August AI enriches patient care with AI health companion powered by Microsoft Azure

August AI is at the forefront of AI-powered innovation in healthcare with August, an AI health companion. The company needed advanced large language models (LLMs) and a secure, scalable IT infrastructure to support its rapidly expanding user base.

The company created a new architecture on Microsoft Azure and migrated several terabytes of data in three months with no downtime. August AI uses the LLMs in Azure AI Foundry to power August and Azure Database for PostgreSQL for scalable storage.

The dynamic infrastructure empowers August AI to support over 3.5 million customers, up from 500,000 before the migration. August scored 100% on the U.S. Medical Licensing Examination and offers customers potentially life-saving medical support.

“The support we get from Microsoft is phenomenal, and I think the technology that’s available on Azure is state of the art.”

Anuruddh Mishra, Founder and CEO, August AI

August AI, an India-based AI startup, is supercharging AI-powered healthcare with its health companion, August, which offers customers constant access to accurate medical information and analysis. The company was inspired to create August after recognizing how often patients are affected by physician shortages, long wait times, and geographic limitations that can delay medical treatment. To support a rapidly expanding data estate, August AI migrated to a new architecture in Microsoft Azure, boosting the security and stability of its IT infrastructure. August’s customer base has grown from 500,000 to 3.5 million users in 160 countries, transforming healthcare and the patient experience worldwide.

Enriching patient care with compassionate, timely answers using AI innovation

A person’s health is at the center of their well-being, but navigating the complex world of healthcare can feel daunting. August AI is driving the future of personalized healthcare and streamlining access to medical knowledge with its AI-powered health companion named August. Customers can use August to interpret lab reports; read prescriptions; explain medical terms; and provide instant, accurate information and an analysis of symptoms.

For August AI Founder and CEO Anuruddh Mishra, creating August was deeply personal. After suffering a painful misdiagnosis, Mishra conceptualized an idea that would harness large language model (LLM) capabilities to answer health questions anytime, anywhere. “I realized that we’re never going to train enough humans to deliver the kind of care that patients need,” says Mishra. “A doctor’s job is giving patients care during a consultation, but patients need a lot more support than that.”

Mishra founded August AI in 2022 to bring the vision to life, but the August AI team realized that its existing IT infrastructure would not be able to support a growing, global customer base. The company needed to securely process sensitive health information in an environment that could also scale quickly to meet customer and data demands. August AI also relied heavily on access to state-of-the-art LLMs to power an empathetic AI companion that understands context and offers its users compassion along with insights and analysis.

August AI turned to Azure to create a new architecture that would meet compliance requirements for the Health Insurance Portability and Accountability Act and the International Organization for Standardization. This dynamic architecture would seamlessly scale with the company and empower it to harness the latest AI innovations to support customers’ health journeys. “Azure is the most compliant cloud available when it comes to healthcare,” says Mishra. “That gave us comfort that we were moving to a safe, secure infrastructure that we could build our own security compliance on top of.”

Migrating to Azure in three months with zero downtime for customers

August AI collaborated closely with Microsoft to move several terabytes of data to an Azure-based infrastructure in three months with no system downtime, an ambitious timeline for a small startup. The company migrated its mission-critical database first, then focused on migrating its remaining data and workloads to Azure without disruptions to the individuals who rely on support from August. “Somebody is asking August a question at 2∶00 in the morning, genuinely worried that they may need to go to the hospital,” says Mishra. “We can’t afford downtime.”

“Somebody is asking August a question at 2∶00 in the morning, genuinely worried that they may need to go to the hospital. We can’t afford downtime.”

Anuruddh Mishra, Founder and CEO, August AI

The company’s new architecture combines multiple Azure products to train the AI companion, collect and store sensitive patient information, and offer instant support to customers. With access to cutting-edge LLMs in Azure AI Foundry, August AI refined its health companion, increasing the accuracy of its responses and engineering the model to safely mimic human behavior. The company generated more realistic, empathetic interactions between August and customers.

To support server application programming interfaces and microservices, August AI uses Azure Container Apps and Linux on Azure to streamline performance and anonymize sensitive patient information. Customers can upload a variety of files to August, ranging from PDFs to audio files, and Azure Container Apps helps August process, analyze, and safeguard the information. “One of the main reasons for using Azure Container Apps is its flexible deployment because we don’t have to worry about the service part of scaling up and down,” says Mishra. “We deploy a lot of Linux virtual machines in Azure, and it helps us be a lot more cost efficient as our traffic ebbs and flows.”

With a rapidly expanding customer base, August AI is doubling its data every three months, and the company uses Azure Database for PostgreSQL to effortlessly scale storage and optimize performance. “We receive a log of queries that are not performing optimally, and within a couple of minutes we can optimize that query with PostgreSQL on Azure and move on,” says Mishra.

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Throughout the migration, August AI worked closely with Microsoft to create an infrastructure that would combine cutting-edge technology with the highest privacy and security standards. With early access to the latest AI innovations, August AI can quickly test new applications and use them to enhance the customer experience. “The support we get from Microsoft is phenomenal, and I think the technology that’s available on Azure is state of the art,” says Mishra.

Transforming the lives and health of 3.5 million customers

Since migrating to Azure, August AI has gone from 500,000 users to an impressive 3.5 million users in more than 160 countries. The company’s new IT infrastructure works seamlessly with 99.99% uptime, empowering its employees to focus on refining the underlying models that power August. Within one year, it went from scoring 94.8% on the U.S. Medical Licensing Examination, a standard benchmark for health AIs, to scoring 100% after fine-tuning the Azure GPT-4o model optimized for healthcare applications with publicly available, de-identified health data sets.

But most important for August AI are the life-changing stories that its customers share. Many customers use August to check symptoms and determine when to visit a doctor. The health companion empowers them to review medical terms and prepare for consultations in a private space.

Customers have also shared how August offered an alternative explanation for a set of symptoms that empowered patients and clinicians to dig deeper and reevaluate. “Some customers have gone to the extent of saying, ‘This saved my life,’” says Mishra. “One customer was going to an oncologist, suspecting they probably have cancer, but they could not do a biopsy. When the customer checked with August, the health companion said it could be a very intense bacterial infection, and it turns out, that was right.”

Envisioning the next wave of AI innovation

With its reliable, secure infrastructure in place, August AI employees can embrace their true passion: creating new services that enhance healthcare for August customers. The company’s next wave of AI-powered innovation will add services that streamline patient care, from booking doctor appointments and ordering medications to helping U.S. customers find in-network health providers. August AI also aims to empower US customers with greater visibility into various healthcare costs.

For Mishra, the company’s ongoing collaboration with Microsoft has laid the foundation for August AI to thrive. “Building a startup is extremely hard, and you want to fight as few battles as possible,” says Mishra. “I don’t ever want those battles to be over optimizing infrastructure or virtual machines, so it’s awesome that we don’t have to worry about our infrastructure.”

MEDICAL DEVICE DISCLAIMER: Microsoft services [1] are not designed, intended, or made available as a medical device(s), and [2] are not designed or intended to be a substitute for professional medical advice, diagnosis, treatment, or judgment and should not be used to replace or as a substitute for professional medical advice, diagnosis, treatment, or judgment.

Discover more about August AI on Instagram and LinkedIn.

“Building a startup is extremely hard, and you want to fight as few battles as possible. I don’t ever want those battles to be over optimizing infrastructure or virtual machines, so it’s awesome that we don’t have to worry about our infrastructure.”

Anuruddh Mishra, Founder and CEO, August AI