The pandemic caused ample innovation in healthcare, and with 2023 in full swing, many are wondering how the industry will continue to advance in the year ahead. One surging meme of the moment that keeps coming up—from call centers and clinics, to healthcare-at-home—is ambient artificial intelligence (AI).
Ever since the well-intended HITECH Act mandated the use of Electronic Health Records (EHRs), providers have been on the journey to adopt technology at the point of care—whether they like it or not. I don’t know any providers who would describe the tech adoption waves of the last decade as “ambient,” but rather quite the opposite. Instead, we hear providers describing healthcare technology with words like endless, distracting and redundant.
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Ambient AI promises a second coming for technology at the point of care enabling EHR systems to elegantly work for providers in the background, in natural workflows and “in conversation,” versus requiring the provider and patients to step aside, waste time, and “feed the beasts” of legacy transactional systems. Ambient AI will prove as the key foundation to improving the patient experience, reducing provider burnout, improving documentation quality, while also helping to boost patient access and provider productivity.
Voice
Perhaps the hottest subsegment of ambient AI innovation is in the area of what people refer to as the “voice” space.
Voice solutions have been widely adopted in healthcare for decades now. Most are familiar with the process: a physician sees a patient, steps aside (perhaps in the hallway), and then takes several precious minutes to verbatim speak out the notes (we call this typing with your tongue). This approach is a dictation workflow, and I certainly wouldn’t consider it ambient.
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In the future, sensors placed throughout the care environment (or present with or on the provider) will process provider-patient conversations as they unfold in real-time, using speech recognition and natural language processing technology in the background to produce high-quality documentation. This approach places note data right where it belongs, without burdening the provider or interrupting the provider-patient connection. In fact, the company I founded, Augmedix, was an early entrant to bring such a solution to the market.
The domain is heating up with Big Tech partnerships emerging and startup entrants sprouting up; this space will be very interesting to watch in 2023. This decade, I predict, ambient point-of-care documentation systems will become as commonplace as the omnipresent stethoscope, the iconic indispensable tool of the physician – quite literally the first thing they put on before they see their first patient of the day.
Voice innovation of this sort has even broader implications. Setting aside the enhanced capabilities brought to in-person visits, ambient AI solutions will be merging into video calls with your provider teams, documenting, translating, and surfacing insights as needed. When you reach a call center to schedule your next appointment, voice markers of depression, anxiety, and other metadata will be collected to help determine next steps and manage your care and experience. Major players to look out for in this space include Ellipsis Health, OPTT Health, and Canary Health, among other emerging innovators.
As we look ahead, understanding the “under-the-hood” technology leaps that make this all possible is valuable. We anticipate advancements in the following areas:
- Automatic speech recognition (ASR) modules (i.e., speech to text)
- These modules go far beyond simple single-party Siri speech to tech technology that most are familiar with. Instead, ASR will be able to handle multi-party conversation, including lots of “mhmms”, “umms” and overtalk.
- Natural language processing (NLP) modules
- Large language models (LLMs)
Startups and innovative companies are building some of this underlying tech. And then there are the big hyperscaler cloud providers, such as Google Cloud Platform and Amazon Web Services, who have recently shown a great deal of commitment to the space. These players have been making huge investments to ensure HIPAA compliance and other enterprise security measures to enable adoption.
Sensors
When innovators talk about ambient intelligence in healthcare, “voice” often steals the show, but there is a slew of innovation emerging in the area of sensors and internet of things (IoT), more broadly.
In the healthcare setting of the future, increasingly, more objects and surfaces will be connected, laden with sensors and seamless interaction devices. Exam rooms will assess patient status using simple, non-invasive visual and auditory monitoring, passively detecting vitals and alerting of urgent events (e.g. falls). These types of smart room technologies will come to the home as well, and it’s already starting to happen.
Although voice will play a huge role in healthcare ambient intelligence, much of the sensor innovation at the point of care will be enabled by real-time locating system (RTLS) technology that allows for systems to know where people and devices are in 3D space.
Here’s an archetypal example of these technologies coming together: imagine the workflow of a critical specialist who is about to perform surgery with a transplant organ also being delivered. In today’s world, providers gear up for a series of signatures, QR-code scanning, attestations, and EHR documentation. In the ambient AI world of tomorrow, biometrics securely identifies the right provider and patient matches in the background, RTLS confirms the right equipment, and items are available and ready, just in time. This occurs in a passive way so care can take place as it should.
There’s a lot of high-tech investment work ahead that is needed to transform everything from hand sanitizers, hospital hallway delivery robots, check-in stations, in-room TVs, at-home Alexas, and even the watch on your wrist, into one interconnected ambient AI mesh, but that day is fast approaching.
Ambient AI at the point of care
I am ready for this second coming of technology at the point of care. Once we liberate providers from the use of needless “wake words,” endless clicking, and other inglorious workflow interruptions and attention shifts, ambient AI will let providers focus on what matters most: patient care. Let’s get to work.
Photo: berya113, Getty Images
Ian Shakil is the founder, director and Chief Strategy Officer of Augmedix, a healthcare technology company that provides industry-leading medical documentation products that alleviate administrative burden and give clinicians more time to focus on patient care. Mr. Shakil has been a member of the Augmedix board since April 2013, and previously served as CEO of the company from 2013 - 2018. In his role, he manages corporate strategy and development, business development and partnerships. Mr. Shakil has a B.S.E. in Biomedical Engineering from Duke University, and an M.B.A. from Stanford University Graduate School of Business. Augmedix is on a mission to help clinicians and patients form a human connection at the point of care without the intrusion of technology. Augmedix’s products extract data from natural physician-patient conversations and convert it to medical notes in real time, which are seamlessly transferred to the EHR.
