From Burnout to Breakthrough: How Pittsburgh Powered Abridge's Rapid Rise
By: Carlos J. Queirós
At Abridge's headquarters along Penn—“AI”— Avenue in Pittsburgh, Dr. Shiv Rao reflects on a crisis that's reshaping American healthcare.
The stats are stark, Rao says: Two in five doctors don't want to be doctors in the next two to three years. Twenty-seven percent of nurses plan to leave within twelve months.
For Rao, a practicing cardiologist born and raised in Pittsburgh, these aren't just statistics. Something had to change.
The conviction that technology could help solve healthcare's burnout crisis at scale came from a moment years earlier.
At Carnegie Mellon, where Rao studied history, an professor told a story that lodged in his mind about an ophthalmologist in India who sat on a revolving platform performing cataract surgeries at different clock positions—12, 3, 6, 9—spinning all day, five to ten minutes per procedure. By the time Rao heard the story, the doctor had restored sight to over a million people. Rao knew then he wanted to be part of a team creating that kind of impact at scale. In healthcare, he realized, technology could unlock that kind of reach.
The Intersection Rao Needed
When Rao founded Abridge in 2018, he recognized Pittsburgh offered unique advantages.
"One of the most interesting aspects of Pittsburgh is that we have all these ingredients for incredible companies," he says. "And as far as healthcare and AI goes, we have some of the top healthcare institutions in the world in this city. And then we also have Carnegie Mellon University, and so we live at that intersection."
Dr. Shiv Rao, Abridge’s Co-founder and CEO
Rao needed that intersection.
Abridge emerged from the Pittsburgh Health Data Alliance (PHDA), a unique collaborative formed by UPMC, Carnegie Mellon University, and the University of Pittsburgh. The alliance provided the ideal incubation environment, merging deep clinical insights with world-class computer science and a direct path to commercialization.
Pittsburgh concentrates what healthcare AI needs: UPMC's 40 hospitals, Carnegie Mellon's AI research, and the University of Pittsburgh Medical Center as a natural testing ground. This ecosystem enables rapid iteration between clinical needs and technical solutions, a rare combination in the current technology landscape.
For Rao, the advantage was concrete. "In this city, we have the privilege of being able to partner with any number of the institutions where we can actually go into the clinic, we can sit down with those clinicians, get their feedback, and make sure that we're really hitting it out of the park for them," he says.
This proximity to real clinical environments would prove crucial as the company scaled.
The Pivot That Changed Everything
Abridge's story began with a different focus entirely.
The company was initially conceived as a mobile application that would help patients remember and understand details from their medical conversations. But Rao soon identified a more pressing challenge.
The overwhelming administrative burden placed on clinicians was driving widespread burnout. A study published in the Annals of Family Medicine found that primary care physicians spend nearly six hours on electronic health records for every eight hours of scheduled patient care.
Rao pivoted.
"Our mission at the company is really to unburden clinicians like me from all the clerical work that we have to do, to help clinicians really be more present and be fully focused on the patient in front of them," Rao says, drawing from his own frustrations as a practicing physician.
The financial stakes couldn't be higher in an already strained system. Healthcare burnout costs the industry an estimated $4.6 billion annually, according to the Annals of Internal Medicine.
No Off-the-Shelf Technology
The pivot required more than just a new business model. It demanded technology that could handle the complexity of medical language across diverse clinical settings.
Today Abridge handles 28 languages and 50+ medical specialties. Every AI-generated summary links back to the actual conversation moment, so doctors can verify what was said.
"This isn’t off-the-shelf technology that anyone can use to build this type of product," Rao says. "You need to be able to fine tune models, you need to be able to post train, you need to be able to do a lot of that deeper scientific work."
Rao envisions something even more ambitious: "What we're really focused on is helping every single one of these clinicians feel like a superhero. Give them superpowers so that they can be almost omniscient to the patient's history, so they can make the best possible decisions for patients.”
Rather than building a narrow vertical solution, Rao describes Abridge as "shaped kind of like a T shaped company” that can go really deep on all things related to the specific problems they’re solving while maintaining a horizontal R&D kind of arm that allows them to think more expansively.
Here, Pittsburgh's unique ecosystem became Abridge's secret weapon.
The talent pipeline runs deep through the city's interconnected institutions. Abridge’s co-founder and Chief Scientific and Technology Officer Zachary Lipton serves as an associate professor at Carnegie Mellon, where he's been able to recruit professors, PhDs, and postdocs. Meanwhile, Chief Operating Officer Julia Chou contributes essential scaling expertise from her time at Google/YouTube. This direct access to cutting-edge research, combined with Rao's continued practice as a cardiologist, ensures the company remains connected to both technological frontiers and clinical reality.
The resulting Abridge platform features sophisticated technology including medically-tuned automatic speech recognition and the recently introduced Contextual Reasoning Engine, which integrates live conversations with patient history, billing guidelines, and individual clinician preferences.
From Party Trick to Urgent Infastructure
By 2021 and 2022, Abridge was still seen as what Rao calls "a party trick." Health systems would call for entertainment, to see a magic trick on Zoom calls. They'd watch demos, be impressed, then move on.
What Rao didn't realize then was that they were essentially pre-selling Abridge. When ChatGPT launched in late 2022—bringing AI into broader public conscious—and clinician burnout suddenly became a CEO-level priority in 2023, those same health systems called back. The party trick had become urgent infrastructure.
A breakthrough came in August 2023 when Abridge became the first "Pal" in Epic's new integration program. Epic built Abridge directly into its system. Instead of being an add-on, the platform became part of the workflow itself. Thousands of hospitals could now adopt it without friction.
Beyond Epic, Abridge has secured strategic partnerships including Wolters Kluwer and athenahealth, extending its reach to 160,000+ clinicians. The July 2024 Mayo Clinic enterprise agreement added the development of nursing workflow documentation.
These partnerships moved Abridge from startup to critical infrastructure.
The Proof in Practice
Seventy hours back per month. That's what many physicians report saving with Abridge. The time translates to nearly two full workweeks returned to their lives. Beyond the hours, 78% of users report increased job satisfaction and 53% say they can give patients their undivided attention again. The platform maintains a 90%+ clinician retention rate and has inspired tear-inducing testimonials from doctors describing what it means to leave work on time.
The adoption exceeded even Rao's expectations. A few years ago, he thought this would be a five to ten year project. Instead, Abridge scaled across 150 of the largest health systems in the country in half that time.
"This industry, more than any other industry, has adopted AI so quickly because we just need automation," Rao says. "We need technology, we need to find a way to scale and to force multiply all of our clinicians."
The platform now serves Johns Hopkins Medicine, Mayo Clinic, Memorial Sloan Kettering, Kaiser Permanente, and Yale New Haven Health. In 2025 alone, Abridge will support over 50 million clinician-patient conversations.
Pittsburgh’s Unicorn Speed Run
The company's momentum has attracted significant investment attention, culminating in a dramatic financial trajectory.
Abridge raised $250 million in Series D (February 2025) and $300 million in Series E (June 2025), totaling $757.5 million raised to date, bringing the company’s value to $5.3 billion. This represents a stunning progression from its $200 million valuation in October 2023 to unicorn status and beyond in less than two years.
Abridge's success reflects Pittsburgh's broader emergence as a unicorn hub. The city now boasts seven companies valued at more than $1 billion, with four achieving that status within the last 12 months alone. Pittsburgh's unicorn roster includes language-learning app Duolingo and autonomous freight company Aurora alongside robotic AI company Skild AI, medical device manufacturer Krystal Biotech, and others. This unicorn momentum has positioned Pittsburgh to compete with Miami in terms of billion-dollar startups while overtaking Detroit.
Abridge plans to strategically deploy these funds to fuel expansion into broader clinical workflows, from automating care coordination to streamlining revenue cycle management. The company is now moving up the stack rapidly, focused not just on capturing conversations accurately, but on enabling clinicians to be more present and effective with their patients.
Conversation as Infrastructure
The insight for Abridge's next move came from a personal place. When Rao's father-in-law recently broke his hip and was hospitalized in New York, Rao experienced the patient side of the room for the first time in years. So many people coming in and out—doctors, nurses, specialists—all asking the same questions. Groundhog Day. The cardiologist would ask about nausea after the patient had spent 30 minutes describing it to the nurse that morning.
What if everyone had access to the same story? What if the doctor walked in already knowing what the patient had told the nurse an hour earlier? That's the nursing documentation problem Abridge is tackling next and it's just one example of where conversation as a data layer can transform care coordination.
Rao has never used the term "AI scribe" to describe what Abridge does. When reporters kept using it in 2023, he'd push back. The company built an ambient documentation tool as a wedge, but Rao sees something bigger: a platform built on conversation as infrastructure. It’s conversation to clinical note, to to billing code, to care management, to clinical decision support. The documentation was always just the entry point.
The Pittsburgh Choice: Building Bridges
Ultimately, for Rao, the company's success reflects something deeper about Pittsburgh's character and his decision to build there.
"First of all, I hope that that humility you find here in Pittsburgh is just crisped into the DNA of our company. I think it's something that we really take a lot of pride in," he says.
The region's characteristic understated excellence has become part of Abridge's identity—a humility that shapes the company's approach and even its naming.
"Built into the name of our company is that we're abridging conversations, we're sort of trying to summarize and distill them. We're also trying to build a bridge between the people who matter most in healthcare, the patient first and foremost, but also their care team around them,” Rao explains. “But then finally, Pittsburgh is the city of bridges. You know, and that's something that will always be in our DNA."
Rao’s vision extends beyond Abridge to Pittsburgh's potential as an AI hub. He sees the opportunity to create a concentrated innovation ecosystem, drawing inspiration from the four-block radius in San Francisco where scientists gather at coffee shops and hear bleeding-edge ideas, while building something uniquely suited to Pittsburgh's strengths.
"That's the same sort of thing that we have started to build here as well," Rao says.
Carnegie Mellon University identifies Abridge as one of two fastest-growing AI startups globally, demonstrating Pittsburgh's concentration of machine learning expertise rivals any tech hub. The operational advantages are substantial—office space costs roughly 60% less than major tech centers while providing access to world-class talent. The company's strategic approach of maintaining its Pittsburgh headquarters while establishing a San Francisco and New York office demonstrates how the local ecosystem can support hypergrowth while accessing broader markets and talent pools.
But the success comes with personal costs that Rao doesn't hide. He keeps a drawing from one of his twin nine-year-old sons made when the boy was seven. The unsteady handwriting reads: "I hope you get done with your meeting soon." Before a recent interview, his wife texted to point out he'd be gone for 14 days in the next three weeks. Rao doesn't frame this as martyrdom—he's clear about the privilege—but his worst fear is specific: that somehow they won't fully seize this narrow window to reshape what healthcare looks and feels like.
"It’s a really exciting, I'd say once in a lifetime, moment right now for healthcare," Rao says.
