Google’s Efforts to Build Patient-Facing AI: A Conversation with Drs. Alan Karthikesalingam and Anil Palepu
In this episode of NEJM AI Grand Rounds, guests Drs. Alan Karthikesalingam and Anil Palepu of Google walk co-hosts Raj Manrai and Andy Beam through the making and evaluation of AMIE, an AI system designed to conduct clinical conversations with patients. Alan and Anil explain how AMIE was trained using synthetic doctor-patient interactions generated by LLMs playing multiple roles—doctor, patient, critic, and moderator. They reveal how synthetic dialogue, guided by structured feedback and grounded in search, proved more effective than noisy real-world transcripts in building a model that could reason, ask questions, and show empathy. The discussion also covers what the “long tail” of medicine demands for building robust AI systems and how AMIE might one day augment real clinical workflows. Finally, Alan reflects on how AI has changed—and how it hasn’t—in the two years since he was last on the podcast.
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Rewriting the Clinical Playbook: Dr. Shiv Rao on Scaling Empathy with AI
Dr. Shiv Rao, cardiologist and CEO of Abridge, joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds for an inspiring conversation at the intersection of medicine, technology, and meaning. Shiv shares the origin story of Abridge, reflecting on how a deeply human encounter in clinic sparked the idea for a company now transforming clinical documentation across more than 100 health systems. From his early days programming electronic music to navigating LLM deployment at scale, Shiv offers a rare look into the soul of a founder building not just infrastructure — but a movement. He unpacks how generative AI can be used to restore presence in the clinic, what it takes to earn clinician trust, and why he believes taste, empathy, and curiosity are the real moats in health care AI.
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Pixels to Protocols: Building the AI Future of Pathology with Dr. Faisal Mahmood
Dr. Faisal Mahmood, Associate Professor of Pathology at Brigham and Women’s Hospital and Harvard Medical School, joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds to explore the frontier of computational pathology. From pioneering foundational models for whole slide imaging to commercializing a multimodal generative AI copilot for pathology, Faisal shares how his team is redefining what’s possible in digital diagnostics. He discusses the power of open-source culture in accelerating innovation, his lab’s FDA breakthrough designation, and how generative AI could trigger widespread digitization in pathology. Faisal also reflects on his creative approach to problem selection and offers a vision for a future shaped by patient-level foundation models and agent-led computational biology.
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From Bedside to Boardroom: How AI, Multi-Omics, and New Business Models Are Shaping the Biomedical Frontier with Morgan Cheatham
Morgan Cheatham joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds to discuss the evolving landscape of artificial intelligence in health care, from its role in automating clinical documentation to its transformative potential in genomic medicine. A venture capitalist and future physician, Morgan shares how his background in computational decision sciences led him to medical school and investing, offering insights into how AI is reshaping everything from disease phenotyping and clinical decision-making to scaling precision medicine. He reflects on his work evaluating ChatGPT’s performance on the USMLE, the growing importance of genomic learning health systems, and why the biggest challenge isn’t technological innovation—but aligning payment models to support AI-driven advancements in medicine.
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From Clinical Notes to GPT-4: Dr. Emily Alsentzer on Natural Language Processing in Medicine
Dr. Emily Alsentzer joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds to discuss the evolution of natural language processing (NLP) in medicine. A Stanford faculty member and expert in clinical AI, Emily shares her journey from pre-med to biomedical AI, the role of language models in medical decision-making, and the ethical considerations surrounding bias in AI. The conversation explores everything from the early days of rule-based NLP to the modern era of large language models, the challenges of evaluating AI in clinical settings, and what the future holds for open-source medical AI.
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NEJM AI Grand Rounds, hosted by Arjun (Raj) Manrai, Ph.D. and Andrew Beam, Ph.D., features informal conversations with a variety of unique experts exploring the deep issues at the intersection of artificial intelligence, machine learning, and medicine. You’ll learn how AI will change clinical practice and healthcare, how it will impact the patient experience, and about the people who are pushing for innovation. Whether you are an AI researcher or a practicing clinician, these conversations will enlighten and surprise you as we journey through this very exciting field. Produced by NEJM Group.
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