Why we built Pajama for doctors

A personal note: this is partly a company story and partly my own. Both matter to what we just launched.

It is 2026. You can pull up every transaction you've made in a decade in two seconds. Every song you've played, every place you've driven, every financial transaction and every email you've sent. But walk into a new doctor's office and your medical history shows up the way it did thirty years ago — in digital fragments, by fax, or not at all. We've built the most expensive healthcare system on earth, and it still can't reliably tell a doctor what happened to you last year. We'd never tolerate this from a bank. Somehow we tolerate it from the system we trust with our lives.

I've spent thirteen years trying to fix these types of problems in healthcare. Here's what I've learned, and what we're doing about it at Credo.

In 2013, I started a company called Arrive Health (formerly RxRevu). The mission was to bring drug cost transparency to doctors and the patients sitting in front of them — to answer a question that should have been simple but almost never was: what is this prescription actually going to cost? I had no idea how opaque that world would turn out to be. I thought we'd solve it in a few years. It took twelve.

Through the relentless work of our team, our investors, and health system leaders who believed in us, we built the largest cost transparency network in the country — eventually supporting nearly every doctor in the United States and processing hundreds of millions of transactions a year. After twelve years, Arrive Health was acquired by Bain Capital (now part of Interra Health). I could write a book on that journey: what it taught me about the pharmaceutical value chain, and about the entire value chain that runs underneath American healthcare.

When I left, I started Credo Health and walked straight into the problem underneath all the others: to bring complete medical records to the providers who need them. Simple to say, brutally hard to do.

I started Credo in early 2022. By the end of that year, the ground shifted under all of us. ChatGPT arrived, and our first real AI moment came with it. What we were sitting on became obvious: years of deep medical record experience, now meeting a technology that could finally make sense of it all.

But that same moment carries a danger most people aren't talking about. AI is only as good as the data you put into it. Point a powerful model at half a patient's chart and it will answer with total confidence — and it may be confidently wrong. It won't know about the medication that interacts badly with what's about to be prescribed. It won't see the diagnosis from a hospital across town, or the allergy buried in a record that never made it over. An incomplete picture doesn't produce an incomplete answer — it produces a plausible one, and in medicine a plausible wrong answer is the most dangerous kind.

That's why we spent four years on the unglamorous part: getting to a complete medical record, so that when AI powers an encounter, it's working from the truth. It's the whole game, and almost no one wants to do the hard work it takes.

Late last year, we launched a feature that allowed doctors to simply chat with the history we had collected. We called it Chart GPT. Almost immediately, we saw a shift: providers weren't just using it to ask questions — they were using it to complete the entire encounter. They had found the path to automating the note, finally taking the chore of documentation off their plate.

That shift in behavior clarified our purpose. We weren't just building a chat tool; we were building a way to eliminate "pajama time" — that soul-crushing ritual where doctors spend their nights, long after the last patient has gone home, finishing their charts. We realized we could turn those 15 to 25 minutes burned on every single encounter back into time for the doctor to actually live their life. Hence the product name Pajama arrived.

That's when we made our most deliberate decision yet: we stopped charging providers entirely. This wasn't charity, and it wasn't because we lowered our expectations. We stopped charging because we want to support every encounter. The reality is that most doctors can't afford to pay for more software, and even fewer have the capacity to "tokenmax" across every patient's chart with AI. By removing the cost, we remove the friction — aiming to reach every encounter, because the more encounters Pajama touches, the better the intelligence becomes for everyone.

Our thesis is simple: providers need to move from being authors to being reviewers, and AI is the path. We've been quietly growing Pajama for a few months. From a standing start in March, we're on track to reach over one million patients this year with our core features — what we call CareMap and Chart GPT. CareMap finds all of a patient's medical history, and Chart GPT lets any provider agentically chat with a patient's full history, build their own prompts, and solve some of the hardest problems in medicine.

The stories coming back are why we do this. Doctors are finding critical missed diagnoses, more easily supporting patients through difficult transitions of care, closing the most important care gaps, and even tracking down advance directives to better support end-of-life care. Doctors are even calling to say they now complete prior authorizations with Pajama instead of the well-funded prior-auth tool they installed a few months ago.

There's a deeper story here, though. One I haven't told publicly.

A year ago, as CEO of Credo, a routine colonoscopy turned up something no one expected. I was diagnosed with early stage lymphoma. I spent the last year fighting it, and I'm grateful to say I'm now in remission.

That year taught me what no amount of healthcare experience could. What it means to be the patient — to sit across from doctors doing everything they can for you. What it means to have your health taken from you. The couch. Curled up in a ball. My hair gone. Waves of nausea. Neuropathy running through my legs. Unable to do the job I love.

And it surfaced something I've carried my whole life. Cancer has run through all of it. I lost both of my parents to the disease by the time I was sixteen. I know what it is to be a kid in a waiting room, to watch the people you love get failed by a system that couldn't see the whole picture in time. That's not a metaphor for me. It's the reason I do this work at all.

So when I think about what Credo is really for, it isn't helping doctors spend less time documenting patient care. If that's all this were, it would be a waste of everyone's effort. What we're after is reshaping every encounter — so a doctor delivers the highest quality care, on a mission alongside AI to heal every patient we reach. Just as I've been healed. If I can do one thing through Credo, it's to give everyone a second chance. Another healthy day to do their best work and show up as their best self for their family, friends, and hopefully the work they love to do in the world.

Yes, we have to fix the administrative burden and the absurd ratio of 40 administrators for every doctor. We have to end the idea that technology only makes healthcare harder and more expensive — when in every other industry, technology has been the greatest deflationary force in history. Healthcare is the exception. It shouldn't be. It's this combination of solving the administrative burden and being on a mission to heal patients through AI that gets me so excited about what we're building at Credo.

We launched Pajama today. If you're a provider, use it — free — and try it with your patients. You can start at pajamahealth.com. I'd genuinely love to hear how you like using it.

I'll be writing more about my journey through cancer and what it taught me as a patient — especially the infuriating moments when someone asked me for a CD-ROM of my medical records. I've never been so clear and so motivated about the mission ahead of us, and the difference we can finally make to turn healthcare into the system we all dream about having.

One last request, to everyone out there trying to fix healthcare and make it better for everyone…

Let's put on our pajamas.
We have work to do.