Physician Builder Spotlight: River Records Co-Founder Jacob Kantrowitz

Since receiving an incredible response to our post about why more physicians should start companies, we've been shining a light on MD-entrepreneurs. Each week, we're featuring someone who's building a cool product or company that you definitely want to know about. Know someone else who should be featured? Reply in the comments or DM us on LinkedIn.

1. What inspired you to become a physician-entrepreneur?

I spent four years studying bioinformatics getting my PhD and learned a lot about how to get things done; at the end of the day though, a lot of my work was in failed computational experiments that led to more questions than answers. It was really interesting work and I loved the people, the work, and the opportunity to dive deeply into topics. When I returned to clinical work, however, I quickly realized that medicine is unable to leverage the data it has for almost anything outside of immediate clinical use. Genomics, if done at scale, has the potential to just break medicine. We are already drowning in data. I want to help solve that problem, and prepare medicine for the future, and I thought that would be best accomplished through entrepreneurship.

2. Tell us what your company does and what problem you're trying to solve.

Medicine has a data problem—there is both too much of it and, paradoxically, not enough actionable information. The electronic health record (EHR) was supposed to modernize medical documentation, but instead, it replicated the structure of paper charts in a skeuomorphic way, preserving their inefficiencies rather than leveraging the power of digital tools. As a result, clinicians now face information chaos—a tangled mess of overload, underload, scatter, and errors that make it harder to provide high-quality care.

John Beasley and colleagues described this problem in a 2011 paper, outlining how poorly structured information increases clinician workload and endangers patients. The EHR enables the accumulation of massive amounts of data, but because that data is redundant, disorganized, and often inaccurate, clinicians struggle to find the information they actually need. Critical details get buried, errors propagate, and essential insights are missing when they’re needed most.

At River Records, we’re tackling this problem head-on. We develop clinical information management solutions that go beyond just transcribing notes faster—a capability that has already been commoditized. Our flagship product, Stream, is an ambient scribe that not only generates documentation but also organizes it by medical problem, ensuring that key information is structured and accessible rather than scattered across the chart. By embedding this structured organization into existing workflows, we’re not just making documentation easier—we’re fundamentally improving how clinical information is managed and used over time.

3. What's your advice to anyone thinking about pursuing entrepreneurship or a nontraditional career in medicine?

In medicine, fix what you can see is broken. Whether it's through traditional entrepreneurship, or intrapreneurship, much in medicine is broken these days, and clinicians and our patients are the ones who feel these problems the most. But before you try to fix a clinical problem, make sure there is someone who is going to be willing to pay for the solution. Many good solutions in medicine will go unused because of financial incentives that don't always align with excellent clinical outcomes. Essentially, make sure there is a customer for your solution.

4. What's one lesson you've learned since building your company about entrepreneurship that wasn't obvious to you before?

It will take you places you couldn't imagine before you started. You start out with an idea, a thought, an 'oh wouldn't that be cool', and then you start to build it, you grow your team, and all of a sudden you've created thing that didn't exist before. It won't be perfect, and things will not go smoothly, but if you find a great team, and some luck, you can bring something into being that didn't exist before.

Thanks for your help and I look forward to seeing your continued work helping clinicians advocate for themselves.

Connect With Jake on LinkedIn or learn more about his company here.