Dr. Mohammad Chelehmalzadeh on Building an AI Medical Assistant From Scratch,

What happens when an ER physician who fled Iran during the revolution as a child, survived Scud missiles and bombings across multiple cities, made it through medical school in Belize, delivered babies as the only doctor in a 25-mile radius in a tiny Minnesota town called Olivia, switched into emergency medicine, and spent years getting lectured by his billing partners about every critical care encounter he was under-documenting — finally picks up a Python programming hobby he had since high school, calls his AI friend at AMD, and spends three to four months building a tool that is not a medical scribe, not a transcription app, and not a copy of anything else on the market? In this episode of the Trustcast Show, Zane Myers speaks with Dr. Mohammad Chelehmalzadeh, ER physician and founder of Teb IQ, about why emergency room doctors are interrupted every 30 seconds, why their notes end up as skeletons of what they should be, and why an experienced physician who just saved someone's life after 20 minutes of CPR ends up billing at the same level as a strep throat visit. Dr. C explains medical decision making — MDM — and why the 2023 Medicare billing change made the thought process the driver of revenue rather than the length of the note, why thinking about stroke and then ruling it out without ordering a CAT scan is a billable event if you document it, and how his app increased his personal critical care billing rate from 8-9% to 22% and pushed his users from level three and four billing to four and five across the board. They also discuss the app's live evolving patient story that gets reanalyzed with every addendum and changes the final assessment as the diagnosis shifts, the HIPAA architecture that redacts the 18 protected variables before the story ever touches an LLM, the clinical scoring module that auto-calculates HEART score and other tools without the physician leaving the screen, the AI critique feature that reviews your entire patient encounter and tells you what you missed — the shoulder X-ray that was ordered but never mentioned, the tetanus shot with no follow-up — and why Dr. C refused to let surgical residents use the full version of the app because cognitive development in residency is too important to hand over to a machine. He also shares why getting into Epic costs over $100,000 before a single hospital ever sees your app, and what his path to scale actually looks like. Dr. Mohammad Chelehmalzadeh is an emergency medicine physician and founder of Teb IQ, an AI-powered clinical documentation and billing optimization platform being piloted across hospitals in Connecticut. Connect with Dr. Chelehmalzadeh: Email: [email protected] Phone: 610-945-8337 tabscribe.com Chapters 00:00 Introduction to Dr. Mohammad Chelehmalzadeh 00:46 The billing conversation that started everything — Dr. C's notes were billing at strep throat level after saving a life 02:30 Learning to code again with ChatGPT and writing Python billing cheat files that spread across the department 03:10 The AMD AI friend who said this is a perfect use case — three months of nightly iteration 04:10 The first web version took five minutes per note — then ten seconds 04:56 The director noticed critical care billing jump from 8% to 22% — and looked the other way 05:10 Becoming a company because the hospital group needed liability separation 05:45 Over 40,000 notes processed and users billing five to six percent more in critical care 06:20 Why this is not a scribe — it is a Swiss Army knife that keeps the chaos organized and timestamped 07:04 What it is like to be interrupted every 30 seconds in the ER and why notes become skeletons 08:00 The live evolving patient story — the AI reanalyzes the whole encounter with each addendum 09:30 The sign-out note feature — dictating an entire shift handoff with one record button 10:00 The supervisory note for PAs and NPs — the right blurb every time 11:38 The shift handoff as an analogy for losing tokens between Claude conversations 12:03 HIPAA compliance — redacting all 18 protected variables before anything touches the LLM 15:25 How the encounter stays linked to the right patient without PHI — diagnosis, age, sex, room number 16:30 End to end encryption, business associate agreements, and why no recordings are stored 17:58 The legal question — how do you protect yourself when data clears after 30 days 19:02 The gray zone around PHI data retention and physician responsibility for what they paste into the chart 20:21 Teb IQ — the name comes from the Persian word for medicine and Ibn Sina the father of modern medicine 21:02 Fleeing Iran during the revolution, surviving the Iran Iraq war, escaping through Australia to Canada and eventually Belize #DrMohammadChelehmalzadeh #TebIQ #TrustcastShow #EmergencyMedicineAI #ClinicalDocumentationAI #MedicalBillingAI #AIHealthcare #EMRDocumentation #CriticalCareBilling #PhysicianAITool