Ambient? Or Ambition? What To Look For In A Real-World Ambient Clinical Intelligence Solution

By Peter Durlach, Senior Vice President of Strategy and New Business Development, Nuance Healthcare
Twitter: @NuanceInc

As technology has advanced significantly since the first ‘personal computing’ device was introduced nearly half a century ago, so too, have our expectations. It’s no longer enough that our machines can calculate and store—now we expect them to listen, learn, and act. Today, voice-enabled technologies such as virtual assistants and smart speakers have become relatively common in our everyday lives. Whether at home, at work, or on the go, the concept of using our voice to place a call, turn on the lights, or get driving directions has shifted from novel to normal.

In a clinical setting, it may be just as easy to equip the ‘walls with ears,’ but that’s only half the equation. To truly unburden care teams from the distractions and complexities that get in the way of focusing all their attention on patients—the walls need to do more than just listen for voice commands, they need to be able to anticipate and act on them. In response, both tech giants and small healthcare startups are adopting the term “ambient” to describe many of their solutions—but calling something ambient, doesn’t make it so.

The anatomy of true ambient intelligence
True ambient solutions don’t just capture or retrieve information via a simple voice command; they absorb live conversations in a secure and passive manner and automatically create something new.

For healthcare, using ambient clinical intelligence (ACI) technology means applying advanced deep learning AI technologies to automatically convert real-time physician-patient conversations into high-quality, structured clinical documentation.

In other words, the technology works in tandem with physicians to capture each patient’s complete story directly into the electronic health record (EHR) rather than forcing them to try to recall and manually enter relevant details of the encounter—sometimes hours later. Using a purpose-built artificial intelligence (AI) engine, ACI technology unobtrusively captures and contextualizes information collected through either ambient sensing hardware or a smartphone—processing both general and specialty medical terminology as well as truly colloquial speech.

However, because these capabilities and performance requirements are orders of magnitude greater than systems that use the term “ambient” but really just mean responding to a virtual assistant command or doing traditional dictation in an ambient manner. It’s important for those considering ACI to truly understand what the technology is really doing and how it supports clinicians and care delivery.

Evaluating ACI solutions
When assessing an ambient clinical intelligence solution, be sure to consider:

  • Does the solution automatically create patient documentation from clinical conversations for inclusion in the institution’s EHR?
  • Can it integrate virtual assistant capabilities for navigating the EHR and working with other applications?
  • Are clinical notes structured and tailored for various specialties?
  • Is it capable of differentiating voices in multi-party conversations involving patients, providers, family members, and nurses?
  • Does it support a natural conversation flow, rather than relying on specific commands to capture information?
  • Does it integrate voice biometrics to enable authentication and verification?
  • Can it work with either special ambient sensing hardware or smartphones to support both exam room and telehealth encounters?
  • Are clinical users and health system IT executives available to discuss deployment, systems integration, usability, patient acceptance, and measurable results based on their experience?
  • Can you see a fully unscripted clinical encounter where the AI produces the documentation?

Distinguishing ACI reality from ambient ambition
Healthcare organizations are pursuing ACI to improve the encounter experience for both patients and providers while boosting physician satisfaction, enhancing documentation quality, and increasing in-clinic and virtual patient volumes. These are worthy goals for an industry long overdue for much-needed relief. But as some vendors exaggerate their efforts to replicate ACI capabilities, be sure you are investing in a real ambient solution—don’t confuse their ambition with your needs.