The goal of ambient AI clinical documentation is to give doctors more time with patients rather than them stare at a computer screen while in the exam room taking notes. Health system tech leaders can compare different products because clinicians are able to use multiple vendors without having to significantly alter their workflows. Nashville, Tennessee-based Vanderbilt University Medical Center plans to compare Nuance to an unnamed second vendor, said Chief Information Officer Dr. Neal Patel.
"We're trying to figure out where the puck will be," Patel said.
Rochester, New York-based University of Rochester Medicine compared two vendors, a larger company that's more integrated into its Epic EHR and a startup specialized in a specific clinical area, said Chief Digital Health Officer Michael Hasselberg.
After the competition, the health system expanded its pilot with the large vendor for primary care, said Chief Medical Information Officer Dr. Gregg Nicandri. The ability to connect to its EHR was a deciding factor, he said.
"Even though providers preferred the more specialized model's output, they were less likely to adopt it because it was not integrated in the EHR," Nicandri said.
The health system is negotiating with both vendors to determine which product it will use for other clinical areas and the system at large. The pilots taught URMC a lot about how clinicians interact with and benefit from the technology. The foundation and core technology for all ambient services are similar across vendors, which makes comparing them a bit easier, Hasselberg said.
"You're working with the same chassis," Hasselberg said. "Right now, we see some that do well in certain areas and some that do well in others."
Burlington, Vermont-based University of Vermont Health Network had a group of 50 primary care providers use technology from two vendors for four weeks each, said Dr. Justin Stinnett-Donnelly, associate chief medical information officer. The system is in the process of implementing Abridge for its clinicians but declined to name the other vendor.
Abridge and Nuance, two of the largest vendors in the space, said they welcome the competition with each other and other ambient AI companies. Nuance, which was acquired by Microsoft in March 2022 for $19.7 billion, added OpenAI’s ChatGPT successor GPT-4 to its product offerings in March 2023. Abridge, founded in 2018, raised $150 million in Series C funding in February. Both companies work closely with EHR giant Epic Systems.
“In the context of a new type of technology, where there are any number of different players out there trying to build in the space, head-to-head competitions can make sense,” said Dr. Shiv Rao, CEO of Abridge.
Some health tech leaders are looking beyond their own organizations. A grassroots group of provider executives are meeting monthly to evaluate how organizations can best use the technology.
The group, called the ambient clinical documentation collaborative, includes leaders from nine health systems. It plans to publish research on the efficacy of AI documentation tools and identify which clinicians may best respond to technology, said Dr. Lisa Rotenstein, researcher and medical director at University of California San Francisco Health System.
"We needed this larger scale data. This is the kind of evaluation that is just so limited at one site," Rotenstein said. "In some ways, it was really organic given the excitement in the field."
Not every organization is comparing and contrasting multiple vendor solutions in pilots. Emory Healthcare uses Abridge because it valued co-development opportunities with the company, said Dr. Alistair Erskine, chief information and digital officer.
Northwestern Memorial Healthcare leaned on its past relationship with Microsoft and Nuance. Chief Information Officer Doug King said he didn't think piloting another vendor's product would be a good use of its resources.
“[They] have a technology that serves our needs, it’s just less complex for us,” King said.
