We spent years caught between patient care and paperwork. So we built something different.
After eight years practicing Internal Medicine in acute care and inpatient settings, I reached a breaking point that many of my colleagues know all too well: spending 3-5 hours every day on documentation instead of practicing medicine.
The irony wasn't lost on me. I had become a physician to care for patients, to solve complex clinical puzzles, to make a real difference in people's lives during their most vulnerable moments. Instead, I found myself racing through encounters so I could spend the evening clicking through templates and satisfying checkboxes.
In 2024, I took on a role as a Physician Advisor. I wanted to understand how the hospital enterprise truly works—and this decision changed everything. It showed me the full scope of the problem.
Working alongside our CDI team, I helped clinicians capture the true complexity of their care in documentation. With Utilization Management, I saw how appropriate medical necessity decisions hinged on documentation that physicians rarely had time to perfect. I assisted denial management teams with peer-to-peer reviews, watching appeals fail not because the care was wrong, but because the documentation didn't tell the complete story. I helped entire departments streamline their templates, trying to bridge the gap between clinical reality and regulatory requirements.
Every team I worked with had the best intentions. Every back-end department was trying to help. But they all shared one fundamental assumption: that clinicians would somehow know the why, when, and how of revenue cycle management, Medicare regulations, and the ever-expanding universe of compliance requirements—and would simply document accordingly.
They expected us to be physicians, coders, compliance officers, and regulatory experts all at once.
Like many physicians, I searched for technology that could help. I tested AI scribe after AI scribe. Not one of them understood acute care.
They were built for the outpatient world—15-minute appointments with a clear beginning, middle, and end. They had no concept of the hospitalist's reality: inheriting complex patients mid-stay, synthesizing days of clinical evolution, managing multiple critically ill patients simultaneously, and documenting care that spans shifts, handoffs, and unexpected deteriorations.
The technology existed. The AI was impressive. But nobody had built it for us.
Here's what became clear: acute care has been largely ignored when it comes to reducing the regulatory burden on clinicians.
Everyone wants clinicians to just be clinicians. But then they add another required field. Another quality metric. Another compliance checkbox. Another template section mandated by a department just trying to do their job.
With every new requirement, we had less time for the work that actually matters—studying our patients, making better clinical decisions, being present during the encounters that families will remember forever.
Something had to change.
Sometimes the biggest changes start with the simplest moments. I was catching up with Balaji, a long-time friend, over coffee. Balaji is a technology expert with decades of experience building solutions across industries. Lo and behold, he had been working on the same problem—but in the mental health space—helping clinicians solve their documentation workflows.
As we talked, we realized we were fighting the same battle from different angles. The challenges were identical: clinicians drowning in documentation, technology that didn't understand clinical reality, and workflows designed by people who had never lived them. We connected instantly on the vision and decided to join forces.
Together, we built SutureNote.
We designed it specifically for multi-day, acute care documentation—because that's the problem nobody else was solving. We built it to understand the regulatory landscape so clinicians don't have to become compliance experts. We made it work around patient encounters, not during them, because preserving the doctor-patient relationship matters more than capturing ambient audio.
SutureNote exists to be more than a documentation tool. We're building a smart AI notepad—a layer of intelligence that sits between your clinical thinking and the EHR.
Yes, we give time back to clinicians. But our vision goes deeper. We're designing a system that automatically understands and keeps pace with the ever-changing regulatory landscape—CDI requirements, revenue cycle considerations, utilization criteria, and the countless departmental needs that shape modern healthcare documentation.
Every department that touches documentation—CDI, RCM, Utilization Management, Quality—they all have good intentions. They all want to collaborate with clinicians. But the burden of translating those intentions into documentation has always fallen on physicians who just want to practice medicine.
SutureNote's future lies in being the intelligence layer that bridges this gap. A place where clinicians capture their ideas and clinical reasoning, and the system evolves its tools to meet organizational requirements automatically. Where hospitals can deploy their institutional knowledge at scale, and clinicians can focus on making better, smarter clinical decisions—before anything ever hits the EHR.
We're building a solution that gives time back to clinicians and gives hospitals the ability to deploy organizational intelligence—all in one.
Because when you became a physician, you didn't sign up to be a professional typist. You signed up to heal.
Let us handle the notes. You take care of the patients.
— Porus Shah, MD
Co-Founder, SutureNote
Internal Medicine | Physician Advisor