Your Software Won't Win the Trial, with Sara Cordrey
What if the most powerful AI in your practice still isn't the thing winning your cases? Sara Cordrey, CEO and co-founder of the legal AI platform Parambil, built with chief medical officer Dr. Ralph Horwitz, argues that technology is leverage—not a substitute for a lawyer's judgment or for the medical record itself. Drawing on her McKinsey work analyzing gaps in patient care, she explains how purpose-built AI helps trial lawyers rip through records, reorder how cases get worked up, and surface insights sooner—while never leaving the primary source behind. Host Ben Gideon digs into build-versus-buy, data security, and where legal AI is heading next.
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☑️ Sara Cordrey | LinkedIn
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☑️ Ben Gideon | LinkedIn | Facebook | Instagram
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☑️ Rahul Ravipudi | LinkedIn | Instagram
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Speaker:Welcome to the Elawvate
Podcast. I'm Ben Gideon.
Speaker:Rahul is off today prepping for trial.
Speaker:So I'm going to do this episode solo,
Speaker:but really not solo at all because I'm
really thrilled to have Sarah Cordrey
Speaker:join us today. Sarah, as I understand
it, is the founder, the CEO,
Speaker:and the moving force behind a
new AI product that I've grown
Speaker:to rely on and use
extensively in our practice.
Speaker:And I can personally vouch for it being
a real game changer for trial lawyers
Speaker:and particularly those of us who
do medical malpractice cases,
Speaker:I'm sure other types of complex
litigation. So first of all, Sarah,
Speaker:welcome and thank you for the product
you've developed. It's really,
Speaker:really been of enormous
value to us in our practice.
Speaker:Ben, thank you for having me.
Speaker:Excited to be on and honored that great
trial lawyers like you are finding value
Speaker:out of an engineer's product.
Speaker:Yeah, and I don't say
that lightly. I mean,
Speaker:we've used a lot of different products,
Speaker:including some I've panned on this
very show. We have very high standards,
Speaker:but the platform you've
created, it's called.
Speaker:One thing that's tricky
is how to say the name.
Speaker:So hopefully you can
clarify this for good.
Speaker:It's spelled P-A-R-A-M-B-I-L.
And in our office,
Speaker:some people call it Parambil and some
people call it Parambil. But what is it?
Speaker:So we know for sure. The.
Speaker:Crazy thing is it's
either. I call it Parambil,
Speaker:but I think the days of companies
trying to name everything themselves are
Speaker:over. We let our clients
name their AI agents.
Speaker:Some call our platform Par, some
call it Bill, some call it Fabio.
Speaker:So I think choose the name that
works for you at the end of the day.
Speaker:Damn it.
Speaker:I was hoping you were going to prove
me right and someone else in our office
Speaker:wrong about that. Where did the
name come from? I'm curious.
Speaker:So Dr. Ralph Horwitz, my co-founder
and chief medical officer,
Speaker:was very good friends with the
author of an Oprah's book club book,
Speaker:The Covenant of Water.
Speaker:It's by Abraham Verkees and is
a book that's about this long.
Speaker:It's the size of a Bible
for those who are listening.
Speaker:And I was reading it during the early
parts of building this company with my
Speaker:co-founders, and the setting
of that book is Parambil.
Speaker:And it's a place in India and
it's a tiny town when it starts.
Speaker:But by the end of the story, which
is really a medical story in itself,
Speaker:it's this bustling hub of energy
and excitement and activity.
Speaker:And so it felt like a natural name
for a company that went from a
Speaker:tiny, tiny bit of nothing to something
really powerful and full of energy.
Speaker:Oh, the name's even better now that I
know the backstory about it. That's cool.
Speaker:So tell us a little bit about
yourself. What's your background?
Speaker:How did you get into this industry
and have interest in trial, law,
Speaker:AI type platform?
Speaker:I'm originally from Miami, live in
New York now with husband and kids,
Speaker:so did the opposite of what
everyone else did during COVID.
Speaker:I stayed in the cold. By background,
I'm an engineer. And interestingly,
Speaker:I have spent the majority of my career
focused on similar problems that I
Speaker:solve now. I remember I was
in an Uber. I was maybe 21,
Speaker:22 years old, and I was working for
McKinsey and my code had just come back.
Speaker:The results were here. And I thought
I must have messed up the code.
Speaker:I must have made a mistake. I've been
building these algorithms for weeks, days,
Speaker:nights, and there's no way that
the results I'm seeing can be true.
Speaker:And what I was doing was I was working
with this group called Medical Unmet Need
Speaker:at McKinsey,
Speaker:and we would take these massive
population level data sets across the US
Speaker:and analyze care to understand where
patients weren't getting the care they
Speaker:should. And then we would
give that information to
pharma companies and they in
Speaker:theory would go send their reps and go
help talk about products and all these
Speaker:other commercial components.
Speaker:But the goal was find patients where
their care is deviating from the
Speaker:guidelines, which probably as a med mal
attorney sounds very familiar to you.
Speaker:And so when we were doing these analyses,
we would find these huge clusters,
Speaker:thousands of people who had clear
symptoms that they needed care,
Speaker:they needed an escalation,
Speaker:but they weren't actually getting
the care they needed. Again,
Speaker:despite going to a doctor's office
multiple times. And so as a young,
Speaker:naive person, I thought, how is
this happening? This can't be true.
Speaker:And we would talk to
doctors and we'd ask them,
Speaker:what's going on in these
offices? And at that time,
Speaker:my belief was they just don't have the
information they need. They don't have
Speaker:the full patient story. Fast-forward,
we keep working on this,
Speaker:and Ralph comes to me and says, Sarah,
Speaker:I think that the old machine learning we
used to use is a thing of the past and
Speaker:this new AI, this new generative AI
is going to unlock medical records.
Speaker:And with that,
Speaker:a really rich data set that will give us
insights on patient care that we could
Speaker:never have before. And so we started
off, we left McKinsey together,
Speaker:which was a little crazy
at the time. And we said,
Speaker:how can we bring this new data set to
better tell a patient's story in the
Speaker:doctor's office? Obviously, we're
talking today, so that didn't work.
Speaker:We quickly realized that the doctors
could ask the questions that they were
Speaker:missing at the time. They could order a
lab result, they could fix all the gaps,
Speaker:but Ralph had been an expert witness
and he started to talk about how in his
Speaker:experience when there's harm in the US,
Speaker:that harm is documented in the medical
record. And when you're in a courtroom,
Speaker:when you're the other side, you can't
just go request the lab results.
Speaker:You can't just go ask the questions
and fill in the gap. Those documents,
Speaker:that data become the basis for your
story for the facts of the case.
Speaker:And so that was three years ago now,
and we've been deep in the legal space,
Speaker:learning and building ever since.
Speaker:How did you make that transition to
decide to go into the legal space?
Speaker:And what was the first step of that? It.
Speaker:Was a lot of phone calls and a lot of
LinkedIn. Ralph came to me and said,
Speaker:"I remember when I was an expert witness,
Speaker:Ralph was head of
medicine at Yale Stanford.
Speaker:He was involved in big mass tort
cases, med mal cases, you name it.
Speaker:He did it early on in his career,
Speaker:and he was recounting these bankers
boxes full of medical records,
Speaker:full of literature from the
epidemiology side. And he said,
Speaker:I'm pretty sure this is still done
by hand." And of course, as a young,
Speaker:stubborn person, I said, "Well,
Speaker:let me go find out if that's still
true." So I personally called hundreds of
Speaker:personal injury firms across the US.
Speaker:I cold called them and tried to get
them to tell me a little bit about their
Speaker:problems and their pain
points. And from there,
Speaker:started to really get a
sense of the challenges that
these firms were facing. So
Speaker:it was a lot of listening in the early
days, and it still is a lot of listening.
Speaker:Yeah. I mean, you can tell
that from using the platform,
Speaker:a lot of thought has gone into the
way in which we analyze and approach
Speaker:cases because the AI seems to
mirror the way we think about
Speaker:a case. Can you just kind of give us a
primer for those who haven't used this
Speaker:platform or understand how
it works and what it does?
Speaker:Can you maybe give us the 10,000 foot
overview first before we drill down into
Speaker:some of the details?
Speaker:Definitely.
Speaker:And feel free to jump in as I explain
it because you probably know it better
Speaker:than me at this point, but the kind of
basic tool is a case intelligence tool.
Speaker:And the idea is a case comes in to Ben's
office and we're deciding whether or
Speaker:not to take the case.
Speaker:So the team dumps all the data they
have about the case into the system,
Speaker:whether that's medical
records, intake transcripts,
Speaker:anything they have that's documents.
Speaker:And the system helps build an initial
sense of is there a case or not?
Speaker:It looks at standard of
care, identifies deviations,
Speaker:different analyses depending on the type
of law that that case is being reviewed
Speaker:for. From there, if
someone takes on the case,
Speaker:it jumps into the pre-lit mode and you
start really working up and digging into
Speaker:the case. And their firms are able to
build the documents that they need,
Speaker:complaints. We've even heard of HIPAA
authorizations being drafted in there,
Speaker:and do the work to get that case moving.
And that case is continually updated,
Speaker:refreshed as new data comes in,
Speaker:and then moved all the way to the
settlement or outcome phase where they're
Speaker:closed out.
Speaker:So really it's a tool that
allows firms to operate to a
Speaker:higher level,
Speaker:and it arms them with the intelligence
they need to build case strategy and
Speaker:ultimately win in court.
Speaker:And just to put people's minds at ease,
what's the kind of security situation?
Speaker:Is the platform secure,
HIPAA compliant, so forth?
Speaker:The platform is HIPAA compliant.
It is also SOC2 compliant.
Speaker:Those certifications
are thrown around a lot.
Speaker:What that means is we have an
independent audit firm come in,
Speaker:review all of our
processes in our systems.
Speaker:They actually bring in an
outside cybersecurity company
that simulates a tax on
Speaker:our platform. And every
year on a consistent basis,
Speaker:we make sure that we're as
secure as is humanly possible.
Speaker:I think that's really important.
Speaker:But I think the other thing that matters
from a security perspective is what's
Speaker:your day-to-day?
Speaker:And we use AI agents to actually
simulate a tax on our system
Speaker:weekly and every time we make an
update to the code base so that we're
Speaker:constantly preparing for how do we
fortify our client's data as much as
Speaker:possible. That's a great question.
Speaker:Can you tell us a little bit more about
the company? You mentioned starting out,
Speaker:you and your colleague leaving McKinsey,
Speaker:which I'm sure was a leap because I
imagine that was a pretty secure and
Speaker:comfortable job. So you're taking a
leap of faith there to start something.
Speaker:How has that gone and where are you
in your company building journey now?
Speaker:Yeah, I feel a kinship to our
clients because we work with many
Speaker:entrepreneurs, people who've
started their own business,
Speaker:who've leapt into the world and
realized it's on you to create value.
Speaker:It's on you to make this business
important and make this worth something.
Speaker:And so I think our business has grown
alongside many other businesses,
Speaker:which is special. We've been at
this for over three years now.
Speaker:We've raised $8 million
in funding from top VCs.
Speaker:We have a massive network of top
litigation firms on our platform in the
Speaker:many hundreds at this point.
And you asked about the change.
Speaker:When we started, we were doing
a lot with medical records.
Speaker:That was our bread and butter,
and it still is, right?
Speaker:That's the heart of the case.
That's never not the focus,
Speaker:but the platform has expanded a
lot within the past three years.
Speaker:And now it's doing everything
from drafting documents
to what we'll be launching
Speaker:by the time this podcast comes out,
Speaker:which is those more CRM-like capabilities
where you're actually automatically
Speaker:pulling data, you're giving admins,
Speaker:firm-level views. So it's really gone
from a little piece of the puzzle,
Speaker:a medical expert within the case,
Speaker:to a full engine that is making
every law firm we work with an AI
Speaker:native law firm.
Speaker:I'm really interested in your thoughts
about where all of this is heading.
Speaker:I mean, it's evolved so
fast. Just a year ago,
Speaker:we couldn't have had this same
conversation. And even your platform,
Speaker:which we've now been on for, I
don't know, four, five months,
Speaker:and using it extensively has
improved dramatically over that time,
Speaker:and I imagine we'll
continue to do so. I mean,
Speaker:firms are accustomed to having
different systems such as you
Speaker:alluded to a CRM. We
use the Microsoft Suite,
Speaker:so we're using all of the
standard products there and
SharePoint to store some
Speaker:and use some documents along with
our CRM to do different things.
Speaker:And then we have Parambil to do more
of the detailed case analysis and
Speaker:litigation workflow there. But where
do you think all of this is heading?
Speaker:I mean, it does seem it would be more
efficient to have one platform that can do
Speaker:everything.
Speaker:At the end of the day, our job is to
create value for customers, right?
Speaker:To help you win, to help you do
things in a more efficient way.
Speaker:And you hit on something big,
Speaker:which is there's all these
different places where data lives,
Speaker:where information is stored,
where work gets done.
Speaker:And more and more the
ask from our clients is,
Speaker:can you pull all of that into one
central system so that our firm's living
Speaker:documents, our data,
Speaker:all this information becomes a
rich repository that we can build a
Speaker:generational law firm from?
Speaker:So I think where every player is racing
to right now is how do we become the
Speaker:operating system for a firm?
Speaker:And we do that by making
every hard problem that you
face today easier to solve
Speaker:within Paramble's ecosystem.
Speaker:Obviously,
Speaker:there's platforms like Harvey that have
become big within the corporate law
Speaker:setting, big law,
Speaker:and then there's stories about some law
firms that have exited that and they're
Speaker:investing money to build
their own internal systems,
Speaker:maybe built on other
platforms like Palantir.
Speaker:So there's kind of the go join in
with others with a platform that
Speaker:is being developed by an outside
vendor versus the building something
Speaker:internally that can be unique to the
firm itself and maybe give them their own
Speaker:sort of potential competitive advantage
if they can do something better than
Speaker:someone else. But dubious of that since
we're in the business of practicing law,
Speaker:not data science or computer
engineering or software engineering.
Speaker:But I don't know, where do
you see that battle heading,
Speaker:the kind of internal proprietary
systems versus adopting
Speaker:or your platform becoming kind
of the standard across the board?
Speaker:I used to be part of the, I
don't want to say problem,
Speaker:but I used to be part of the problem
when I was at McKinsey where you'd have
Speaker:consultants come in and
they'd say, Big Pharmaco,
Speaker:why don't you build this
proprietary software yourself?
Speaker:Doesn't that sound exciting?
Speaker:Doesn't that sound like a secret sauce
that you can tell all of your investors
Speaker:about?
Speaker:And what it usually resulted in was
a very expensive build followed by an
Speaker:ongoing maintenance that never ended.
Because to keep up with innovation,
Speaker:to keep the platform on the bleeding
edge requires a lot of work and a
Speaker:lot of time. I think it can be
done, right? Kirkman and Ellis,
Speaker:I think is what you're referring to.
Speaker:And I think they're
spending 500 million on it,
Speaker:so you certainly have budget
to do it. But the question is,
Speaker:are you winning trial because of your
software or because your skills as a trial
Speaker:lawyer? And this might be a controversial
take because I'm a builder of
Speaker:software. I think our software helps
these firms get bigger outcomes,
Speaker:see information that they
might not have seen as quickly,
Speaker:but you are the ones
that are winning, not us.
Speaker:And I think it's a bit hubristic to
imply that Parambil's the reasons Ben is
Speaker:getting that multimillion dollar
verdict. Sure, Parambil's helping,
Speaker:but you're the one that's
winning at the end of the day.
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Speaker:In addition to Paramble, which is what
I've always called it, across our firm,
Speaker:we use ChatGPT.
Speaker:Everybody has an account for that
and they use it for certain things.
Speaker:I've actually developed a whole
Claude-based project system that I use
Speaker:extensively for other things.
Speaker:And sometimes I will run some
of my cases through Claude or
Speaker:I'll have Parambil develop a
detailed research memo using the
Speaker:proprietary nature of it,
Speaker:and then scrub it for client identifiers
and then run it through Claude or
Speaker:Chat. I'm just curious, I mean,
Speaker:obviously my sense is that all of these
platforms are using the same large
Speaker:language data sets. That
seems obvious to me,
Speaker:but is there still a use case for
using different platforms for different
Speaker:things? And if so, how do you
break that down for folks?
Speaker:Yeah, that's a great
question. And you're spot on.
Speaker:We use whatever foundation models
are the best for the task at hand.
Speaker:So we work closely with Anthropic's
team, OpenAI's team, Google's team,
Speaker:and we're constantly evaluating and
benchmarking these models and figuring out
Speaker:what's the right spot to put
each model within our workflow.
Speaker:And let me just say, Claude is
amazing. I use it all the time.
Speaker:We have a lot of respect for that
company and the work that they put out.
Speaker:I would say what's different is
Claude is a general purpose tool.
Speaker:We are very tailored to the types of
work that you and other personal injury
Speaker:attorneys do.
Speaker:And so that purpose-built component
and forward-looking component helps us
Speaker:iterate very quickly towards
the work that you need done.
Speaker:So chances are if it wasn't
in Parambil two weeks ago,
Speaker:it will be in two weeks.
We're moving quickly on those use cases.
Speaker:And the way I would think about it too
is let's say you're going into trial.
Speaker:Do you want a part-time attorney on
the case or do you want someone who is
Speaker:spending day and night focused on the
same problems and winning that case?
Speaker:Frankly, if Anthropic were to turn to
this space and try to do the same thing,
Speaker:they'd probably do an incredible
job. They're just not. We are.
Speaker:And so we're purpose-built,
we're forward-looking,
Speaker:and we're building more and more.
Speaker:So chances are if you're doing it in
Claude today and talk to one of our
Speaker:engineers, it will be in our
platform soon. How do you think, Ben,
Speaker:about these Claude workflows
as a business owner?
Speaker:Does that scale across your
organization or do you run into hiccups?
Speaker:It's a great question. I
mean, I use Claude personally,
Speaker:but we have not ruled it out across the
board to the rest of our office yet.
Speaker:Everybody else is on chat
and we use that more for
Speaker:routine tasks, administrative
tasks, back office functions,
Speaker:not for analyzing records
or uploading client data.
Speaker:It's been great for that.
I mean, for example,
Speaker:there could be if we're doing
intake calls, as we do many,
Speaker:many intakes with people who have
potential medical malpractice cases,
Speaker:we're not going to enroll in a parable
case for somebody who just happens to be
Speaker:on the phone.
Speaker:But our intake person can
input data from the call into
Speaker:chat without any client-specific data,
but just kind of what are the issues?
Speaker:They had a hip replacement, they had
bleeding, they had complications,
Speaker:and quickly get guideline standards,
Speaker:things that can help them
during that phone call,
Speaker:ask what are the questions I need to ask
during a 10-minute call to drill down
Speaker:and clarify whether this might be a case
or not. So we use it more like that,
Speaker:and it's really helpful, I think,
Speaker:in extending the reach of people who
don't have highly technical backgrounds in
Speaker:terms of medicine or maybe aren't
as experienced and know what to ask.
Speaker:Very much accelerates the learning
curve of people doing medical cases,
Speaker:which is it can take a long time to
become serviceable and being able to
Speaker:issue spot and analyze
cases. But we haven't rolled
Claude out across the board.
Speaker:We had been marketing for a chief
AI officer with the idea that we
Speaker:were going to build out our own kind
of AI structure for workflow and
Speaker:operations. And we're still
very much interested in that.
Speaker:We interviewed a really great
candidate and offered her the position,
Speaker:and then she got a better
offer at a different company.
Speaker:And so we kind of had to go back to ground
zero on that. That's why I asked you
Speaker:about the build your own versus
rely on third-party vendors.
Speaker:I've had somewhat of a change of heart
just because the progress I've seen on
Speaker:your side has been so great that a lot
of the problems we identified that hadn't
Speaker:been addressed are now being solved
by other people in rapid fashion.
Speaker:And obviously you're investing a
lot of time and money to do that.
Speaker:Why should we duplicate that
when it's not necessary?
Speaker:What are you hearing from the lawyers
who are using your platform in terms of
Speaker:what people love about it and what are
the next things people are looking for
Speaker:they wish it could do
that it can't do today?
Speaker:Flipping your question order.
By the time this is out,
Speaker:there are two big things that I think
your firm and others will love. The first,
Speaker:and clearly I'm not a marketing
person, I'm an engineer.
Speaker:So if you want to rename these.
Speaker:By the way, your marketing person,
I think his name is Jordy, right?
Speaker:The guy I originally dealt with.
I really enjoyed working with him.
Speaker:He was great, very personable,
not a hard sales guy,
Speaker:just really nice relational person.
Speaker:And I've dealt with so many of these
hardcore salespeople from different firms
Speaker:trying to push products on you. I
really appreciate that. He was great.
Speaker:I'm glad to hear. As I was walking
out of the office yesterday,
Speaker:my account executives were discussing
whether ACOG guidelines were a little too
Speaker:conservative.
Speaker:Not your.
Speaker:Typical sales guys. A.
Speaker:Little water cooler conversation about
the ACOG guidelines. That's nice.
Speaker:But the two things that I
think you'll find exciting.
Speaker:So number one is called Power Query. And
it is the idea that you can go in, Ben,
Speaker:as your firm leader, and ask any
question you want across all cases.
Speaker:And you can use this to
better steer your ship.
Speaker:You can also use it to
find potential new cases.
Speaker:You can scan all your med mal cases and
see if any qualify for a mass tort case.
Speaker:You can scan all of your data and make
sure that complaints are being completed
Speaker:in a timely fashion. And frankly,
Speaker:I can't imagine what else people will do
because we launched these products and
Speaker:the uses explode. So
that's one, Power Query.
Speaker:And then two speaks to this admin
component that you were talking about.
Speaker:So we are integrating with calendars,
with transcription services,
Speaker:with anything you need,
Speaker:and we are building workflows
that let you run every part of
Speaker:your case through with the brain of Ben
Gideon guiding it basically. So you can
Speaker:go in and you can take a MedMal workflow
and you can tailor it maybe based on
Speaker:what you've built in Claude and pull
in the skills, pull in the templates,
Speaker:pull in the documents you want
drafted on demand, pull in the tasks,
Speaker:and facilitate the way work
gets done for your team.
Speaker:And also in some ways kind of watch it
all happen and make sure it's happening
Speaker:to the quality and level you would expect.
Speaker:That's amazing. Now, what
is that going to be called?
Speaker:Is there a name for that function?
Speaker:People are calling it AICRM, but
if you help me come up with a name.
Speaker:That's a terrible name. It's got to have
something more catchy than that. Yeah.
Speaker:I'll come up with one. I tend
to be really good at that,
Speaker:although the name of this podcast
doesn't seem to reflect that,
Speaker:but that's Raul's. We blame him for that.
Yeah. I mean,
Speaker:what you just described is exactly what
we are trying to accomplish with the med
Speaker:mal review section of our Claude workflow,
Speaker:which is to take the collective
knowledge of people that have decades of
Speaker:experience doing this
and allow their brains,
Speaker:the way they think about the
case, to translate to the newer,
Speaker:younger lawyers and potentially
paralegals so that they're getting the
Speaker:benefit of our knowledge and be able
to leverage that across the firm.
Speaker:So that would be amazing to have that
and really to make it personalized
Speaker:because I mean, we're all, I'm
sure, very arrogant. But I mean,
Speaker:I've spent a lot of time doing this work
and I would like to think I've learned
Speaker:quite a bit over the years that has
unique value and that it would be great to
Speaker:preserve that and be able to hand that
off to others and have them benefit from
Speaker:it.
So I'm excited to hear about that.
Speaker:You probably got to that point because
you heard from lawyers out there who
Speaker:wanted to accomplish that goal, right?
Speaker:Exactly. Lots of listening.
Speaker:And I think what's also important is
because we've gone back and forth with
Speaker:continuously learning system. Our
system doesn't train on any client data,
Speaker:it doesn't train on any client
interaction. We do not do that.
Speaker:And we've thought about whether opting
into training would help or hurt a law
Speaker:firm. And at the end of the day,
Speaker:you do not want your firm brain
learning from the mistakes or the bad
Speaker:habits of maybe your newest employees
or the employee that does something a
Speaker:little bit crazy.
Speaker:And so part of how we've been designing
this is how do you allow the people with
Speaker:all the training,
Speaker:the people guiding the ship to put in
their learnings without propagating bad
Speaker:habits, as they might say.
Speaker:Right. I mean,
Speaker:one of the things as a firm owner
and leader that I constantly worry
Speaker:about is that in the old days,
Speaker:we would review paper records and
flag them with Post-it notes and
Speaker:highlighters.
Speaker:And then at some point that transitioned
to paperless and we would do the same
Speaker:thing in PDF form. And we still
do and bookmark our records.
Speaker:But that process kind of gives you,
Speaker:it structures your brain to have a
physical understanding of a record
Speaker:and what the different
components are and what should be
Speaker:there,
Speaker:what maybe you can readily identify
as missing that you should expect to
Speaker:find, how things are organized.
And just like any system,
Speaker:a record in a way reflects
an organizational structure
and a thought process of
Speaker:whoever's developing that and the people
that have input into it, the doctors,
Speaker:nurses, et cetera. It's
more than just paper,
Speaker:it's a reflection of a system and work
process and thought process. I mean,
Speaker:even just the selection of what to
go in, what's in and what's not,
Speaker:or if you have dropdown menus,
Speaker:what are the options on the menu to
choose from or what populates a field
Speaker:automatically versus all these and what
data is tracked in a flow sheet and what
Speaker:data is not tracked in a flow sheet?
Speaker:And all those things play into your
understanding of how medical care is
Speaker:delivered in a case.
Speaker:My worry is that jumping right to
a product like Paramble for newer
Speaker:lawyers who don't know that,
Speaker:they don't have the understanding of
what underlies that. But it's also,
Speaker:I mean,
Speaker:do you need to train somebody
to do complex division in
their head if they have
Speaker:a calculator? Is that a good use of
anybody's time? No, it probably isn't.
Speaker:So just balancing that. I mean,
Speaker:we can be much more efficient now
and accelerate people's learning,
Speaker:but where is the balance between
training and real understanding
Speaker:versus just maybe getting to an answer,
Speaker:but not understanding how you got there
or why? And does that create extra risk?
Speaker:And I'm just curious,
Speaker:you obviously know all of this because
you started out doing the processing of
Speaker:the medical data in a different
world, kind of like we did,
Speaker:and then have evolved to this world.
Speaker:So where do you see the balance there
of real understanding on the human
Speaker:level and how to interact with the
AI if the AI's understanding is now
Speaker:exceeding that of some of the
people that are new to this work?
Speaker:This question takes me back to fifth
grade when you're learning about primary
Speaker:versus secondary sources.
Speaker:I think what happens with technologists
is technologists get over eager and they
Speaker:go and take everybody into
the new world very quickly.
Speaker:And I remember it was probably
three or four months ago,
Speaker:we were talking to a great
firm in Connecticut and
they were walking me through
Speaker:their process. And I felt like I had
been hit over the head with the obvious,
Speaker:which was as much as AI is
going to help all these pieces,
Speaker:you're never going to leave
behind the medical record.
Speaker:You shouldn't leave behind the medical
record. That is your primary source.
Speaker:That is the fact.
Speaker:There is nothing like the primary
unabridged version of that data source.
Speaker:And that actually prompted
us to go back and say,
Speaker:"We've been spending all this time
thinking about how to ask questions to the
Speaker:record. What if we just
organize the record in a way
that lets someone go to the
Speaker:key pieces of the case faster,
Speaker:but gets them back in that primary
document?" And so to your question,
Speaker:I think there's a little bit of a
slingshot where you go really far in one
Speaker:direction, but then you
pull back and you say,
Speaker:"What are the different pieces that are
needed for this case?" And the medical
Speaker:record is one that you cannot replace
and you cannot ignore under any
Speaker:circumstance.
Speaker:That's one thing I really like about
your platform is they're things like you
Speaker:can just look at all the vital signs and
we could do that before they're on page
Speaker:55 and then page 1022.
Speaker:So you go through an 8,000 page record
and you can flag all of the blood
Speaker:pressure findings. But with Parable,
Speaker:you can just say there's a simple flow
sheet that shows you all of the blood
Speaker:pressure findings at every
point throughout the chart,
Speaker:and it can even give you a graph to
show those and you can easily spot
Speaker:deviations or abnormalities.
Speaker:And you can do that with a lot of the
different lab findings, vital signs.
Speaker:It just gets you to that answer very
quickly and organizes in a way that's
Speaker:really useful.
Speaker:I think you can always click on the
hyperlink and go back to see it to
Speaker:confirm that that's actually the accurate
reading that's depicted in the record
Speaker:if you want to confirm it. I've stopped
doing that as often because I mean,
Speaker:it's always accurate.
Speaker:And there are things that are sometimes
not accurate that you want to check,
Speaker:and that tends to be more of a
conclusion or an editorial comment
Speaker:on something that's in the record.
But generally the actual data,
Speaker:like the vital sign was
125 over 76 or something,
Speaker:that's going to be accurate
if it's listed there.
Speaker:I'm curious about radiology
and fetal monitoring.
Speaker:So if you have a birth injury case,
Speaker:you can elect to choose a
birth injury case in Parambil.
Speaker:So it will do an analysis of all the
electronic fetal heart monitoring for the
Speaker:baby.
Speaker:But my understanding of what it's
doing is just reflecting what the chart
Speaker:indicates the findings were.
Speaker:So if there was a documented deceleration
or acceleration or category one,
Speaker:category two, whatever it may be,
Speaker:it will reflect that. It will give you
the specific timestamp from the record
Speaker:and then what the findings were
on the fetal monitoring strip.
Speaker:But what it's not doing is reading the
squiggles on the page and interpreting
Speaker:that the way a maternal fetal medicine
doctor would. Similarly with radiology,
Speaker:I think it can tell you what the
findings are based on a report,
Speaker:but it's not reading the imaging
the way a radiologist would.
Speaker:And it might be a lot to ask of course,
Speaker:but it would be extremely useful at
some point for the technology to be able
Speaker:to read and interpret
x-rays, MRI studies, CTs,
Speaker:electronic fetal monitoring.
Speaker:And I do think that technology
is available at some level,
Speaker:though probably very expensive
at the medical level,
Speaker:but do you see there coming a point in
the near future where the platform could
Speaker:do that?
Speaker:Yeah, great question. So
one, fetal monitoring strips,
Speaker:and then two on the radiology side
imaging and having a perspective there.
Speaker:So on the first one,
Speaker:the birth injury template has evolved
to actually read those squiggly lines.
Speaker:The challenge with fetal monitoring -.
Speaker:Well,
Speaker:that's funny because I asked Parable the
other day because I had it do that and
Speaker:I'm working on a birth injury
case with it. And I said,
Speaker:"Are you interpreting the squiggly lines
or are you just telling me what's in
Speaker:the chart?" And it said, "I'm not
interpreting the squiggly lines.
Speaker:I'm just telling you what the nurses or
somebody else documented in the chart.".
Speaker:Sometimes these agents are a
little too scared of legal battles,
Speaker:but what's basically happening on our
end is there's a separate processing
Speaker:pipeline for these fetal monitoring
strips that goes through and extracts that
Speaker:information and then analyzes it based
off of ACOG guidelines to try to get a
Speaker:sense of what do you think is a true
deceleration versus acceleration.
Speaker:And then within the notes
section of the platform,
Speaker:it's actually trying to match up what
was happening from the record with what
Speaker:was happening in those
fetal monitoring strips.
Speaker:Because there's plenty of funky
readings on a fetal monitoring strip.
Speaker:Someone gets up and goes to the
bathroom, someone is readjusted.
Speaker:And so trying to tie it up to where
was an intervention truly needed?
Speaker:And so in the notes, that's where
the model's trying to do it.
Speaker:We have a different agent
than the Ask AI system,
Speaker:and maybe we need to tell it
that that's what's happening,
Speaker:but that is what's
happening behind the scenes.
Speaker:Okay. And if you go to the fetal
monitoring strip tab and look at that,
Speaker:that's where you're going to find that?
Speaker:Exactly. It's pulling all the
data out and then analyzing it.
Speaker:And then you asked about images.
Speaker:So we recently started processing
images within the platform,
Speaker:and that created a host of confusion,
Speaker:a whole world of confusion because
people thought we were handling imaging,
Speaker:but it really incentivized the
engineers to solve imaging.
Speaker:And so they're working on DICOM files and
how to process something that is many,
Speaker:many, many thousands of images in one,
Speaker:and that should be launched
within the next month or two. Wow.
Speaker:That would be very useful. I mean,
Speaker:even just to get a second opinion or
to have a sense for what might be in an
Speaker:image, because as lawyers,
Speaker:we're not really skilled as you
can imagine it reading. Now,
Speaker:sometimes it's obvious, but
a lot of times it isn't.
Speaker:And frankly,
Speaker:you can show fetal monitoring strips
to two experts and get two different
Speaker:responses.
Speaker:So there's a level of art and science to
this too that we don't claim to solve.
Speaker:Well, that's great.
Speaker:What are other things that you guys are
working on now that we might have to
Speaker:look forward to in the future?
Speaker:Lots of cool things. Let me
think of what's shareable.
Speaker:A couple things that you might find
helpful. Co-counsel relationships,
Speaker:facilitating work when you have multiple
firms together is something that we
Speaker:just launched. So firms are linking up.
Speaker:Something in the physical world that
we're doing is a community event in
Speaker:November that is Paramble customers only.
Speaker:And the goal is to innovate.
Speaker:It's to talk to other incredible attorneys
and understand how they're using AI,
Speaker:what's working,
Speaker:what are all the things that you could
be doing with AI that you might not even
Speaker:realize are possible, like HIPAA
authorizations or a bill of particulars,
Speaker:and then to inform the Parambil roadmap.
Speaker:So we will have engineers sitting with
our customers as always to listen to them
Speaker:and understand what they need at a firm
level so that we can make sure that
Speaker:Parambil is continually evolving as
the technology evolves and as the
Speaker:needs evolve.
Some of AI is now table stakes,
Speaker:but we're always pushing on how can
we be better? How can we do more?
Speaker:How can we create more magical experiences
for the great people we work with?
Speaker:We do a lot of medical cases obviously,
Speaker:and we use Parable for
every one of those cases.
Speaker:It strikes me that it would also have
value for other kinds of catastrophic
Speaker:injury cases on the damages side for sure,
Speaker:because you're analyzing the records
and trying to build the damages case to
Speaker:some extent, medical
records or other things.
Speaker:Is there a plan to expand
the functionality and
learning out to other types
Speaker:of plaintiff's cases?
Speaker:Great question. Yes.
Speaker:Part of our workflows and our templates
let firms customize the results to what
Speaker:they need. So we already have
personal injury, motor vehicle cases,
Speaker:we have trucking templates, we have
mass torts. Any mass tort you can name,
Speaker:we probably have a template for it.
Speaker:So the goal is really to
be this flexible system.
Speaker:I think maybe a mistake on our part is
sometimes we harp too much on the medical
Speaker:records themselves without focusing
on all that the platform can do.
Speaker:But that's just because
again, it's where we started.
Speaker:It's part of the case and we're never
going to stop trying to make that piece
Speaker:better, but we are servicing
many, many case types now.
Speaker:And as the case goes forward,
Speaker:you start to develop the record
with depositions and discovery.
Speaker:Are you finding people are adding those
documents to the case file and what
Speaker:are the benefits of doing
that? What can you do with it?
Speaker:Because we've done less of that.
Speaker:We use it more to kind of build the
structure of what the legal theories are
Speaker:in the case. Also,
Speaker:part of it is it hasn't been around that
long and we haven't used it for that
Speaker:long. And most of our cases are at
the early phases where we've used it.
Speaker:So they're all now moving through the
litigation process. What are people doing?
Speaker:Are you seeing people upload their
discovery documents, depositions,
Speaker:and then what are the things that can
be done to manipulate or utilize those
Speaker:through the platform?
Speaker:The way AI is helping attorneys rip
through data is changing the way attorneys
Speaker:practice law, even from
a sequence perspective.
Speaker:We have an attorney down in Florida who
has stopped taking in-person depositions
Speaker:because she has Parambil up for every
deposition and is asking questions,
Speaker:going back and forth and creating much
stronger results because she's using the
Speaker:platform in tandem.
Speaker:We also have firms that are dumping
in audit logs and they're actually
Speaker:requesting them earlier now from a
case perspective because now they have
Speaker:something that can power through them
and find them the insights. Before,
Speaker:it was a trade-off of,
Speaker:do I have a paralegal spend two weeks
going through a giant Excel or do I focus
Speaker:on something else that I need for trial?
Speaker:And so we see the types of data being
pulled up earlier into a case because they
Speaker:can result in more. And you asked
about other types of data. I mean,
Speaker:our average case now has over a thousand
documents because people are dumping in
Speaker:everything. I had a salesperson run into
my office the other day and say, Sarah,
Speaker:I need to tell you about the
coolest thing I just did.
Speaker:And he had a case with a customer
where the person devolved in care and
Speaker:ultimately needed a hyperbaric
chamber to resolve the injury,
Speaker:but the hospital's hyperbaric
chamber was down. So the salesperson,
Speaker:Sal and the attorney were sitting there
and they started dumping in all the
Speaker:hospital's policies and
procedures, the guidelines.
Speaker:They're starting to try to figure out
what do you do when a hyperbaric chamber
Speaker:is down? What is the policy
here? How should you act?
Speaker:How should you treat this injury?
Speaker:And by the end of 30 minutes of them
asking questions and staring at it,
Speaker:they built up a really strong case.
And that's maybe not the most obvious
Speaker:use case of Paramble, understanding
the hyperbaric chamber outage policies,
Speaker:but we are seeing things like
this analyzed on a daily basis.
Speaker:My Facebook feed tells me I can buy a
personal hyperbaric chamber for my home
Speaker:for only $60,000.
Speaker:I don't know what it is about me that
makes them think that I'm in the market
Speaker:for one of those, but maybe I need one.
Speaker:The challenge with this type of
law, you get a lot of targeted ads.
Speaker:Yeah. So what you just described
in putting a lot of data in and
Speaker:an audit trail, for instance,
Speaker:I had been putting my audit trails
into Claude and having you do that,
Speaker:but that you're saying that Parambil
would process audit trails and do the
Speaker:analysis on that's been
educated on how to do that.
Speaker:We see them with trucking cases
too, right? Trucking cases,
Speaker:you have all of these activity logs for
messages and interactions that in some
Speaker:ways look like an audit log and
are just as hard to run through,
Speaker:but the AI can help not just
review it, but to your point,
Speaker:understand how that data fits into the
whole case constellation and strategy
Speaker:too.
Speaker:Before we end,
Speaker:can you just give our listeners sense
for how the pricing structure works for
Speaker:the platform? If people are interested,
Speaker:how should they go about
inquiring and what does it cost?
Speaker:So we do the first case
for free. We show you,
Speaker:not tell you what this looks like.
Speaker:And then we have firms on our platform
as small as solo shops to as big as
Speaker:hundreds of attorneys, and we have
pricing that works for every firm.
Speaker:Ultimately, it's charged back to
the case for most of our clients,
Speaker:and we give invoices that reflect that
cost so that firms can use the best
Speaker:tech for their clients. That's
the goal at the end of the day.
Speaker:So it's nothing crazy.
Speaker:It costs less than one hour of billable
time and can be the difference between a
Speaker:$2 million verdict and
a $70 million verdict.
Speaker:I really do like the way you guys have
developed the pricing structure because
Speaker:as you point out,
Speaker:it can be a case cost because it's priced
separately for each individual case.
Speaker:There is a different price point for
a case review that doesn't have the
Speaker:full-blown, at least we've been
using that full-blown thing,
Speaker:but for cases where there's a higher
probability you're going to reject it and
Speaker:you don't want to be
spending money unnecessarily.
Speaker:And then once you buy a case,
you can continue to work on it,
Speaker:it seems like for the life of the case
without incurring additional costs.
Speaker:So it's worked quite well for us.
Speaker:I keep waiting for the pricing to go up
because I don't understand how you guys
Speaker:are making a living over there,
Speaker:but for right now it's working pretty
well for all of us who are using it.
Speaker:So appreciate that.
Well, Sarah,
Speaker:it's so great to have you and thank
you again for developing this wonderful
Speaker:product.
Speaker:It's really helped us in our practice
and it's helped a lot of our clients get
Speaker:to better results.
Speaker:And hopefully I'm sure that's the
case for lawyers all over the country.
Speaker:And folks, if you are interested
and want to learn more,
Speaker:contact Parable and I'm sure they'll
give you the demo and show you what it's
Speaker:all about.
Speaker:Thank you for being part of the
Paramble community and inviting us on.
Speaker:And it sounds like we probably need to
do an in-person training to show you guys
Speaker:all of the new things that are launching.
Speaker:I think that's one of the
biggest frustrations we hear
from our customers is it
Speaker:gets better every week, but now I
need to keep up with all the changes.
Speaker:So we're actively thinking about how to
make sure we're offering enough training
Speaker:and support through all this change.
Speaker:I mean,
Speaker:you guys send out weekly emails with the
updates and changes and improvements to
Speaker:the system,
Speaker:and we actually have designated one
person internally as kind of our parable
Speaker:guru, and her job is to read those,
to attend trainings occasionally,
Speaker:and then to report back on
what the new things are.
Speaker:But actually it would be helpful
to have another firm-wide training.
Speaker:So maybe I'll reach out and see
if we can arrange for that. Well,
Speaker:thanks so much for joining.
Speaker:Thanks for having me.
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Speaker:when we elevate people
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