Most doctors go into medicine because they wish to help patients. But today's healthcare system requires physicians to spend hours every day on other work—searching electronic health records (EHRs), writing documentation, coding and billing, prior authorization, and utilization management—that usually extends beyond the time that they spend on caring for patients. The situation results in physician burnout, administrative inefficiencies and poorer overall patient care.
Ambience Healthcare is working to vary this with an AI-powered platform that automates routine tasks for doctors before, during and after patient visits.
“We are constructing Co-Pilots to offer clinicians AI superpowers,” says Ambience CEO Mike Ng MBA ’16, who co-founded the corporate with Nikhil Buduma ’17. “Our platform is embedded directly into EHRs so physicians can deal with what matters most: providing the very best possible patient care.”
Ambience's product suite handles pre-charting and real-time AI scribing and helps navigate 1000’s of rules to pick out the appropriate insurance billing codes. The platform also can send follow-up summaries in several languages ​​to patients and their families to maintain everyone updated and on the identical page.
Ambience is already used at roughly 40 major institutions, including UCSF Health, Memorial Hermann Health System, St. Luke's Health System, John Muir Health and more. Doctors use Ambience in dozens of languages ​​and greater than 100 specialties and subspecialties, including emergency departments, hospital inpatients, and oncology units.
The founders say clinicians who use Ambience save two to a few hours per day on documentation, report fewer burnouts, and construct higher relationships with their patients.
From the issue to the product to the platform
Ng worked in finance until he got an in depth have a look at the health care system after breaking his back in 2012. He was initially misdiagnosed and given the fallacious care plan, but he learned rather a lot concerning the U.S. healthcare system along the best way. This includes how doctors spend most of their days documenting visits, choosing billing codes and completing other administrative tasks. The average clinician spends only 27 percent of their time providing direct patient care.
In 2014, Ng decided to attend MIT Sloan School of Management. During his first week, he attended the “t=0” celebration of entrepreneurship hosted by the Martin Trust Center for MIT Entrepreneurship, where he met Buduma. The two quickly became friends and eventually took courses together, including 15,378 (Building an Entrepreneurial Venture) and 15,392 (Scaling an Entrepreneurial Venture).
“MIT was an incredible training ground for assessing what makes an incredible company and learning the basics of constructing a successful company,” says Ng.
Buduma had undertaken his own journey to find problems within the healthcare system. After immigrating to the U.S. from India as a toddler and battling ongoing health problems, he had watched his parents struggle to navigate the U.S. health care system. During his undergraduate studies at MIT, he was also closely involved with the AI ​​research community and wrote an early textbook on modern AI and deep learning.
In 2016, Ng and Buduma founded their first company in San Francisco – Remedy Health – which operated its own AI-powered healthcare platform. As they hired clinicians, cared for patients, and implemented technology themselves, they developed an excellent deeper understanding of the challenges facing healthcare organizations.
During this time, in addition they gained insight into advances in AI. Jeff Dean, chief scientist at Google, a significant investor in Remedy and now Ambience, led a research group inside Google Brain to invent the Transformer architecture. Ng and Buduma say they were among the many first to bring transformers into production to support their very own clinicians at Remedy. Subsequently, several of her friends and roommates founded the massive language model group inside OpenAI. Her friends' work formed the research foundation that ultimately led to ChatGPT.
“It was very clear that we were at this inflection point where we were going to have this class of general-purpose models that were going to get exponentially higher,” Buduma says. “But I feel we also found a giant gap between these general-purpose models and people that will actually be robust enough to work in a clinic. Mike and I made a decision in 2020 that there must be a team specifically focused on fine-tuning these models for healthcare and medicine.”
The founders began Ambience by developing an AI-powered scribe that works on phones and laptops to record the small print of doctor-patient visits in a HIPAA-compliant system that protects patient privacy. They quickly realized that the models needed to be adapted for every area of ​​medicine and, over a process lasting several years, step by step expanded the topic area coverage.
The founders also recognized that their writers needed to be integrated into back-office operations akin to insurance coding and billing.
“Documentation will not be only for the clinician, but in addition for the revenue cycle team,” says Buduma. “We had to return and rewrite all of our algorithms to be coding aware. There are actually tens of 1000’s of coding rules that change yearly and vary by specialty and contract type.”
From there, the founders developed models for physicians to make referrals and send comprehensive visit summaries to patients.
“In most care facilities before Ambience, when patients and their families left the clinic, they wrote down the whole lot they remembered from the visit,” says Buduma. “This is one among the features that physicians value most as they struggle to offer the very best experience for patients and their families. By the time the patient is within the car parking zone, they have already got a very meaningful, high-quality summary of their portal of what you talked about and all of the shared decisions surrounding your visit.”
Democratization of healthcare
By improving physician productivity, the founders consider they’re helping the healthcare system address a chronic shortage of physicians that is anticipated to extend in the approaching years.
“In healthcare, access continues to be a giant problem,” says Ng. “Rural Americans have a 40 percent higher risk of avoidable hospitalization, and half of that’s attributable to an absence of access to specialty care.”
With Ambience already helping health systems manage razor-thin margins by streamlining administrative tasks, the founders have a longer-term vision to extend access to the very best clinical information across the country.
“There is a very exciting opportunity to further democratize expertise at a few of the foremost academic medical centers within the U.S.,” says Ng. “Currently, there are simply not enough specialists within the United States to support our rural population. Through an AI infrastructure layer, we hope to assist expand the knowledge of the country’s leading specialists, especially as these models develop into more clinically intelligent.”
