at how many more diseases can be detected. Look at how much time it can save so that clinicians can build better relationships with their patients, so that they can focus on their families and not do notes and documentation on weekends. It's making us much more efficient. From a content creation perspective, there's so many millions of new problems that AI can help humans solve, so that they can focus on their families, so they can focus on their wives and their husbands and their relationships to free up the time that we would spend nights and weekends maybe writing that white paper or writing that documentation.

Ross Young:

So AI for good, to really help the people who help people, is what we're focused on. And I think it's really important that we get the word out about that, because a lot of fear just comes from ignorance, which is just a lack of knowledge. And as we explain and show people how it's making their lives better, they feel good about using AI, and they know they're using it really in the right way.

Demetrios:

Of course. Excellent, Ross. Well, I'm very excited for everything that you've got coming and what you are doing. I appreciate you coming on here and exploring and talking about your journey with us and everything that you're doing with clinical notes.

Ross Young:

Thanks Demetrios for having me on, and it's always a pleasure to connect with you, and hopefully we can do it again soon.