(Image source: IIR.)
SecondLook Health, a San Mateo, Calif.-based provider of AI-powered clinical record analysis, has placed its clinical reasoning platform into paid production with its first enterprise client, a national organization providing services to the workers’ compensation market.
The unnamed client has used the platform on live physical therapy cases since mid-2026 under a multiyear agreement. Operating in all 50 states, the organization serves insurers, third-party administrators and self-insured employers.
Nathan Gunn, MD, CEO and Cofounder, SecondLook Health.
SecondLook reports that the platform has maintained what Nathan Gunn, MD, CEO and Cofounder, SecondLook Health, describes as 99 percent fidelity across more than 500 live cases, all reviewed by the client’s clinicians.
“What this deployment validates is that software can read a medical record and reason on it well enough for a licensed clinician to value its insights and save time on live claims,” Gunn comments. “Our client graded our output item by item before they trusted it.”
The client currently uses SecondLook within its physical therapy concurrent case-management unit. As provider notes arrive, the platform reads and scores them before returning the cases to clinical reviewers.
The longer-term objective is to screen every physical therapy case and direct reviewers toward claims exhibiting the greatest clinical risk. SecondLook says this could help identify treatment that has departed from its expected trajectory earlier and extend clinical oversight across more of the client’s book.
Beyond Medical-Record Summarization
SecondLook distinguishes its approach from medical-record summarization by comparing documented progress with what clinicians would expect at that stage of treatment.
“Summarization shortens what is on the page,” Gunn explains. “Clinical reasoning compares what is on the page against what should be there at that point in treatment.”
For example, three consecutive physical therapy notes might report the same shoulder range of motion and unchanged pain levels. A conventional summary would present the measurements. SecondLook is designed to recognize that the patient appears to have plateaued when the treatment plan anticipated improvement and flag the case for attention.
The software does not make clinical or claims decisions, Gunn stresses. Nurses and physical therapists serving as the client’s case managers determine whether treatment is progressing as expected, requires monitoring or warrants intervention.
SecondLook processes initial evaluations and progress notes, including scanned PDFs, faxes and handwritten documents. It extracts clinical facts such as range of motion, strength, pain scores, functional outcomes, attendance, work status and treatment goals.
The platform produces a structured summary, a status for each clinical category and an overall risk score. Each flag includes an explanation and links to the source note. Missing information is labeled “not documented,” while conflicting statements are displayed rather than silently reconciled.
“The platform reads only what is documented; it does not examine the patient,” Gunn notes.
Every case classified as “at risk” goes to a licensed clinician. Accountability for clinical and claims decisions remains with the client.
Customer Testing Leads to Production
The engagement followed a six-week proof of concept conducted in late 2025 using several dozen closed physical therapy cases. The client’s clinical team established the evaluation categories, and its case managers graded SecondLook’s output item by item over three rounds.
The tests considered clinical accuracy, agreement with the reviewer’s risk classification and reductions in the time needed to extract information from the record.
SecondLook reports that approximately 99 percent of graded outputs in the final round contained no clinical discrepancy and that the platform’s risk classifications matched the case managers’ determinations in every instance. The results came from the customer’s internal evaluation rather than an independent study.
The client subsequently increased production volume while continuing to have its clinicians review every case and report discrepancies. Gunn says SecondLook has maintained 99 percent fidelity through more than 500 live cases.
The potential significance for workers’ compensation organizations lies in extending the reach of a limited pool of clinical reviewers. The technology is intended to reduce the time clinicians spend extracting information and help them concentrate on claims requiring attention.
Earlier identification could allow a reviewer to intervene after six visits rather than discovering after 16 that treatment has failed to produce the expected progress, Gunn suggests. The broader objectives are shorter treatment episodes and earlier returns to work when clinically appropriate.
Beyond physical therapy, SecondLook sees potential applications in auto bodily injury, general liability, Medicare Set-Asides, disability and medical malpractice. These uses rest on the same proposition: AI can help interpret evidence scattered across medical records while leaving consequential decisions with qualified professionals. SecondLook Health is HIPAA-compliant and SOC 2 Type II-certified.