Predoc and Nebraska Cancer Specialists: Not Letting the Fax Be the Fumble

Nishant Hari did not train in medicine. He spent a decade in finance and derivatives before deciding to solve a problem right in front of him.

It all happened because, "I married a doctor."

His wife is now a teaching attending at a large academic medical center in New Jersey, and like so many physicians, the woes of the fax machine chewed up hours of her schedule. "For years I've just been hearing a lot of her workflow pain points around medical records," Hari said in an interview with The American Journal of Managed Care® (AJMC®).

"To this day, when they get a new patient referral and a patient booked, there’s a huge manual process that goes into retrieving all the appropriate external medical records and then organizing them back into the EHR [electronic health record] before the patient comes in,” he said.

Sometimes the records sit on a health information exchange. Often they do not. “Many times they still fall back to having to phone one of the providers in that patient’s network, one of the previous providers, fax the HIPAA authorization form, and get that practice to fax records back over," Hari said.

For patients with multiple chronic conditions, that could mean “500 to 1000 pages of PDFs associated with their longitudinal medical record that are all being faxed over.”

From that frustration came Predoc, which Hari cofounded in 2022 and leads as CEO.¹ Today, Hari said, the company will announce that Nebraska Cancer Specialists (NCS), an independent practice with 15 locations across Nebraska and Iowa, has selected Predoc to support its medical records workflow, from inbound fax ingestion and document management to retrieval of outside records.

More Faxes, Fewer People Faxing

Oncology's dislike of the fax machine is well documented. At the Community Oncology Alliance (COA) Community Oncology Conference in April, Larry Bilbrey, director of data insights and innovation for Tennessee Oncology, said automated fax processing had cut the practice's handling time from roughly 10 minutes to under 2 minutes per document.²

Bilbrey’s Tennessee Oncology colleage Johnetta Blakely, MD, MS, MMHC, who is also chief medical officer for COA, has expressed frustration with the reliance on faxes and said the field remains “a little bit on the sidelines” with time-saving technology, especially compared with the advances in therapeutics.³

Hari does not promise to kill the fax, which has survived due to fears that electronic transfer of patient information could allow data to be stolen easily.

"I think we have a very contrarian view on the fax machine," he said. "In a world where you fully adopt Predoc, there won't be any human beings using the fax machine anymore, but in our world, there could be actually increased usage of the fax machine, but by our agents.”

How would this work?

"There's never going to be one magic API that connects all the different EHRs and disparate systems together," he said, and "the phone and the fax are still really the only 2 public and reliable end points that every practice has."

From 2 Weeks to as Little as 15 Minutes

Done by hand, Hari said, gathering records "can take anywhere from 1 day all the way to 2 weeks, depending on the practice, the complexity of the patient." In oncology, that wait lands when days and minutes count.

“These are critical moments in the patient's life,” he said. “It's honestly not even a practice's fault. It's just the system that we currently have to deal with.”

He described Predoc as "a multi-agent system designed to retrieve, organize, and extract the clinical context out of medical records, and then deliver them exactly back into the places that clinicians work." Voice agents place the calls. In one that Hari audited, “that voice agent was on hold for 11 minutes," he said. "That's 11 minutes that a human would have been on hold instead of actually delivering care, engaging with patients, getting them booked for visits."

Turnaround runs from "15 minutes, if we can find all the digital documents off of any of the digital sources, to about 3 days," he said. The system then sorts what the oncologist needs for a first visit. "We could strip out prior oncology notes, medication list, lab results, imaging results, genetic testing," Hari said, and “get those into the specific folders of the EHR that they need to go to.”

At NCS, “We're going to start with taking over their document ingestion, fax ingestion, processing first," Hari said, likely in a phased rollout before adding retrieval. The practice draws referrals from regional hospital systems, primary care groups, other specialists, he said, “which really accentuates the problem of having to retrieve all of these records from all of these disparate sources.”

A Workforce Problem, Not a Payroll Cut

Debra Patt, MD, PhD, MBA, FASCO, executive vice president of Texas Oncology and president of COA, has previously told AJMC that AI tools are critical for practices that are dealing with workforce challenges.

“Staffing is a huge challenge,” she told AJMC in early 2025. “Demand is increasing and supply is decreasing. That's not a good setup." AI helps, she said at the time, “not because it replaces the workforce—because I don't think that that's going to happen—but I think it can help our workforce act more efficiently."⁴

More recently, Patt has said that AI’s impact on giving back staff time has exceeded her expectations. “We are in a nursing shortage crisis, so these types of investments can be transformational,” Patt said in April.⁵ At COA's Payer Exchange & Innovation Summit in September, she said AI-enabled decision support had shifted triage nurses from splitting their time evenly between nursing and clerical work to spending 80% of it on nursing.⁶

Hari made the same case. "There already is a massive labor shortage in health care, and that labor shortage gap is only going to increase," he said. "I wouldn't really think about it as payroll reduction. I think about it as human resource reallocation to the more patient-engaging tasks."

"No one goes to work at a leading cancer institute or a leading community oncology group and says, 'I want to spend 40% of my time phoning and faxing and looking at documents and scanning and uploading,'" he said. Giving staff "the opportunity to do what they really signed up to do," he added, will "reduce burnout across the entire stack."

Proving It

COA's AI Playbook, released in June, advises practices to plan pilots with measurable outcomes. “Innovation alone does not improve care,” Patt said when it was released.⁷

When AJMC asked how Predoc would measure success, Hari listed 2 metrics: turnaround time and staff hours. As an example, he said, “if it's 4 days, if we can get that down to 2 days, that's almost cutting it in half.” If a referral fax packet takes a team 10 minutes to process and "our system is managing 50, 60, 70 a day," the savings add up to hours per clinic each day.

"Can we help practices deliver the best oncology care that they possibly can to their patients?" Hari said. "That's really our north star.”

References

1. Garfinkle A. Predoc raises $30 million to stop document chasing in healthcare. Fortune. September 2, 2025. Accessed October 7, 2026. https://fortune.com/2025/09/02/predoc-raises-30-million-to-stop-document-chasing-in-healthcare/
2. Caffrey M. AI in oncology practice: innovation in the delivery of care itself. AJMC. May 1, 2026. Accessed October 7, 2026. https://www.ajmc.com/view/ai-in-oncology-practice-innovation-in-the-delivery-of-care-itself
3. Blakely J. Community Oncology Is “a Little Bit on the Sidelines” When It Comes to Key Advances. Oncology News Central. May 7. 2026. Accessed October 7, 2026. https://www.oncologynewscentral.com/video/oncology/community-oncology-is-a-little-bit-on-the-sidelines-when-it-comes-to-key-advances
4. Caffrey M. As COA president, Patt promotes advocacy: "each of us holds an important part of the story." Am J Manag Care. 2025;31(Spec No. 2):SP109-SP111. https://www.ajmc.com/view/as-coa-president-patt-promotes-advocacy-each-of-us-holds-an-important-part-of-the-story-
5. Astor L. Working at top of license and improving care delivery: a Q&A with Debra Patt, MD, PhD, MBA, on AI's practical promise in oncology. ASCO AI in Oncology. April 7, 2026. Accessed October 7, 2026. https://ascoai.org/articles/2026/04/working-at-top-of-license-and-improving-care-delivery/
6. McCormick B, Patt D. AI can ease administrative burden in community oncology. AJMC. September 18, 2026. Accessed October 7, 2026. https://www.ajmc.com/view/ai-can-ease-administrative-burden-in-community-oncology
7. Caffrey M. COA offers playbook to help community oncology practices navigate AI partnerships. AJMC. June 29, 2026. Accessed October 7, 2026. https://www.ajmc.com/view/coa-offers-playbook-to-help-community-oncology-practices-navigate-ai-partnerships