Matthew Rothstein, VP of Engineering at Akido, on building the first AI native health system

Matthew Rothstein, VP of Engineering at Akido, joins Christina Farr to talk about what changes when a technology company becomes a health system. He built a credit card, sold it to Goldman Sachs, helped launch the Apple Card, and now works on the AI foundation for a bi-coastal network of nearly 100 clinics and a street medicine program in LA and San Francisco. They get into his case for open weights models over commercial frontier models in medical imaging, why he thinks an AI answer is information rather than care, and whether benchmarking AI against a panel of clinical experts is a fair test when most patients never get access to that panel.

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SPONSOR:
Akido is a technology company re-engineering healthcare around AI. Its AI-native health system frees physicians from the cognitive heavy lifting of medicine and partners on the investigation and discovery, so doctors can focus on judgment and care. This stretches a limited physician supply to reach far more people. Akido operates a national network of more than 1,000 providers across 26 specialties and six markets. Founded in 2015 out of USC's Digital Health Lab, its Series B was led by Oak HC/FT. For more information, visit www.akido.com

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LINKS:
Aikido: https://www.akido.com/ 

Chrissy Farr on YouTube: https://www.youtube.com/@LiferswithChristinaFarr 
Chrissy Farr on Instagram: https://www.instagram.com/cfarr/ 
Subscribe to the Second Opinion Newsletter: https://secondopinion.media/ 
Chrissy’s Book: The Storyteller's Advantage: https://www.chrissyfarr.com/books 

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FOLLOW:
Matthew:
https://www.linkedin.com/in/marothstein 

Chrissy:
https://www.linkedin.com/in/christinafarr/ 
https://x.com/chrissyfarr 

Second Opinion Media:
https://www.instagram.com/second.opinion.media/ 
https://x.com/second_op_media 

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TIMESTAMPS:
(00:00) Lead In
(00:37) Intro
(01:23) From NIH to fintech
(03:12) Life inside Goldman
(04:38) Fintech vs health tech
(07:26) AI aha moment
(09:51) How genAI changes teams
(12:31) Staying relevant by building
(14:27) Rebuilding healthcare systems
(17:38) Why care delivery wins
(20:34) Designing for clinicians
(22:37) Prioritizing impactful AI
(23:36) Scaling complex care
(24:33) Open models explained
(27:28) Data access and privacy
(30:01) Synthetic data and twins
(32:52) ChatGPT triage reality check
(36:42) Doctors plus AI tools
(39:28) General vs specialized models
(42:35) Reimbursement and value based care
(45:14) AI reshapes engineering teams
(49:13) Empathy in care delivery
(50:46) Akido rebrand and AI native system
(51:41) Wrap