From Ambient to Impactful: How AI and EHRs Go Hand in Hand

UPMC and Northwell Health are launching enterprise-wide ambient AI tools while also consolidating their EHRs on one platform. Executives share how they're managing both projects at the same time.

AI integration is one of the most hyped technology trends in healthcare, and health system leaders are under the gun to fit the right tools into their EHR platform without overloading clinicians.

So it's somewhat surprising that two major East Coast health systems – Pittsburgh's UPMC and New York's Northwell Health – are launching ambient AI across the enterprise while at the same time undertaking massive EHR projects.

"I think [ambient AI] is going to become a requirement for how healthcare is delivered from a technology perspective at least," says Chris Carmody, UPMC's Chief Technology Officer and SVP of Information Technology. He says clinicians have been "gracious" in dealing with the challenges of a large-scale EHR integration, so giving them an AI tool that promises to reduce workload stress was "the right thing to do."

It's a familiar refrain for health system executives across the country. How does one fit innovation into an already stressed technology budget? And where do you draw the line between things you want and things you need?

A Runway for Innovation

Carmody says UPMC was struggling to keep up with growth on an overburdened technology platform, highlighted by roughly 10 different EHRs and multiple third-party tech systems across their 42 hospitals. That's what made the Epic project necessary.

The UPMC Bridges Project is introducing a comprehensive Epic EHR platform across the health system in stages, and with that comes 13 generative AI tools built into the platform. Carmody says leadership also decided to look at ambient AI. The Epic migration "provided us with that runway," he adds.

"That's going to be the challenge for our industry: Picking and choosing the right models for your organization," he says. But the potential of an ambient AI tool for reducing clinician stress and burnout made the decision easy.

Carmody said the health system decided to test two different products: Microsoft's Nuance tool and one developed by Abridge, which was actually launched out of UPMC in 2018 by Shiv Rao, a former EVP of UPMC Enterprises and practicing cardiologist.

"We actually did a bake-off" between the two products, Carmody says, splitting the health system's estimated 1,800 physicians involved in the project into two equal groups. "To be honest, I think is a great approach to always compare and contrast what works well and what doesn't work well."

Chris Carmody, Chief Technology Officer and SVP of Information Technology at UPMC. Photo courtesy UPMC.

By early 2025, UPMC opted to go with Abridge, and has been slowly rolling out the tool since then, along with thousands of iPhones that physicians can use to access the AI app. Within the first month of adoption, those doctors had already recorded about 1.5 million minutes of clinical encounters.

Balancing Necessity With Stress Relief  

Kristin Myers, Northwell's Chief Digital Officer, says leadership was mindful of the fact that they were asking clinicians to embrace a new technology while the health system was in the midst of a $1.2 billion project to unify more than 30 different EHRs into one Epic platform.

"We're in the middle of this major digital transformation with Epic, Salesforce and Google, so it's a very exciting time," she says. "But we also want to make sure that we're not overwhelming our physicians and clinical staff. We need to make sure that we're being very intentional about how we're scaling and rolling out."

Kristin Myers, Chief Digital Officer at Northwell Health. Photo courtesy Northwell Health.

Myers says the ambient AI integration with Abridge was a natural step – not only because Abridge is integrated with the Epic platform but because of the hype surrounding ambient AI's benefits for clinicians.

"We had a number of physicians already using ambient technology, [trying] different vendors and experimenting," she says. "We really wanted to take the opportunity to step back and think about what was ultimately the best solution for Northwell."

In announcing the Abridge rollout, Northwell Health executives emphasized the tool's potential to reduce stress and burnout among clinicians. Abridge points to a study published earlier this year that indicated ambient AI technology could reduce burnout by two-thirds.

"Physician wellness and resiliency is one of the most essential issues facing healthcare today, and promoting it requires redesigning how we work," Jill Kalman, MD, Northwell's CMO, EVP and deputy physician-in-chief, said in a press release. "The patient and clinician interaction is precious, and time is an invaluable resource. By reducing documentation burden, Abridge will help our clinicians return to what they do best: caring for our patients."

Myers says she's mindful of reports from other health systems that have seen an adoption rate of between 30% and 50%, but she's wary of setting high benchmarks. She'd like to see initial interest in the tool at around 20% to 30%, and is far more interested in how many of those clinicians try it and continue using it.

"It's one thing to be signed up and trained for this," she says. "It's another to incorporate it into your workflow on a day-to-day basis."

Myers says it's also important to note that the health system isn't mandating that clinicians use it, especially at a time when they're being asked to accept so much disruption. They're being asked to try it out and see whether it improves their workflows. Clinicians are far more likely to adapt to new technologies and ideas when they're not being forced into it.

"It's just another tool that we're offering them," she points out.

A Responsible Growth Strategy

Carmody says that while initial results from the Abridge rollout at UPMC have been positive, that doesn't mean the health system will be embracing and integrating new tools left and right.

"Everyone says they have an A I solution that's going to solve world hunger," he says. "The key is to make sure we funnel all those ideas, all those requests, and all the problems and say OK, what's the best solution here vs. getting enamored with one thing and kind of running off. We don't want to go down that pathway. We want to have solutions that work broadly, that are more platform-based and not point solutions."

Like Myers, Carmody says it's great to see early adoption at such a high rate, but the true litmus test will be in scalability and sustainability. One or two doctors saying they can't live without ambient AI is great, but if they're the only ones using the tool consistently, that may be a problem.

"Can you do 1.5 million minutes and not have delays and latency," he wonders, "and be able to continue to grow with the organization as we further adopt this?"

Both UPMC and Northwell Health have support networks in place to help clinicians with their new tools, and Myers says the clinical informatics team has been heavily involved in the process. Carmody says that's a step in the right direction, as is learning from those early adopters how to make things easier for the rest of the clinicians, some of whom may be reluctant or even stubbornly against embracing new technology.

"It's not easy to take what you're doing today and flip it around tomorrow," he says. "It will take a while beyond turning it on for them an letting them get used to it."

But Carmody is optimistic. He's already looking beyond the doctors for the next program.

"Once we get past the physicians, we're talking about other uses cases specific to nursing and other aspects of care delivery."