Ask health system CIOs which EHR task they first wanted AI to take off clinicians’ plates, and the answer was the note.
In a survey released in July 2025 by CliniComp and the CHIME Foundation, 54% of CIOs said documentation burdens such as note-taking, ambient listening and dictation were the top challenges they wanted AI to help address.
Ambient AI has since spread quickly. Nearly two-thirds of U.S. hospitals on Epic had adopted ambient AI documentation tools as of June 2025, according to a study Becker’s reported in January. As the note gets easier, CIOs are turning to the work that comes after it.
Tom Gordon, CIO of Marlton, N.J.-based Virtua Health, described the first wave’s payoff in January.
“By automatically capturing patient-provider conversations, these solutions have reduced administrative burden on clinicians, enhanced the accuracy of medical records, and improved the overall patient experience,” Mr. Gordon told Becker’s.
A cleaner note has not cleared the rest of the clinician’s to-do list. Rick Leesmann, CIO of Sky Lakes Medical Center in Klamath Falls, Ore., described what he wants next in January.
“I want the fully integrated experience, tools that trigger the right processes to ensure nothing from the appointment gets missed,” Mr. Leesmann said. “Order the lab work. Flag the follow-up. Route the referral.”
Darrell Bodnar, CIO of Whitefield, N.H.-based North Country Healthcare, pointed to the same gap in January.
“Most tools do a good job creating notes, yet they struggle to reliably support orders, referrals, charge capture and care plan updates,” Mr. Bodnar said.
Jordan Ruch, CIO of Atlantic City, N.J.-based AtlantiCare, which uses Oracle Health’s Clinical AI Agent, explained in January where his organization is headed.
“These gaps are shaping our roadmap toward solutions that are interoperable, role-specific, and deeply embedded in the clinical system, not just better at transcribing conversations, but better at completing the work that follows them,” Mr. Ruch said.
Tom Barnett, chief information and digital officer of Memphis, Tenn.-based Baptist Memorial Health Care, argued in January for a yardstick that covers the whole visit.
“I think ambient listening focuses on one part of the overall workflow. It is an important part as it directly impacts physicians, but we also need to look at the elapsed time it takes for the entire encounter to be closed — not just the physician documentation,” Mr. Barnett said.
The list extends beyond the exam room. Maggie Helms, senior vice president and chief data, AI and digital officer of Bloomington, Minn.-based HealthPartners, named her targets for 2026 in January.
“In 2026, I’ll be paying closest attention to initiatives that prove real ROI and genuinely redesign workflows — especially prior authorization modernization and scheduling/access transformation — because the greatest value will come from reducing friction and reshaping how work gets done, not just automating today’s processes,” Ms. Helms told Becker’s.
Ryan Smith, senior vice president and chief digital and information officer of Salt Lake City-based Intermountain Health, laid out the system’s agentic AI plans for the year in January.
“A major focus will be advancing agentic AI tools designed to manage multistep processes, such as scheduling, documentation, care coordination, clinical follow-up, and contact center automation, so caregivers can spend more time with patients,” Mr. Smith said.
EHR vendors are building toward the same list. In February, Oracle Health expanded its Clinical AI Agent to automate order creation for lab tests, imaging, prescriptions, follow-up appointments and referrals during visits. Two days later, Epic released AI Charting, which drafts notes and suggests orders in real time. Epic has also said more than 200 organizations use its Penny AI tool to automate professional billing coding.
In October, Epic introduced Connectors, which will let its AI assistants retrieve information and complete tasks in third-party applications. Health systems will be able to find developer-built Connectors beginning in March 2027.
Even so, CIOs draw a line at what AI does on its own. Muhammad Siddiqui, CIO of Richmond, Ind.-based Reid Health, explained the distinction in June.
“We’ve already seen what ambient AI can do,” Mr. Siddiqui said. “But there’s a real difference between AI that drafts something for a clinician to approve and AI that acts on its own. We’ve kept a person in the loop, and we’re not ready to remove them yet.”
Richard Zane, MD, chief medical and innovation officer of Aurora, Colo.-based UCHealth, described where his system’s line sits in April.
“AI does not independently diagnose, order, or treat — it can strongly recommend and prebuild orders, but a clinician must click ‘accept,'” Dr. Zane said. “The limit is driven by regulation, liability, and culture, not by what the models can already do.”
For CIOs, the gap between a better note and a closed encounter is becoming the test for their next AI purchases.
“That’s what will shape my next investment decisions,” Mr. Leesmann said. “Can this tool actually improve continuity of care while collapsing technological silos, or is it just making one piece of the process less painful?”
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