Today in health, it we're going to talk to ambient scribing or ambient clinical listening whenever you want to call it. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health set of channels and events dedicated to transform health care. One connection at a time. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

Notable service now, enterprise health parlance, certified health and Panda health. Check them out at this week. health.com/today. You may have noticed yesterday, we did not publish a. A new stage show. Which is not normal for us. There was a little miscommunication amongst the team that we'll be back again next week, but you may have also noticed that we started dropping the. Uh, two minute drill.

And if you didn't catch yesterday's two minute drill with Drexel Ford, it is a classic it's already a classic it's one day old. It is a, an April fools classic, uh, directs. It is fantastic. Uh, you're going to be seeing that on this channel. Uh, three times a week. That's what a directs is doing on that show.

Basically taking a complex. Uh, cybersecurity stories in terms and putting them into layman's terms. So you can share it with your friends and others. So, uh, be looking out for that. All right. One last thing, share this podcast with a friend or colleague, especially with new content coming from Drex. And obviously, uh, we have one more surprise for you at the end of this month. And we will be sharing that in due time.

But, uh, as we continue to add to this content, you can use this as a foundation for daily or weekly discussions on the topics that are relevant to you in the industry. Use it for mentoring. They can subscribe wherever you listen to podcasts. All right, let's talk. Ambient clinical listening. Most CIO as I'm talking to today. Have, uh, some sort of pilot going or have implemented this in some way. Uh, it has evolved over the years.

A lot of us started with a dragon. And then went to, uh, other things as they sorta came, uh, available. But with the advent of the, uh, large language models and other things, we have seen a plethora of new players. In fact, I'm going to talk some players. And pricing rough pricing of some of these players. But at the end of the day, there's new ones popping up every day.

I was talking to a CIO yesterday. They developed their own. Go figure. And, uh, and that's a possibility for some, if you have the wherewithal to do that, But, uh, you know, the main players are the main players. It's a nuance of bridge, ambience, um, there's, uh, uh, novela, uh, Suki and others. My source for this is a great article written by Matthew Holt on the healthcare blog, the latest AI craze, ambient scribing.

I love his perspective. He goes a little bit through the history and. Uh, some of the challenges and it used to be when we were doing this, we thought we were going to a computer and it was spinning it back, but really what we were using. It was a form of scribes in another location that we're translating the notes and bringing them back. Uh, there's also the, uh, idea of integration.

There's some of these, uh, nuance obviously has some, uh, tight integration with the EHR providers. Uh, bridge has tight integration with. Uh, with epic. Uh, but some of the others are still copy and paste. So there's a little bit of that. Uh, going on. Uh, this isn't going to just end in the clinic. This is going to, uh, according to him and I agree it's going to be pervasive.

It's going to be, uh, all across the clinical workflows. Uh, the other thing I think he mentioned in the story, and then I'm going to go into the individual solutions a little bit. The other thing you mentioned to this story is, uh, we're already seeing this become pervasive. In other technologies that are out there. And, uh, it meaning that speech to text, right?

It's on your phone. It's, uh, being integrated. It's. It's integrated into the application I'm using right now to record this podcast. And by the way, the accuracy, when I started doing this, the accuracy was okay. And then it got good. And now it's really good. Um, and it's moving really rapidly towards extremely good. And that's, uh, that's the level at which we need in healthcare, but. I say all that to say. It's uh, we're looking at individual solutions today.

There might come a time where this is just baked into the EHR. And you don't have to go to a bridge or ambience or novela or nuance or others. That it could get baked in. You could see epic. Go directly to Microsoft and just drop it in. So just keep that in the back of your mind as you're, as you're analyzing these solutions.

And I don't think the, the cost of swapping this out, when we think about these solutions, like the EHR, the cost of swapping it out is just dramatic. Like you can't even kind of get your arms around it. But the cost of switching these things out. Uh, you know, all of a sudden it's the same phone that's sitting in front of the doctor.

It's the same doctor who's transcribing it. They don't know what the technology is. And it's still showing up in the note or it's still showing up in the. Uh, uh, the prescription or wherever, wherever it happens to be, uh, putting the information. Uh, the doctor's not going to care. And that's really what technology is meant to do.

It's meant to start to move itself to the background. It's meant to be transparent. So that the user is just interacting and getting their job done. And so that's where it's going to go. All right. Let's talk about some of these solutions and there's, uh, you know, there's more than the ones I'm going to talk about.

There's a really interesting chart. I found this one on Axios.

And, um, and they will tell you that the pricing was not sourced. From the actual company, but the pricing was sourced, uh, in other ways. So. Uh, take the pricing with a grain of salt or validate it yourself. However you do that validation. Uh, it also has an accuracy number in here. A latency number, specialty supported. And, um, integrations at least three plus integrations.

Right? And so it looks at a bridge ambience. Novela nuance and Suki. And. Nuance. We'll talk. We'll start with nuance. Nuance has a price. According to this around $600. Um, You know, per, per physician, uh, Per month, I believe. Uh,

Yeah. $600 per physician per month. So 7,200 bucks a year. Uh, the accuracy that they have no accuracy rate, but it's a very high accuracy rate latency about 10, 10. Uh, seconds. Uh, especially supported about 30 and a three plus EHR integrations. Obviously nuances is. Well integrated into the EHR community that ends up being of these five players ends up being the highest cost.

Now I'm sure through negotiations and other things, And through scale, you can get that number down, but the question is, where's it going to. And I think this is going to be one of those things that gets commoditized. Probably over the next three to five years. And, you know, so I would not write a contract where that number can't come down because it will likely come down. So that's one thing.

So that's a, I want to go, I want to go in price order here. Ambiance is next at 250. But think about that six, 600 to two 50, you're talking 7,200 bucks a year to. Uh, let's see. So that's 24 and half of that is a. 12 3600 bucks. So you're talking 7,200 bucks versus 3,600 bucks, or, you know, roughly, uh, Or little less than that actually. So you're talking less than half of what it is.

Ambience versus nuance. There could be a reason, uh, to do one versus the other. So this is not a comprehensive look at this. I'm just giving you an idea. Uh, latency five seconds versus 10 seconds. Specialty supported, 115. And three-plus EHR integrations. They say, yes. Now, I don't know what that looks like.

You're going to have to do that. Research yourself. This gives you a here's the starting point. I'm trying to give you. Here's the, here's the playing field. Here's some players. If you're going to do a bake-off, here are some companies you may want to contact and have a conversation with, and then you can explore the specialties in the EHR integration based on the EHR that you're using. Uh, next in this list of pricing and I apologize, I actually went, uh, ambience next to two 50.

Actually, Suki is at a 400, 390 $9. Uh, per month per physician accuracy, 92%. Um, You have latency. Uh, 50 seconds specially supported 33 plus EHR integrations. Yes. On that. So you have $400 for Suki, 600 for nuance, two 50 for ambiance. We then go down even further to a bridge is $200 per physician per month.

Accuracy rate of 92%. Um, then you go down. Latency is not listed, especially supported 55, 3 plus EHR integrations. They all have three plus EHR integrations. So a bridge is next to 200. So that's 2,400 bucks versus nuance at 7,200 bucks. And again, check the pricing because this is third-party. Uh, gathered and validated, and then you go even lower to novela at $120 per physician per month. Accuracy rate of 95%. Uh, 20 seconds latency, 58 specialties supported.

And so, uh, you know, I think if you're going to be evaluating this stuff, it's going to be, uh, the integrations, you know, it doesn't integrate well with your EHR. What's the user experience. Uh, the integration sometimes. If you don't have the integration, you're going to have to copy paste. And I don't think that's going to be the best solution for a lot of doctors.

It's not going to get the adoption rate that you're looking for. The adoption rate, by the way, on this stuff is really going through the roof. Uh, just, uh, anecdotally through conversations and through some. Studies that you could see, you could actually hit a, uh, Matthew Holt's blog. And he has a link to some studies that show the adoption rates going way up.

And that's, that's a huge positive. This is one of those things that, uh, is a huge satisfier with physicians. Uh, when implemented correctly with the right solution. And, uh, it's an opportunity for a win-win all around. Uh, so it's a win for the clinician. It's a win for the patient. It's a win for coding and for billing, it's a win for workflow. You name it, it's just, uh, It's just a win. Uh, so, uh, definitely a, a, a solution that you should be looking at.

It's also a high efficiency. Uh, play as well. So it's definitely something to be looking at. Yes, it's an additional cost in a lot of cases, but it's getting to the point where the cost is such that you can give it to every doctor. I know that's one of the things that we were limited prior to this. We did not give it to every doctor because of the cost.

It was just too prohibitive. And now we're getting to a point where again, I think the lower end of this is, is going to be, uh, where you're going to see these players start to get to, but I think. Again, you know, three to five years from now, I think this is going to be baked into the technology. I've seen it baked into a lot of other things.

It's baked into the phone it's baked into, uh, you know, it could be a situation where you don't want to sign a 10-year contract. Because this, this space is changing pretty rapidly. Um, and I'm not even sure this is one of those cases where a shorter term contract might make sense. 1, 2, 3 year contract might make sense. Uh, because again, the switching costs, not that high. And there's an opportunity to look at, uh, at the advancements. As they move forward.

So anyway, that's all for today. Lot for today. Uh, pretty exciting. Hey, if you didn't check it out, check out Drexel's show from yesterday. Fantastic. I really enjoyed it. Uh, again, two minute trail. So two minutes unlike myself, uh, I will try to go a little shorter in the future, but, um, we'll see what happens.

Hey, don't forget to share this podcast with a friend or colleague. You said as a foundation to keep the conversation going and to mentor someone, we want to thank our channel sponsors who are invested in our mission to develop the next generation of health leaders. Notable service now, enterprise health parlance, certified health and 📍 Panda health.

Check them out this week. health.com. Slash today. Thanks for listening. That's all for now.