Reasoning Labs.Get early access

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A Gram stain: violet rods and cocci scattered across a pale field.
.gramMicrobiology
A peripheral blood smear, May-Grünwald stained.
.cbcHematology
A CT angiogram of the head: gold cerebral vessels branching against black.
.angioVascular
A whole-slide scan of kidney tissue.
.akiNephrology
A grid of axial MRI brain slices in false colour, blue and amber on black.
.mriNeurology
A lateral radiograph of the skull and cervical spine.
.xrRadiology
Sunlight and the shadow of a tree falling on a sheer linen curtain.
.consultConsult

Reasoning Labs is a breakthrough in physician tooling.

You said22words

52-year-old man, brought in overnight with confusion and ataxia. Wide anion gap on the ED chemistry. Fluids started before I saw him.

The note247words

you

HPI
52-year-old man brought in overnight by family with
confusion and ataxia. No fever, no head trauma, no witnessed
seizure activity. Last known well 2100 the prior evening. No new
medications, no known ingestion.
Labs
Na 138 · K 4.1 · Cl 100 · HCO3 11 · BUN 34 · Cr 2.4
Wide anion gap at 27 on the ED chemistry. Baseline Cr 0.9.
Measured osm 322, calculated 291 — osmolar gap 31.
VBG 7.24 / 32. Lactate 2.1. Serum ethanol negative.
Exam
Gen: somnolent, rousable to voice, oriented to self only.
CV: regular rate and rhythm. Resp: clear. Abd: soft, non-tender.
Neuro: dysmetria on finger-to-nose bilaterally. No focal deficit.
Assessment
1. High anion gap metabolic acidosis with an elevated osmolar gap.
A negative ethanol narrows this to a toxic alcohol — ethylene
glycol or methanol until proven otherwise.
2. Acute kidney injury, KDIGO stage 2 (Cr 0.9 → 2.4).
3. Confusion and ataxia consistent with the same exposure.
Plan
Fluids started in the ED before my evaluation — continue
isotonic crystalloid and reassess the gap in two hours.
Fomepizole loading dose now — do not wait on the send-out level.
Nephrology at the bedside regarding urgent hemodialysis.
Urine microscopy for calcium oxalate crystals.
Thiamine and pyridoxine. Hold nephrotoxics, renally dose all
standing medications. Poison control notified.
Disposition
Admit to the MICU for q2h labs and possible urgent dialysis.
Discussed with the accepting intensivist and with the patient's
daughter at the bedside, who is the healthcare proxy.

Why this exists

Nobody went into medicine to do paperwork.

Administration turned care into documentation and left the patient whatever time survived. Engineers fixed this a long ago, by picking and building their own tools. Medicine never got that. We are building tools by and for physicians.

Status quo
Three logins
Reasoning Labs
No SSONo tenant
One tab
Status quo
12+ weeks
Reasoning Labs
No IT ticketNo security reviewNothing to approve
0 weeks

How it works

You already work around all of this.

None of these are hard problems. They stayed broken because the people who feel them are not the people who buy the software.

01

You already said it out loud on rounds. Then you sit down and type it again, in order, under twelve headings.

Say it once, in any order. It comes out under the headings it belongs to.

02

The dictation app needs a licence you may not get, on whichever machine you happen to be sitting at.

A tab next to the chart. It opens to a microphone. Your own phone too, so there is nothing to provision.

03

Anything that touches the record needs approval and a slot on a roadmap that is already full.

It never touches the record. Copy from the next tab, paste. Nothing to set up in Epic.

04

Every tool that offers to help you write the note would also like to keep it.

We keep your email. Not one word of the note — which means you cannot come back for yesterday's.

Try it

Say the exception. Keep the rest.

Same block, a dozen times a day, identical except for the part that is about this patient. Say that part.

Say it the way you would on rounds: "fever and chills, productive cough, no chest pain, some loose stools since Tuesday."

Demo — no signed agreement covers this page, so keep real patient details out of it. Made-up details work just as well.

It files what you said. It does not add findings, it does not infer, and it does not decide anything — if you did not say it, it is not in the note.

Review of systems
Constitutional
Reviewed and negative.
HEENT
Reviewed and negative.
Cardiovascular
Reviewed and negative.
Respiratory
Reviewed and negative.
Gastrointestinal
Reviewed and negative.
Genitourinary
Reviewed and negative.
Musculoskeletal
Reviewed and negative.
Skin
Reviewed and negative.
Neurologic
Reviewed and negative.
Psychiatric
Reviewed and negative.
Endocrine
Reviewed and negative.
Heme/lymph
Reviewed and negative.

History obtained from the patient directly. All other systems reviewed and negative.

Early access

Built for the physicians who still believe patient care comes first.