Most doctors enter medicine because they want to help patients. However, today’s health care system requires physicians to spend hours each day on other tasks, including electronic health record (EHR) retrieval, document creation, coding and billing, prior authorization, and utilization management, often exceeding the time they spend caring for patients. . The situation leads to physician burnout, administrative inefficiencies, and worsening overall care for patients.
Ambience Healthcare is working to change that with an AI-powered platform that automates routine tasks for clinicians before, during, and after patient visits.
“We build co-pilots to give clinicians AI superpowers,” says Ambience CEO Mike Ng MBA ’16, who co-founded the company with Nikhil Buduma ’17. “Our platform is embedded directly in the EHR, allowing clinicians to focus on what matters most: providing the best patient care possible.”
Ambience’s suite handles proactive charting and real-time AI scribing, and explores thousands of rules to help you select the right insurance claim code. The platform can also send post-visit summaries to patients and their families in multiple languages to keep everyone informed and on the same page.
Ambience has already been used by UCSF Health, Memorial Hermann Health System, and St. Louis. It is used by approximately 40 large institutions, including St. Luke’s Health System and John Muir Health. Clinicians utilize Ambience in dozens of languages and over 100 specialties and subspecialties in settings such as emergency rooms, hospital inpatient settings, and oncology units.
The founders say clinicians who use Ambience save two to three hours a day on documentation, reduce fatigue, and develop high-quality relationships with patients.
From problem to product to platform
Mr Ng worked in finance until he took a closer look at the healthcare system after breaking his back in 2012. Although he was initially misdiagnosed and given a poor treatment plan, he learned a lot about the American healthcare system along the way. Includes how clinicians spend most of their time recording visits, selecting billing codes, and completing other administrative tasks. The average clinician spends only 27% of their time providing direct patient care.
In 2014, Ng decided to attend the MIT Sloan School of Management. During his first week, he attended the “t=0” celebration of entrepreneurship hosted by the MIT Martin Trust Center for Entrepreneurship, where he met Buduma. The two quickly became friends and ended up taking classes together, including 15.378 (Building an Entrepreneurial Venture) and 15.392 (Scaling an Entrepreneurial Venture).
“MIT was an amazing place to evaluate what makes a great company and learn the fundamentals of building a successful company,” says Ng.
Buduma went on his own journey to discover what was wrong with the healthcare system. After immigrating to the United States from India as a child and battling persistent health issues, he watched his parents struggle to navigate the American health care system. While earning his bachelor’s degree at MIT, he also immersed himself in the AI research community and wrote an early textbook on modern AI and deep learning.
In 2016, Ng and Buduma founded Remedy Health, the first company to operate its own AI-based healthcare platform in San Francisco. As they hire clinicians, care for patients, and implement technology themselves, they gain a deeper awareness of the challenges facing healthcare organizations.
During that time, they also took an internal look at advances in AI. Jeff Dean, Google’s chief scientist who was a major investor in Remedy and is now a major investor in Ambience, led a research group inside Google Brain and invented the transducer architecture. Ng and Buduma say Remedy was one of the first companies to put transformers into production to support its own clinicians. After that, a few friends and housemates started a large group of language models within OpenAI. The friends’ work formed the research foundation that ultimately led to ChatGPT.
“It was very clear that we were at an inflection point where we would have this kind of universal model that would improve exponentially,” says Buduma. “But I think we’re finding that there’s a big gap between these general-purpose models and models that are actually robust enough to be used in hospitals. Mike and I decided that there should be a team specifically focused on fine-tuning these models for healthcare and medicine in 2020.”
The founders started Ambience by building an AI-powered notepad that works on phones and laptops to record doctor and patient visit details in a HIPAA-compliant system that protects patient privacy. They quickly realized that the model needed to be fine-tuned for each area of medicine, and over a multi-year process, they slowly expanded the scope of application for each specialty, one by one.
The founders also realized that it needed to fit into back-office operations such as insurance coding and billing.
“Documentation isn’t just for clinicians, it’s also for the revenue cycle team,” says Buduma. “We had to rewrite all the algorithms to make them coding-aware. There are literally tens of thousands of coding rules that change every year and vary depending on specialty and type of contract.”
From there, the founders built a model that allowed clinicians to make referrals and send comprehensive visit summaries to patients.
“Before Ambience, in most practice settings, whatever patients and families wrote down when they left the clinic was what they remembered from the visit,” says Buduma. “This is one of our doctors’ favorite features because they strive to create the best experience for their patients and their families. By the time the patient is in the parking lot, they already have a very robust, high-quality summary in your portal of what you talked about and all of the shared decisions related to their visit.”
Democratization of Healthcare
The founders believe that improving physician productivity will help the health care system manage chronic physician shortages, which are expected to increase in the coming years.
“Accessibility is still a huge issue in healthcare,” says Ng. “Rural Americans have a 40% higher risk of preventable hospitalizations, half of which are due to lack of access to specialty care.”
Ambience is already helping health systems manage razor-thin margins by streamlining administrative tasks, so its founders have a long-term vision to help increase access to the best clinical information across the country.
“There is a really exciting opportunity to further democratize the expertise of some of the leading academic medical centers across the country,” Ng said. “Currently, there are not enough professionals in the United States to serve our rural population. “We hope this layer of AI infrastructure will help expand the knowledge of the country’s leading experts, especially as these models become more clinically intelligent.”
