By Laura Landro

Even the hospital walls may soon have ears.

A fast-growing technology known as ambient listening is taking over an onerous but necessary task in healthcare: documenting what happens in the doctor-patient encounter.

Already gaining traction for outpatient medical visits, the AI-powered systems are also moving into hospital rooms and emergency departments to capture discussions at the bedside, update medical records, draft care plans and create discharge instructions. Healthcare systems nationwide, including Stanford Health Care, Mass General Brigham, University of Michigan Health and Ardent Health, are adopting the technologies widely referred to as AI scribes.

"We are just scratching the surface of what this technology can do," says Dr. Lance Owens, regional chief medical information officer at University of Michigan Health, which uses Microsoft's DAX Copilot ambient-listening technology. "I see it being able to provide insights about the patient that the human mind just can't do in a reasonable time." By connecting older data with new information in the medical record, for instance, the technology could help make sure that an incidental finding years ago was followed up on.

Ambient-listening software runs on devices from desktops to mobile phones and tablets, using speech recognition and AI language models to capture and process conversations between a clinician and a patient during a visit. The AI, from companies including Microsoft, Ambience Healthcare, Abridge, Onpoint Healthcare Partners and Nabla, can recognize pertinent medical dialogue, distinguish voices and filter out casual chitchat, such as talk about the weather or sports.

By the time a doctor's appointment is done, an AI scribe can generate a comprehensive note for the electronic medical record, create a concise after-visit summary for the patient and provide data for coding and billing purposes.

Researchers predict the systems will evolve into a 360-degree presence that extends before and after the medical visit: analyzing records before an appointment to identify red flags, prompting doctors about recommended tests and treatments based on patient symptoms, and teeing up follow-up actions like lab tests and prescription orders. Ambience Healthcare is developing an AI agent to help patients manage their care outside the clinic, calling or texting with updates, medication reminders and follow-up scheduling.

New features are on the way, including diagnostic aid tools that suggest conditions and more sophisticated multilingual capabilities. Microsoft is working with Canary Speech on applying its technology to analyze vocal features for early signs of conditions like anxiety and mild cognitive impairment.

Research has shown that the technology has already helped save time and reduce burnout for doctors, who often cobble together their summaries after each visit or at the end of the day, working from handwritten or computer notes or dictation devices. It has also unshackled them from staring into a computer or scribbling notes rather than being present with the patient.

"We are actually using technology to put providers and patients back in the room together rather than putting up a barrier between them," says Dr. Rebecca Mishuris, chief medical information officer at Mass General Brigham in Boston.

Mass General Brigham conducted a successful pilot program with two different ambient-listening programs, from Microsoft and San Francisco-based Abridge. It now has more than 2,500 physicians using the technology, including around 90% of its primary-care providers for adults.

In the pilot, physicians reported cutting daily documentation time outside clinic hours to under 30 minutes from 90 minutes. Around 79% said they focused more on their patients, and 60% indicated they were more likely to extend their careers thanks to the technology. Giving doctors back a slice of time for their own lives has been "transformative," Mishuris says, with doctors telling her "I don't remember the last time I was able to eat dinner with my family after clinic."

While promising, ambient-listening technologies raise privacy and security concerns in an industry already plagued by data breaches that compromise patient information. The technology doesn't currently require regulatory approval. That could change if capabilities such as diagnosis were added in the future.

Legal and bioethics experts warn that healthcare providers should plan around potential risks and ask patients for permission before using ambient listening in appointments. Cost is also a concern -- users typically license or subscribe to the technology, and fees can range from $200 to $600 per doctor per month. It isn't yet clear how the technology would affect healthcare costs in the longer term.

With a wave of companies rushing into the market now dominated by Microsoft, which acquired leading player Nuance in 2022, there is a measure of hype around what the technology can do. For now, it is mainly being used to record appointments in exam rooms. One study of a pilot with 10,000 physicians at the Permanente Medical Group in California published last year found that while feedback from patients and doctors was positive, AI scribes can produce inconsistencies and require a physician's review and editing -- highlighting that AI isn't a replacement for clinicians.

"We still need to have real people checking the data to make sure it's right, but we now have as accurate a recording as you can expect of what's transpired," says Dr. Christopher Sharp, a clinical professor of medicine at Stanford Medicine and chief medical information officer at Stanford Health Care. After a successful pilot of Microsoft's DAX Copilot, Stanford is now rolling it out to all of its doctors. It is also experimenting with a version for nurses in its hospital and another for its emergency room.

Microsoft is issuing an enhanced version of the technology, called Dragon Copilot, and recently signed an agreement with data company Press Ganey to help analyze the content and tone of patient-doctor conversations alongside patient-experience survey data. The aim is to proactively address patient concerns and coach doctors in having difficult conversations with patients and showing more empathy.

The goal is to help doctors, not replace their judgment, says Joe Petro, vice president of health and life sciences for Microsoft. "This is a co-pilot, not a pilot or an autopilot, and the physician is always in command of the situation."

Brentwood, Tenn.-based Ardent, with hospitals and outpatient facilities in six states including Texas and Oklahoma, has been piloting ambient-listening technology from San Francisco-based Ambience Healthcare with 88 doctors who used it for 40,000 office visits in the program's first 13 weeks. One goal is to retain doctors who are overwhelmed with administrative tasks, as well as recruit new physicians to facilities in more rural areas, says chief medical information officer Dr. Brad Hoyt.

The technology also customizes the creation of notes for different medical specialties, by recognizing unique terminology, documentation needs and work flows for specialties such as cardiology and pediatrics.

"It's been a game-changer because there are so many things I will do that never made it into the note because of half of what we are talking about happens when I'm not at the computer, I'm with the patient," says Dr. Theresa Horton, a pediatrician at Ardent's Utica Park Clinic in Owasso, Okla. Parents might bring up something that wasn't the reason for the visit but could be important to follow up, such as an unexplained rash. In addition, "so many times parents will be on their phone trying to write down what I say, and I can tell them you don't have to do that anymore."

Patients have also provided positive feedback. Ginger Johnson, a 67-year-old patient at Utica Park Clinic, says the patient summary she received after a visit with a cardiologist was clear, concise and accurate, in contrast to experiences she has had elsewhere in the past with discrepancies and errors. Equally important, Johnson says, "the attentiveness, the ability for the doctor to actually look at you, watch you, and see your reaction is all enhanced."

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May 27, 2025 05:30 ET (09:30 GMT)

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