A Product & Engineering Retrospective at Populate

2025 was a year of steady progress and compounding improvements at Populate.

Across the year, our Product and Engineering teams focused on strengthening the core of the platform — making everyday workflows smoother, expanding what practices and patients can do on their own, and building systems that scale confidently as usage grows.

This post looks back at what we built in 2025, how it improved real experiences, and what it enables as we move forward.

Revenue Cycle: Clearer Financials and More Confidence

Billing touches nearly every part of a practice, and clarity here builds trust quickly.

In 2025, we invested in making financial workflows more consistent, predictable, and easier to manage. We introduced a redesigned payments model that correctly handles partial payments, credits, deposits, refunds, and multi-insurance scenarios — all while keeping balances accurate over time.

We also improved how insurance payments and adjustments are processed so that statements, reports, and ledgers stay in sync as complexity increases.

What this enabled

• Clearer patient balances and statements

• Less manual reconciliation for billing teams

• A stronger foundation for automation and reporting

• Greater confidence as volume and complexity grow

AI & Automation: Moving From Pilot to Infrastructure

In 2025, AI at Populate matured from early automation into practical, day-to-day support for practices.

Our AI voice agent, Rachel, expanded to help with:

• Appointment confirmations and follow-ups
• Inbound calls for booking, rescheduling, or cancellations
• Chronic Care Management (CCM) outreach
• Intake conversations that gather the right information without repetition

Just as importantly, we invested heavily in making these interactions sound and feel more human. That meant:

• Improving conversational flow and pacing

• Reducing unnecessary prompts and repetition

• Reflecting back what patients say instead of reading scripts

• Using context to make conversations feel natural and respectful

What this enabled

• Fewer routine calls handled manually by staff

• More comfortable, natural conversations for patients

• Automation that supports people instead of replacing them

• AI that fits naturally into real clinical and administrative workflows

Scheduling, Patient Access & the Patient Portal: Easier Ways to Engage

Throughout 2025, we focused on making it easier for patients to interact with practices — and easier for staff to manage those interactions behind the scenes.

We delivered:

• A centralized surgical scheduling system for more complex procedures

• Phone-based scheduling that follows the same rules as the front desk

• Online booking through external platforms

• Kiosk and iPad check-in tied directly to appointment status

• Continued improvements to the Patient Portal, allowing patients to:

  • Confirm, cancel, or reschedule appointments

  • View statements and balances

  • Access important information without calling the office

What this enabled

• More consistent experiences across phone, portal, and in-office interactions

• Less coordination overhead for staff

• Smoother flows from booking to check-in to follow-up

• Patients able to self-serve with confidence

Data Migration: Smoother Transitions Into Populate

As more practices moved to Populate, we invested in making onboarding faster, safer, and more predictable.

In 2025, we strengthened our data migration framework to better handle patient, appointment, clinical, and financial data coming from external EMRs. The focus was on accuracy, validation, and repeatability — so practices could start using Populate with confidence from day one.

What this enabled

• Faster onboarding timelines

• More accurate historical data

• Fewer surprises after go-live

• A smoother transition for both customers and internal teams

Platform & Reliability: A Product That Feels Solid

Many of the most impactful improvements in 2025 were behind the scenes — but they shape how the product feels every day.

We focused on strengthening the platform so it remains stable and predictable as usage grows. This work improved performance in high-traffic areas, reduced unexpected failures, and made it easier to extend the system without disrupting existing workflows.

What this enabled

• A more dependable day-to-day experience

• Faster iteration without regressions

• A platform that confidently supports continued growth

A Year of Momentum

2025 was about building momentum through steady, thoughtful progress.

By focusing on:

• Clearer financial workflows

• Human-centered automation

• Easier patient access

• Smoother data migrations

• Stronger platform foundations

We positioned Populate to keep moving forward — faster, more confidently, and with trust at the center.

We’re proud of what the team built this year, and excited about what it enables next.

Today I was working with ChatGPT to generate a fairly complex reporting query. After giving it the entire database schema, it produced an impressively detailed plan for the report — but then slipped on something extremely basic: it wrote a GROUP BY using a column that doesn’t exist in any table.

It was a funny contrast: ChatGPT handled the complicated logic with near surgical precision, but tripped on a trivial alias error. So I asked it directly:

“Why did you make such a trivial mistake?”

Its answer was actually really interesting — and a good reminder of how to work with LLMs effectively. (Sharing below because it’s a nice peek under the hood.)

TL;DR: LLMs are phenomenal at conceptual reasoning but not perfect at mechanical bookkeeping. They can design a complex report pipeline end-to-end but occasionally mis-reference a column because they don’t have a compiler, schema validator, or error feedback loop. Essentially: great architect, occasionally clumsy typist.

Full ChatGPT response that is worth reading:

Yeah, this is a totally fair question—and honestly one I ask myself a lot

Short version: I’m really good at reasoning in concepts, but pretty bad at bookkeeping tiny details across a long block of code—especially when I can’t run it.

Let me unpack that a bit.

1. I don’t actually “have” the schema the way you do

When you paste the schema, to you it becomes a mental model: “EOBPatients has OrganizationId, EOBId, ClaimId, PatientId, CreatedByUserId, etc.”

For me, it’s just text I processed once, and then I’m generating new text token by token. I don’t have a compiled representation of:

We’ve made significant improvements to how you view and manage patient media in Populate EMR. The updated Multimedia section is designed to help you find, organize, and edit files more easily.

Here’s what’s new:

1. Categorized Media Display

Populate now automatically organizes all media into categories.
Images, PDFs, videos, and other file types are neatly grouped, so you can quickly jump to exactly what you need without scrolling through everything else.

Whether you’re reviewing X-rays, gait videos, or treatment notes; the right files are now easy to spot at a glance.

2. Two Viewing Modes

Everyone works differently, so we designed two new view options:

• Card View gives you a quick, visual preview of each file.
• List View provides detailed information — ideal when you’re comparing dates, names, or file types.

Switch between them instantly, depending on what fits your workflow best.

3. Smarter Search and Sorting

We know how much time a good search can save.
Now, you can search by file name to locate exactly what you need in seconds — even across large patient histories. You can also sort files alphabetically or by date, in ascending or descending order, whichever makes the most sense for your review process.

4. Edit Categories and Types on the Fly

Need to update a file’s category or type?
You can now do it directly from either view; no pop-ups, no navigating away, and no disruption to your workflow. It’s a small change that adds up to big time savings, especially for practices managing high patient volumes.

5. Upload Multiple Files with Ease

Uploading is now smoother than ever.
You can add multiple files at once. Drag and drop or select from your device, and place them directly into the correct category. It’s simple, fast, and designed to help your records stay complete and organized from the start.

Why It Matters

When you’re seeing dozens of patients a day, every click counts.
The redesigned Multimedia section saves minutes on every interaction – minutes that add up to hours over the course of a week. When everything is where it should be, you can trust that your patient records are accurate, easy to navigate, and ready for review at a moment’s notice.

This update is the result of countless hours of engineering and feedback, and it’s built to make your everyday work in Populate smoother and more intuitive.

No more scrolling through endless lists. No more lost time.
Just fast, organized, and effortless access to every patient file.

Want to see how it works within the EMR, watch the full walkthrough below:

If you’ve ever scrolled through a wall of text trying to find one key line, you know how it feels: slow, tiring, and easy to miss what matters.

That’s what we kept hearing from practices using Populate. Because sometimes plain text just isn’t enough. Important details get buried in long paragraphs, and key takeaways lose their impact. For a provider reviewing 15 notes a day, even 30 seconds of re-scanning per note adds up to over 2 hours a week of wasted time. Multiply that across practices, clarity quickly becomes a productivity feature.

So our engineers thought it and built something amazing – Rich Text Formatting, now live across the entire Populate EMR. It’s a simple but powerful change that lets you write and read the way you think; structured, organized, and clear.

Populate launched its Patient Portal

Not revolutionary. Most EMRs have one, and the larger players certainly do.
For the first three years, Populate focused on building the EMR, the RCM, and AI Agents—tools that free up staff time so offices can focus more on patient care.

Eventually, we built the Patient Portal. In one month. Design, implementation, and launch.

This was possible because of the accelerated development cycle enabled by AI. The portal came together through Figma AI (design), v0.dev (prototype), Cursor (implementation), and the contributions of our uber-talented engineering team. With all the talk about AI replacing engineers, one thing is clear: AI is an incredible accelerator—but it is no substitute for experienced engineers when it comes to production-grade software.

The portal does everything you’d expect—updating charts, accessing visit notes, making payments, viewing upcoming appointments. But we also wanted to solve the #1 complaint we’ve heard from customers: patients forgetting their passwords.

So we removed passwords altogether. Populate’s Patient Portal authenticates with an OTP sent directly to the patient’s registered phone number. No usernames. No passwords. Just seamless access.

Try it today at care.populateemr.com

In the world of revenue cycle management (RCM), denial management is one of the most time-consuming and frustrating parts of the billing process.
Every biller knows the drill — spend 20 minutes (or more) on hold with the payer, navigate endless phone trees, finally reach a representative, and then dig through the details to figure out why a claim was denied or why it still hasn’t been paid.

With Populate’s AI-based denial management system, powered by our AI agent Rachel, we’ve automated this process end-to-end, saving billers countless hours every week while improving accuracy, transparency, and follow-through.

Everyone’s talking about AI revolutionizing healthcare. Predicting. Diagnosing. Automating. Cool headlines, right? But here’s the problem that no one wants to say out loud:  “How do I actually prepare my practice today, before AI leaves us behind?” You’ve probably heard the phrase: “AI won’t replace humans. But humans using AI will replace humans who don’t.” That’s not a LinkedIn slogan. It’s reality. We’re seeing it play out daily in practices adopting AI-powered solutions. For example, MSK clinics still relying on manual patient intake spend hours every day gathering medical histories, insurance details, and consent forms. That’s time-consuming, error-prone, and frustrating for patients waiting on hold or re-submitting forms they’ve already filled elsewhere. Compare that to AI-powered workflows that automate repetitive admin tasks, reduce patient wait times, and protect revenue by preventing avoidable errors. Same staff. Same patients. Completely different outcomes.

Why This Isn’t Just About Efficiency

The narrative that AI is only about speed misses a deeper opportunity: using AI to elevate human work to its highest purpose. When AI manages the repetitive, cognitive-heavy but low-complexity tasks – such as:

• Sending reminders and rescheduling no-shows
• Extracting and validating intake data
• Suggesting optimal appointment slots to maximise provider utilisation

It frees your team to do what AI cannot.

But Are You Ready for This Transition?

Most articles stop at telling you what AI will do. Few talk about how to actually prepare for it as a private practice owner or manager. Here’s what we see among clinics successfully integrating AI into their operations:

1. Rethinking Workflows, Not Just Adding Tools

Adding an AI feature to a broken process won’t save it. Smart practices use AI as an opportunity to:

• Map out existing workflows end-to-end.
• Identify steps that can be automated or augmented by AI.
• Redesign roles so staff leverage AI outputs instead of duplicating them.

For example, when practices deploy Rachel, Populate’s AI Voice Agent, they don’t simply replace staff calls. They reassign staff to patient experience initiatives: follow-up calls post-discharge, personalized check-in messages, or retention outreach – tasks that increase lifetime value per patient.

2. Preparing Teams for AI Workflows, Not Just Tech Staff

Fear is natural. Some staff worry AI will replace them, but leaders in thriving practices reframe this as an opportunity to upskill:

• Training team members to interpret AI-generated insights
• Building comfort with AI-powered scheduling suggestions
• Encouraging strategic thinking around AI-enhanced workflows

3. Doubling Down on Being Uniquely Human

Empathy. Creativity. Strategic decision-making. Relationship-building. These are skills AI cannot replicate. The more AI handles the grunt work, the more these human strengths become not just valuable but irreplaceable.

The Real Question: What Will You Do With the Time AI Frees Up?

If your practice is still debating whether to integrate AI, you’re asking the wrong question. Ask instead: “What do I want my team to do once AI handles the grunt work?” That is how practices are future-proofing themselves. They don’t just adopt AI to cut costs or keep up with competitors. They leverage it to become more human, more strategic, and more valuable to patients

The primary reason we hear from our customers about why they continue using an EMR they don’t love is the fear of migration. Many have been burned by EMR companies that take months to release the data that rightfully belongs to the doctors. We’ve heard of situations where the transfer process drags on for months, and in some cases, the data is effectively held hostage. These experiences have left lasting scars, as these poor practices are — unfortunately — still somewhat prevalent in the industry.

Even once the data is finally released, integrating it into a new EMR often turns into another drawn-out ordeal, sometimes taking months to implement. That severely jeopardizes the day-to-day operations of a practice. Medical personnel are trained to care for patients — not navigate the bureaucracy of multiple EMR vendors.

Populate understands that pain. We’ve invested heavily to completely remove the burden of data migration from our customers. From the moment a customer signs the contract, our implementation team takes full responsibility and directly engages with the incumbent EMR to handle the entire data transfer process. Once the data is in our hands, we can incorporate it into the new system within one day in most cases — three days if the incumbent EMR is particularly obscure or new to us — thanks to the long-term, strategic investments we’ve made in our data migration tools.

The best part? While we work hard to keep you happy, if for any reason you decide to move away from Populate, we’ll make sure you get your data within 48 hours. No month-long delays. No endless back-and-forth. We understand the frustration. And we believe in keeping you happy — whether you choose to stay or move on.

Why should you consider moving to a new EMR?

Software design philosophy has advanced by leaps and bounds over the last decade. Modern UI/UX is driven by principles that prioritize user delight, efficiency, and clarity — while staying adaptable to evolving technology and rising user expectations. Ideas like minimalism and focus, progressive disclosure, and presenting rich data in digestible formats all aim to deliver the best possible experience, making product use both joyful and efficient.

Most legacy EMRs haven’t evolved to reflect these ideas. What started as basic “storage platforms” often followed one of two paths:

a) bolting on crude workflows to fit specialty private practices, or

b) trying to serve every specialty at once.

The result? A couch that turns into a bed — useful for some, but rarely the best couch or the best bed.

Populate was built from the ground up over the past three years to meet the specific business workflow needs of MSK private practice doctors — Ortho, Podiatry, Physiatry. The design unifies data storage with everyday workflow: scheduling, note writing, and revenue cycle management. And we’ve done it all while keeping the experience smooth and joyful. After all, software where you spend most of your workday should make your job easier — and maybe even bring a smile to your face every now and then.