As health systems continue to face increasing workloads and staffing challenges, ambient scribes are emerging as transformative forces.
During Becker’s Healthcare 13th Annual CEO + CFO Roundtable, Tom Kelly, MD, chief executive officer of Heidi, discussed how ambient AI can unlock clinical productivity, reduce legal risk and reshape administrative workflows.
Here are four key takeaways from the session
1. Useability is crucial
Many ambient documentation tools are built to populate EHR fields, but Dr. Kelly and his team focused on the opposite approach.
“We just try to be as useful as possible to clinicians,” said Dr. Kelly. “Integrating with the medical record is about capturing that usage and the data that you need to capture about the clinical encounter in the structure that they want.”
Rather than confining workflows to rigid EHR templates, Heidi functions as a full-screen interface that clinicians can personalize. Over time, it integrates with the EHR by mapping structured output to the required formats, including specialty-specific templates, tailored to support each clinician’s note-taking style.
2. Scribing enables scalable automation
Dr. Kelly emphasized that transcription is only the beginning. By capturing the full context of patient-clinician conversations, tools like Heidi can begin to automate a broader range of care tasks, from patient outreach to follow-up coordination and billing optimization.
“If you imagine your health system, every day it is the sum of all these little clinical interactions,” Dr. Kelly said. “Scribing is the wedge to get the context of what happened.”
Once Heidi understands the objective, for example, reducing a patient’s hemoglobin A1c, it can autonomously plan and execute steps such as scheduling calls, checking glucose trends and escalating to care teams when needed.
3. Governance is key
With increased autonomy comes increased responsibility. Dr. Kelly was candid about the risks associated with deploying AI tools that influence patient care. He urged health systems to treat these tools as regulated medical devices.
“If you’re setting these tools loose in your organization, you are going to be responsible for the decisions it makes,” Dr. Kelly said. “You are putting your job on the line and picking this tool and putting it in front of patients and clinicians, you want a system that you can trust in.”
He also stressed the importance of bias-free systems and transparent monetization models. Understanding how tools are being funded and how data is being used is crucial in building trust among providers and patients.
4. Supporting clinicians
While integration with EHRs matters, Dr. Kelly said the key to success is clinical adoption — and that requires precise attention to how clinicians work. “The difference between getting 80 to 90% of your clinicians using it and 30 or 40% is all in the personalization of the notes,” Dr. Kelly said.
Heidi learns from user edits and adapts over time, capturing each clinician’s preferred style and language. This level of nuance makes it valuable not just for generating notes, but for supporting downstream actions like care coordination and risk management in complex cases.
At health systems such as Beth Israel Lahey Health, Heidi has gained traction by supporting specialty-specific workflows, like prostate cancer documentation in urology, that other scribes couldn’t handle.
“We have to do that real clinical work and hold ourselves to a higher standard because we actually want to do that clinical work over time and support clinicians beyond just filling some fields in the medical record,” Dr. Kelly said.
