Scaling decision-making, designing eng orgs for speed & scope as underrated leverage
with Dhruv Parthasarathy
June 25, 2025
What does it take to operate with startup-level speed… in one of the most complex, high-stakes industries on the planet?
In this episode, we go inside Commure’s engineering org w/ Dhruv Parthasarathy (CTO @ Commure & Athelas). We cover how to push decision-making down to move faster and reduce risk, structure teams for rapid iteration, and turn customers into product co-creators. Dhruv also shares how they cultivate polymath capabilities across EPD to accelerate velocity, why scope is one of the most underrated sources of leverage in engineering, and the frameworks they use to identify compound wins. If you’re scaling an eng org, leading in a complex domain, or designing your team for speed—this episode is packed with tactical frameworks you can apply immediately.
ABOUT DHRUV PARTHASARATHY
Dhruv Parthasarathy has spent the last 8 years focused on applying modern software and machine learning techniques in healthcare. Dhruv currently serves as the CTO of Commure, HATCO, and Augmedix. In the role of CTO, he leads product, engineering, and design teams. Prior to this, Dhruv helped found Athelas which eventually merged with Commure.
In these roles, Dhruv has designed and developed end-to-end solutions for revenue cycle automation, ambient documentation, patient engagement, and at-home diagnostics for oncology.
Before this, Dhruv was the Director of Machine Learning Programs at Udacity, where he led the development of the AI, Self-Driving Car, Deep Learning, and Machine Learning Nanodegree programs.
Dhruv also worked as a Product Engineer at Udacity, where he rebuilt the main signed-in experience and was responsible for the backend development. Dhruv obtained a Bachelor's degree in Computer Science from Massachusetts Institute of Technology in 2013. Following this, they pursued a Master's degree in Computer Science with a concentration in Artificial Intelligence at MIT from 2013 to 2014.
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SHOW NOTES:
- How the Commure team moves with speed & momentum (3:26)
- Commure’s operational strategy / key leadership principles (4:57)
- Hiring & cultivating multi-talented individuals (7:16)
- How to optimize decision-making, push decisions down & minimize risk (8:40)
- Why speed is a core principle for building successful eng orgs (11:36)
- Getting unstuck in your decision-making as an eng team (13:07)
- Challenges faced while building a high-performing eng team in healthcare (15:47)
- Tactics for hiring less experienced engineers & bringing them up to speed (18:22)
- Customization as a product principle and how it manifests in EPD (20:55)
- Why the polymath style approach to engineering is more vital now than ever (23:47)
- Lessons learned around scope & using it to create leverage (26:06)
- Frameworks for assessing areas most likely to create a compound win (28:22)
- Rapid fire questions (30:35)
LINKS AND RESOURCES
- Cinema Speculation - The long-awaited first work of nonfiction from the author of the #1 New York Times bestselling Once Upon a Time in Hollywood: a deliriously entertaining, wickedly intelligent cinema book as unique and creative as anything by Quentin Tarantino.
This episode wouldn’t have been possible without the help of our incredible production team:
Patrick Gallagher - Producer & Co-Host
Jerry Li - Co-Host
Noah Olberding - Associate Producer, Audio & Video Editor https://www.linkedin.com/in/noah-olberding/
Dan Overheim - Audio Engineer, Dan’s also an avid 3D printer - https://www.bnd3d.com/
Ellie Coggins Angus - Copywriter, Check out her other work at https://elliecoggins.com/about/