When ambient AI scribes first emerged in healthcare, they were viewed as niche tools — cutting-edge, yes, but not quite ready for widespread use. Today, ambient documentation has evolved from a proof of concept to a top IT priority across nearly all U.S. health systems.
The promise is straightforward: free clinicians from the keyboard by using AI-powered tools that listen, transcribe and structure patient conversations. Amid worsening provider burnout and staffing shortages, that promise is gaining momentum.
“Like many other institutions, we’re experiencing record levels of burnout among our clinical staff,” Rebecca Mishuris, MD, chief medical information officer at Somerville, Mass.-based Mass General Brigham, told Becker’s. “A significant portion of this burnout is due to documentation burdens. Over the years, we’ve tried various approaches to alleviate this burden. Ambient documentation was the first truly scalable solution that had the potential to reduce documentation burden for our providers and alleviate some of the burnout they’re experiencing.”
A brief history of ambient AI in healthcare
Ambient AI scribes first gained traction in 2020 when Nuance launched its Dragon Ambient eXperience (DAX).
Major inflection points include Microsoft’s $19.7 billion acquisition of Nuance in 2022 — signaling Big Tech’s confidence in the space — followed by a surge of competitors entering the market, including Suki, Abridge, Nabla, Augmedix and others, each offering its own approach to AI-assisted charting.
Health systems begin pilot testing
Hospitals and health systems began testing the tools through small-scale pilots with select providers, evaluating whether the technology could help combat “pajama time” — the after-hours documentation clinicians often complete at home. Initial feedback was positive but tempered by concerns around cost, workflow integration and scalability.
In 2024, Daniel Yang, MD, vice president of artificial intelligence and emerging technologies at Oakland, Calif.-based Kaiser Permanente, highlighted concerns to The Wall Street Journal about a growing divide in AI adoption.
“The AI ‘haves’ will be large, well-resourced systems like Kaiser Permanente that invest in testing, evaluating and responsibly deploying AI technologies for the benefit of our members,” Dr. Yang said. “The AI ‘have-nots’ will be health systems like county hospitals, federally qualified health centers and rural hospitals that lack the infrastructure or expertise to deploy these technologies effectively, or that do so without fully understanding their capabilities and limitations.”
From pilots to enterprise rollouts
Over the past two years, many health systems have expanded from pilot programs to full-scale deployments — particularly with tools integrated directly into their EHRs.
At Madison, Wis.-based UW Health, that shift is well underway. After launching a pilot with 20 providers in June 2024, the system expanded use to approximately 100 clinicians by year’s end. The technology is now deployed across more than 20 specialties, including family medicine, pediatrics and dermatology. UW Health plans to quadruple its number of users in the first half of 2025.
Mass General Brigham began with a limited rollout to 20 clinicians and has since built one of the most expansive ambient deployments in the country. More than 2,500 clinicians now use the tool daily, and the system reports higher provider satisfaction and less time spent on documentation.
At Sioux Falls, S.D.-based Sanford Health, 100 clinicians began piloting ambient AI tools in July 2024. Roxana Lupu, MD, chief medical information officer at Sanford Health, told Becker’s the technology has contributed to clinician retention.
Among Sanford’s pilot users, 76% said they are more likely to remain with the organization, and 80% said the tool increased their likelihood of continuing to practice in the field.
What’s next for ambient AI?
As more systems move from pilots to enterprise-wide rollouts, the focus is shifting to scaling, integration, increasing adoption and continuous refinement based on clinician feedback.
A March 25 report from the Peterson Health Technology Institute found that ambient scribes are on track to become one of the fastest-adopted technologies in healthcare history.
