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Healthcare leapfrogged the software era
Where the tools landed
Both tools landed in a corner of the industry that the software-as-a-service era largely left behind. AI scribing writes up the visit, and voice AI handles scheduling. Founders are now racing to build for practices that never fully adopted the last generation of software.
The gap between old and new is wide. Demos get a reaction like watching a magic show. Venture investors always ask whether a product is 10x better, and here there are real examples, where before the improvement was a little better.
Money pressure
Money pressure adds urgency. Providing care has become harder, insurance adds burdens, and bottom lines are squeezed, so buyers want a return on every investment.
Adoption from the bottom
Adoption also starts at the bottom. Physicians pick up the AI tool of their choice without waiting for administrators to select a vendor and sign a contract. That matters because buyers and users often want different things: user satisfaction scores for electronic health records run low, while buyers like how the system documents and gets the billing done. The newer tools are winning over both.
Why are health records built around billing?
In the United States, insurers and Medicare pay according to documented billing codes, so every visit note has to support the code attached to it. Electronic records grew up around that need for documentation and claims. The HITECH Act of 2009 then offered federal incentive payments for adopting certified electronic records. That spread systems designed around billing and compliance across practices.
How does an AI scribe write the visit?
An AI scribe listens to the conversation in the exam room and turns the speech into a transcript. A language model then sorts that transcript into the sections of a clinical note and drops the small talk. The physician reviews the draft and signs it. The SOAP note structure many of these tools follow traces to Lawrence Weed's problem-oriented medical record, which he described in the late 1960s.
Why is documentation such a burden for doctors?
A 2016 time-and-motion study in the Annals of Internal Medicine, led by Christine Sinsky, followed physicians in four specialties across several states. It found they spent nearly twice as much time on record-keeping and desk work as on face-to-face time with patients. Much of that paperwork happens in the record system. The study found physicians also spent extra hours on it outside clinic time.
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