Most doctors enter medicine because they want to help patients. However, in today’s health care system, physicians must spend many hours each day performing other duties such as searching electronic health records (EHRs), creating documentation, coding and billing, prior authorizations, and managing usage. This often exceeds the time spent caring for patients. This situation leads to physician burnout, administrative inefficiency, and overall poor patient care.
Ambience Healthcare is working to change that with an AI-powered platform that automates routine clinician tasks before, during, and after a patient visit.
“We are developing a co-pilot to give clinicians the superpowers of AI,” says Mike Ng MBA ’16, CEO of Ambience. He co-founded the company with Nikhil Buduma ’17. “Our platform is built directly into the EHR, allowing clinicians to focus on what matters most: providing the best patient care possible.”
Ambience’s suite of products handles pre-charting and real-time AI scribing to help you navigate thousands of rules and choose the right claim code. The platform can also send post-visit summaries to patients and their families in different languages to keep everyone informed and on the same page.
Ambience is already in use at approximately 40 large institutions, including UCSF Health, Memorial Hermann Health System, St. Luke’s Health System, and John Muir Health. Clinicians use Ambience in dozens of languages and over 100 specialties and subspecialties in settings such as emergency departments, hospital inpatients, and oncology units.
The founders say that clinicians using Ambience save two to three hours per day on documentation, experience lower levels of burnout, and develop higher quality relationships with patients. .
From problem to product to platform
Ng worked in the financial industry before taking a closer look at the health care system after breaking his hip in 2012. Although he was initially misdiagnosed and placed on the wrong care plan, he learned a lot about the U.S. health care system in the process. This includes how a large portion of a clinician’s day is spent recording visits, selecting billing codes, and completing other administrative tasks. The average clinician spends only 27% of their time on direct patient care.
In 2014, Ng decided to enroll at the MIT Sloan School of Management. During his first week, he attended “t=0,” a 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 a great training ground for me to assess what makes a great company and learn the fundamentals of building a successful company,” Ng says.
Buduma was on his own journey to discover what was wrong with the healthcare system. Having immigrated to the United States from India as a child and battling lingering health issues, he watched his parents struggle to navigate the U.S. health care system. While earning his bachelor’s degree from MIT, he also became deeply involved in the AI research community, writing some of the earliest textbooks on modern AI and deep learning.
In 2016, Ng and Buduma founded their first company, Remedy Health, in San Francisco, operating a proprietary AI-powered healthcare platform. In the process of hiring clinicians, caring for patients, and implementing technology themselves, they developed a greater awareness of the challenges facing healthcare organizations.
During that time, they also got an inside look at advances in AI. Jeff Dean, Remedy’s lead investor and Google’s chief scientist now at Ambience, led a research group within Google Brain that invented the Transformer architecture. Ng and Buduma say Remedy was one of the first companies to mass produce transformers to support its own clinicians. Some of their friends and housemates then started a large language modeling group within OpenAI. Their friends’ work formed the research foundation that eventually led to ChatGPT.
“It was clear that we were at a tipping point where this class of general-purpose models was going to improve dramatically,” Buduma says. “But I think we also realized that there was a huge gap between these general-purpose models and models that were actually robust enough to work in the clinic. We decided that we should create a team specifically focused on fine-tuning these models for healthcare and medicine.”
The founders started Ambience by building an AI-powered scribe that runs on phones and laptops, recording details of doctor and patient visits in a HIPAA-compliant system that protects patient privacy. They quickly realized that they needed to fine-tune their model for each area of medicine, and slowly expanded coverage one specialty at a time in a multiyear process.
The founders also realized they needed to staff scribes with back-office tasks such as insurance coding and billing.
“Documentation isn’t just for clinicians, it’s also for revenue cycle teams,” Buduma says. “We had to go back and rewrite all our algorithms to make our coding conscious. There are literally tens of thousands of coding rules that change every year and vary by specialty and contract type.”
From there, the founders built a model for clinicians to create referrals and send patients a comprehensive summary of their visit.
“Before Ambience, in most medical settings, when patients and their families left the clinic, everything they wrote down was their memory of the visit,” Buduma says. “This is one of the features that doctors like the most because they strive to provide the best experience for their patients and their families. We have a very robust and high-quality overview of the content and all shared decisions regarding your visit on our portal.”
Democratization of healthcare
The founders believe that improving physician productivity will help health systems address the chronic clinician shortage, which is expected to increase in the coming years.
“Access remains a big issue in the medical field,” Ng says. “Rural Americans have a 40 percent higher risk of preventable hospitalization, and half of that risk is thought to be due to lack of access to specialized care.”
Ambience already helps health systems manage razor-thin margins by streamlining administrative tasks, and its founders have a long-term vision to increase access to the best clinical information across the country. Masu.
“There is a very exciting opportunity to further democratize the expertise of several major academic medical centers across the United States,” Ng said. “Currently, there is a shortage of experts in the United States who can support rural populations. We are committed to leveraging the nation’s leading experts through our AI infrastructure layer, especially as these models become more clinically intelligent. We want to help you expand your knowledge.”
