Walnut Creek, Calif.-based John Muir Health has successfully increased adoption of an AI-driven documentation tool from Ambience Healthcare from 25% to 60%, Priti Patel, MD, the health system’s chief medical information officer, told Becker’s.
John Muir Health selected Ambience Healthcare over other AI-driven documentation solutions after extensive physician testing, including live demonstrations across multiple specialties, such as cardiology and hospital medicine.
“In every instance, our physicians were impressed with Ambience’s output, particularly the quality of the generated notes,” Dr. Patel said.
Strong physician interest in AI facilitated rapid adoption of the tool, with 25% of eligible users onboarded as early adopters. These physicians became superusers who helped drive adoption, leading to a 60% utilization rate that continues to grow, according to Dr. Patel. To further support adoption, the health system has hosted weekly office hours since September 2023 and offers ongoing drop-in sessions and dedicated meetings for users.
“However, reaching the last group of users has been more challenging, as they tend to have highly efficient workflows and are less inclined to integrate AI into their practice,” Dr. Patel said. “That said, as the majority of physicians continue to use Ambience, those who were initially hesitant are gradually coming on board.”
Ambience is now available to all clinicians following the transition to an enterprise contract in January.
“In January, with the transition to an enterprise contract, Ambience became available to all users, which we expect will further drive adoption this year,” Dr. Patel said. “Previously, access was limited to full-time physicians who expressed a strong interest in using the tool regularly.”
Overcoming challenges
One of the biggest initial challenges with the tool was the lack of EHR integration, which was resolved in November 2023 with the implementation of bidirectional integration.
Another challenge was the requirement for written patient consent before using Ambience.
“John Muir Health requires physicians to obtain written patient consent before using Ambience, which meant training both physicians and staff on how to explain the technology to patients and address any concerns,” Dr. Patel said. “This extra step was initially a barrier for some staff and providers.”
To address this, John Muir Health provided extensive training and developed educational materials for both physicians and patients.
“Over time, as ambient AI scribing technology has become more widely recognized, patient consent has become significantly less of a hurdle. We make clear to patients that their consent to have their physician use Ambience is completely optional,” Dr. Patel said. “We ask for written authorization so that patients are clear on how we use this technology and can make an informed decision about whether to participate. We’ve received great feedback from patients who have given their authorization.”
Positive impacts
Since implementing Ambience, John Muir Health has seen an 11% decrease in physician burnout. Physicians are also spending less time on documentation and more time with patients, reducing after-hours charting, or “pajama time,” according Dr. Patel.
“Additionally, Ambience reduces cognitive load. Many physicians have reported feeling less fatigued at the end of the day, as reviewing and editing a note is far less mentally taxing than generating one from scratch,” she said. “Beyond the immediate benefits, the introduction of AI has given physicians hope that future advancements—such as AI-assisted order entry—will further ease administrative burdens.”
Patients, in turn, have reported qualitative improvements in their experiences.
“Patients have shared that they feel they now receive their physician’s full attention during visits. Many have also noted that their physicians seem happier and more engaged, appreciating the benefits of having a tool that supports them,” Dr. Patel said.
Financial impact and future expansion
John Muir Health estimates $3 million in cost savings from reduced physician turnover since adopting Ambience.
“This is an estimate based on turnover data that we are in the process of reviewing and verifying,” Dr. Patel said. “We have been tracking annual physician turnover rates and observed a significantly lower rate in 2024 compared to previous years. There are many factors that contribute to the lower rate. Based on direct feedback, one of those factors seems to be Ambience’s ability to alleviate documentation burden and enhance the practice of medicine.”
Looking ahead, John Muir Health plans to expand Ambience beyond physician use to support other clinicians, including nurses, case managers and nutritionists. The health system is also exploring AI-assisted order entry for tests and medications to further streamline clinical workflows.
