Orthopedic practices are running full clinic and surgical schedules while documentation demands keep climbing, pushing physicians into after-hours charting and capping how many patients they can see.
Ambient AI has become a near-ubiquitous documentation aid, but the more pressing question for orthopedic leaders is whether these tools are actually returning time and revenue or simply replacing dictation.
In a featured session hosted by Heidi at Becker’s Spine 2026 in June, Nancy Cibotti, MD, chief medical information officer at Heidi, made the case that the value of ambient AI in orthopedics depends less on the scribe itself than on how broadly the technology is adopted and how well its pieces work together.
1. The cost of inefficiency
Dr. Cibotti opened with the operational squeeze on orthopedic practices: about a third of clinical time goes to administrative work — finishing notes, drafting letters and completing workers’ compensation forms — while non-urgent appointments book 20 to 30 days out in many markets.
She cited figures placing orthopedic surgeon burnout at 44% and estimating more than $15 billion in revenue lost to practice inefficiency across the country each year. The common thread, she argued, is documentation that is detailed and repetitive, spilling into evenings and weekends as “pajama time” and steadily shrinking the capacity to see more patients.
2. The scribe as starting point
Early ambient AI tools showed that physicians would use AI scribes. But Dr. Cibotti said the next step is connecting those tools more directly to clinical workflows.
She described a future in which AI not only drafts notes in a clinician’s voice, but also creates orders and task lists, surfaces trusted medical evidence at the point of care, supports routine pre- and post-op patient outreach and captures encounters in settings where Wi-Fi is unreliable, such as the operating room. As medical knowledge grows rapidly, she said, clinicians will increasingly need tools that bring reliable evidence into the moment of care.
3. Adoption decides the return
For Dr. Cibotti, the sharpest dividing line between deployments that pay off and those that don’t is utilization. A tool used by only 20% to 30% of providers, she said, represents a failed rollout, and the practices that clear that bar share three traits: minimal disruption to existing workflows, fast onboarding and enough accuracy that clinicians trust the output rather than reworking it. She pointed to two orthopedic practices as examples: Kennedy-White Orthopedic Center in Florida, which had been spending more than $400,000 a year on transcription and reached 89% adoption after switching, and St. Cloud Orthopedics in Minnesota, which standardized documentation across the practice and hit 100% adoption.
4. Ambient AI as standard of care
Dr. Cibotti closed with the returns Heidi attributes to its tools: an estimated $110,000 saved annually per provider and about 11 hours returned each week, alongside survey results in which 88% of users reported more comprehensive notes, 93% reported reduced burnout and stress, and 20% reported greater happiness at work.
That recaptured time, she noted, can be reinvested in added visits or simply in getting home for dinner. For her, ambient documentation is shifting from a nice-to-have to an expectation, and the legal and compliance conversations she once had to win have grown markedly easier as the technology becomes standard practice.
The throughline of Dr. Cibotti’s session was that the scribe is table stakes. The practices seeing real financial and clinical returns are the ones treating ambient AI as an integrated layer across the care pathway.
For orthopedic leaders weighing a deployment, the questions that matter are less about which features a vendor lists and more about whether clinicians will actually use the tool at the point of care and whether its outputs are accurate enough to earn their trust.
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