Ankit Raj
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Case study 02 / AI · Health tech

AI audits for every doctor consultation

Quality checks on our doctor consultations covered a ~10% manual sample. I moved them to AI audits of every consultation, proved the scoring against consultations scored by real doctors before going live, then replaced the vendor tool with our own system. Coverage went to 100%, cost fell 70%, and the effectiveness score became accurate enough to feed the doctors' incentives.

Company
Kapiva
Role
VP and Head of Product
Period
Sep 2020 – Present
My part
Owned
QA coverage
~10% sampled→100% audited
Cost of the audit system
Vendor tool→70% lower, in-house
What the score is trusted for
Spot checks→Doctors' incentives
01 / Context

Doctor calls are part of the product

Kapiva runs a doctor and health-coach programme alongside its products. Doctor calls are guidance, not a sales pitch: they set the right expectations and answer the small questions people won't take to their own doctor.

Doctors work in Care Studio, the tool we built for them: appointments, each patient's history and next stage, and the prescriptions they create and edit.

02 / Problem

A ~10% sample can't manage quality

Consultation QA relied on manual sampling of ~10% of consultations, so most consultations were never reviewed at all.

03 / Who it's for

Who the audits serve

01

Doctors

See their scores, audits and strong and weak points in Care Studio, and can dispute feedback there.

02

Quality reviewers

Still review 5% of consultations by hand, alongside the AI.

03

Customers

About a quarter of consultations are in regional languages, so the audits had to hold up beyond one language.

04

Doctor performance

The effectiveness score feeds the doctors' incentive and performance system.

04 / Solution

A 14-parameter rubric, scored by AI, grounded in evidence

Every consultation is audited by AI against a 14-parameter rubric that rolls up into two composite scores: an effectiveness score (CES) and a satisfaction score (CSS).

Every score is grounded: it cites the transcript line that supports it. That makes each output auditable, gives doctors something concrete to act on or dispute, and makes a wrong score easy to catch.

rubric

14 parameters

One rubric for every consultation, including medical-knowledge parameters.

CES · CSS

Two composite scores

Effectiveness and satisfaction, rolled up from the rubric.

grounding

Evidence for every score

Each score cites the transcript line behind it.

Every score shows its evidence, and every doctor can dispute it.
05 / How it works

The audit pipeline

The pipeline runs on every consultation, not a sample, and has run in production first on a vendor tool and now on our own system, at 70% lower cost.

ingest

Consultation

Every doctor consultation; about a quarter are in regional languages.

100% coveragemultilingual
transcript

Transcript

The model's input, and the source every score cites.

inference

Rubric scoring

The model scores the 14 parameters, with domain vocabulary and few-shot examples from real consultations.

14 parametersfew-shotdomain vocabulary
grounding

CES and CSS, with citations

Each score is tied to the transcript line that supports it.

serving

Care Studio

Doctors see scores, audits and strong and weak points, and can dispute feedback.

HITL

Human-in-the-loop review

People review 5% of consultations: a standing check on production scores.

downstream

Incentives and performance

CES feeds the doctors' incentive and performance system.

From a consultation to a score a doctor can see, question and be rewarded on.
06 / Validation

Evals against real doctors before go-live

Before going live, I validated the model against golden eval sets: consultations scored by real doctors. The evals found CES off on two medical-knowledge parameters, so we fixed those and ran the evals again before shipping.

  1. Golden eval sets

    Real doctors labelled consultations with rubric scores.

  2. Run the evals

    The model scored the same consultations; we compared it with the doctors.

  3. Error analysis

    CES was off on two medical-knowledge parameters.

  4. Fix

    Reworked their rating scale, expanded the model's medical vocabulary and added real cases as few-shot examples.

  5. Regression

    Re-ran the golden sets, broken down by language.

07 / Testing

Quality controls in production

  • Evals broken down by language, not just in aggregate: about a quarter of consultations are in regional languages.
  • Grounded outputs: every score cites its transcript line, so a wrong score is visible, not hidden in an average.
  • A feedback loop: doctors dispute feedback in Care Studio.
  • Human-in-the-loop: people still review 5% of consultations.
  • A high bar for use: CES feeds incentives only because it proved accurate enough.
08 / Rollout

Buy, then build

We started on a vendor tool, auditing every consultation, then moved the audits to an in-house system at 70% lower cost.

  1. Buy

    AI audits of every consultation on a vendor tool, up from a ~10% manual sample.

  2. Build

    An in-house system replaced the vendor tool, at 70% lower cost.

  3. Trust

    CES became accurate enough to feed the doctors' incentive and performance system.

09 / Results

What changed

QA coverage went from ~10% to 100%, the in-house system costs 70% less than the vendor tool, and the effectiveness score is now trusted enough to feed how doctors are rewarded.

BeforeAfter
QA coverage
~10% sampled
100% audited
Cost of the audit system
Vendor tool
70% lower, in-house
What the score is trusted for
Before: Spot checks
After: Doctors' incentives
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