Using technology to reclaim our time

OUR ENTIRE FIELD of hospital medicine grew out of the need to innovate to address the growing complexities of inpatient medicine. Since the mid-1990s, our capacity for innovation has never stopped as hospitalists navigate a complex landscape of acute illnesses, interprofessional collaborations and the imperative to provide efficient, high-quality care.

We have seen explosive growth and become a cornerstone of modern health care systems. Yet this expansion has come with a significant administrative burden, particularly that of clinical documentation.

Documentation isn’t just time-consuming; it also contributes to pervasive physician burnout. The promise of technology to alleviate these pressures has never been more critical, and a new wave of innovation—led by ambient dictation technology—is poised to transform hospitalist workflow.

The evolution of our notes

For years, many of us relied on traditional dictation methods, speaking into recorders or phone systems and having our words transcribed later. When speech recognition software arrived, we finally had a glimpse of a more streamlined future in which spoken words were converted directly into text. But these early systems often struggled with complex medical terminology and the natural flow of conversation.

This isn’t about replacing your clinical judgment. It’s about augmenting your capabilities.

 

For many of us, the emergence of medical scribes, both in-person and remote, provided a valuable solution, offloading documentation and allowing us to have more focused patient interactions. While human scribes were limited by cost and scalability, they helped pave the way for the next leap forward: ambient dictation technology.

Ambient dictation, or ambient clinical documentation, represents a paradigm shift. Instead of actively dictating notes after an encounter, these intelligent systems passively listen to the natural conversation between you and your patient, leveraging the power of artificial intelligence to understand, contextualize and generate a draft of the clinical note.

Fueled by advancements in speech recognition, natural language processing (NLP) and machine learning, this technology promises to be a game-changer in our daily workflow.

How does ambient AI work?

Imagine an invisible assistant in the room, one that captures the essential details of an encounter without you having to lift a finger or type a single word.

That’s the essence of ambient dictation. At its core, the technology utilizes sophisticated speech recognition to transcribe a conversation in the exam room or at the bedside. These systems are trained on vast datasets of medical language, ensuring a high degree of accuracy even with complex terminology.

But ambient AI goes far beyond simple transcription, and this is where the power of NLP comes in. The system analyzes the transcribed text, understands the context, identifies key medical terms and discerns different speakers.

It can differentiate between a physician’s questions and a patient’s responses and even filter out non-relevant small talk. Some advanced systems employ generative AI models, which—in addition to just transcription—can then draft fluent, well-structured clinical notes that mimic the way we naturally document patient encounters.

The result? Within moments of an encounter, a draft note appears, ready for your review and finalization. You retain complete control with the ability to edit, add details or make corrections as needed, either by typing or using voice commands. Some platforms now even generate structured data elements such as problem lists and assessment codes from the encounter, improving coding accuracy.

This isn’t about replacing your clinical judgment. It’s about augmenting your capabilities and freeing you from the more tedious aspects of documentation.

Tangible benefits

For hospitalists, the advantages of ambient dictation are compelling. The most immediate benefit is the potential to save a significant amount of time.

Studies have shown that using ambient AI scribes can save physicians up to an hour of charting time per day. Reclaiming that hour and reducing the documentation burden directly address burnout and allow us to refocus on those aspects of our profession—patient care and clinical decision-making—that truly matter.

Beyond time savings, ambient AI can enhance the quality of our patient interactions. By removing the need to constantly look at a screen or type notes, we can be more present and engaged, fostering stronger therapeutic relationships and improving patient satisfaction.

And ambient dictation can lead to more comprehensive, accurate documentation. The AI captures details in real time, ensuring that important information isn’t missed or forgotten, potentially improving billing accuracy and compliance. These systems also provide a consistent note structure, which can improve the overall readability and utility of patient records.

AI Implementation: key considerations

Integrating new technology in a hospital requires careful planning and attention to detail. For ambient dictation, we need to consider several key factors to achieve a smooth workflow.

It is crucial to have seamless integration with the existing EHR system. Many vendors are now focusing on tight EHR integration to minimize disruption and ensure a user-friendly experience. As an example: Modern ambient documentation platforms are increasingly offering smartphone apps that act as secure microphones, eliminating the need to carry additional hardware.

These apps allow clinicians to initiate ambient capture directly from their phone, integrating with the EHR and the ambient AI backend. Importantly, conversation is not stored on the personal device. Instead, it is securely streamed to HIPAA-compliant cloud services for real-time transcription and note generation, ensuring both convenience and data privacy.

While ambient AI is designed to be user-friendly, successful adoption demands adequate training and support. Clinicians need to feel comfortable using the technology and understand its capabilities and limitations.

We also need to address concerns about accuracy and the need for physician review. And we must maintain transparency with patients, obtaining their consent and clearly explaining how the technology works to safeguard their privacy.

Finally, we must consider implementation costs. While the initial investment may seem significant, the potential return on that investment can be substantial in time savings, reduced burnout and improved efficiency. And hospitals that adopt ambient AI gain a recruiting edge by reducing the burden of documentation and the potential for burnout.

The future is listening: trends and innovations

The rapid evolution of ambient dictation technology is set to profoundly transform our daily work. Looking ahead, here are several emerging innovations that promise to shape the next generation of these tools:

Deeper integration with hospitalist workflow: Initiating an AI-assisted note may soon be as effortless as speaking naturally during a patient consult—no disruptions, no clicks. Partnerships between EHR vendors and ambient AI providers are now enabling this level of integration, or EHRs are embedding native voice-enabled documentation capabilities.

Voice commands will also become increasingly common, allowing hospitalists to interact with the EHR hands-free, asking questions like “What was the last potassium level?” or issuing orders such as “Order a CBC and BMP.” This will streamline information access and task execution, freeing up valuable time for direct patient care.

Some ambient platforms are already testing proactive features that suggest orders or auto-fill follow-up actions based on the conversation. If a patient mentions pain, for example, the system might prompt consideration of an analgesic. While clinicians will retain final control, this kind of intelligent assistance could greatly reduce documentation load and cognitive overhead.

Enhanced AI capabilities with generative models: Incorporating large generative AI models specifically trained on medical data will further enhance the power of ambient dictation tools. These advanced AI models are increasingly able to:

• Customize documentation: Generate notes that align with each hospitalist’s preferred style and the institution’s format. Some hospitalists might prefer narrative SOAP notes, while others prefer bullet points; the AI will adapt accordingly.
• Handle complex conversations: Distill coherent notes from multi-party conversations, such as rounds with multiple specialists and nurses. This ensures that all relevant information is captured accurately and efficiently. Some ambient AI platforms now support real-time interpretation across multiple languages, enhancing communication in diverse patient populations and improving both documentation accuracy and patient understanding.
• Generate patient-friendly summaries: Create lay-language summaries of a visit for patients, ensuring you leave them with a clear understanding of their care plan. This will improve patient engagement and treatment adherence.
• Suggest differential diagnoses: Based on a patient’s symptoms and history, the AI could offer potential diagnoses for hospitalists to consider, aiding in the decision-making process.

Focus on hospitalist-specific needs: Ambient systems are increasingly being designed with hospitalists in mind, focusing on such needs as:

• Capturing detailed physical exam findings: The AI will be able to accurately transcribe and interpret subtle physical exam findings, ensuring comprehensive documentation.
• Identifying and documenting key clinical decision-making points: The system will recognize and highlight critical decision-making points during an encounter, ensuring that the rationale behind treatment choices is clearly documented.
• Facilitating handoffs and transitions of care: Ambient documentation will streamline the process of handoffs and care transitions by providing a clear, concise summary of a patient’s condition and treatment plan.

Embracing the change

Ambient dictation technology isn’t about replacing the human element in medicine. Instead, it’s about empowering us to be better clinicians. By relieving documentation burdens, it allows us to focus on what matters most: delivering compassionate, high-quality care.

As front-line hospitalists, embracing innovations like ambient AI will be key to shaping the future of our field. It offers us a path toward reclaiming our time, reducing burnout and ultimately enhancing the care we provide.

By advancing these key trends and innovations, ambient dictation has the potential to revolutionize hospital medicine once again—freeing us to spend less time on charts and more time at the bedside.

Mihir H. Patel, MD, MPH, MBA, is a hospitalist and digital health innovator with a strong focus on telemedicine and clinical informatics. Dr. Patel currently serves as a telemedicine and clinical informatics leader at Ballad Health, a 21-hospital integrated health system.

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