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The exploding number of medical AI scribes — created to solve clinician burnout — is causing its own burnout.

Why it matters: Neither small clinics nor hospitals want to invest in a clinical documentation tool that turns out to be an emperor with no clothes.

Context: Getting under the hood of the potential of medical AI scribes has become an increasingly tall order as the sector booms.

Stakeholders must navigate a web of nebulous features, varying accuracy figures and wide-ranging prices.

Players in the space vary from fledgling startups to tech behemoths, all with their own claims about superiority and future capabilities.

Zoom in: The crowded landscape will shake out when AI tools advance beyond transcription and documentation — what UCSF Department of Medicine chair Robert Wachter calls "table stakes" — and into the realm of influencing patient care.

"We're probably in for a decent-sized bubble," says Wachter.

State of play: AI scribe companies have different end-users, meaning they may follow different requirements, have varying road maps and face differing regulatory concerns.

While smaller AI scribe companies might focus on doctors as their key constituents, larger companies may aim to also address the needs of CIOs and CFOs at large health systems.

As a result, scribes prioritize, organize and surface various pieces of information in different ways and at different times.

Different scribes also integrate with different electronic health record vendors, from Epic and Cerner to Athenahealth and Meditech.

What they're saying: To serve a large constituent like a health system, "the CIO, the CMIO and the CFO all need to agree that all the boxes are checked off," Abridge CEO Shiv Rao tells Axios.

These checkboxes are often related to security, privacy and integration, and future technology and capabilities, Rao says. Health system execs will ask, "'What's your road map, and can you improve with our feedback? Do you have the scientists to be able to do that?" Rao adds.

Large health systems might then try multiple companies' tools at the same time in the same or different settings to see how they perform.

That trial process doesn't take nearly as long as it did with previous AI tools. "You can see a fast ROI," says MDisrupt's Ruby Gadelrab. "Is it improving patient satisfaction? Is it improving work-life balance? Is it transcribing accurately? You don't need an 18-month window."

Case in point: Emory Healthcare and Kaiser Permanente are using clinical note scribe tools from Abridge and Epic, per STAT's generative AI tracker.

Other health systems are taking similar approaches, says Wachter.

Between the lines: Other considerations include how well a scribe can surface relevant context and reconcile it with a doctor's specialty and individual preferences.

For example, says Rao, "I'm a cardiologist. If I see a patient who has athlete's foot, and it was the first problem we discussed, it would be the first problem in your assessment plan."

"That's actually not how a cardiologist would want their note to be written," he adds. They'd want athlete's foot to be secondary to the patient's heart issues.

Reality check: Most AI medical scribes aren't currently targeting high-stakes, high-risk interactions that could impact the outcome of a patient's care.

Many players are focusing on time-consuming, lower-stakes workflows, or what Rao calls "the low-hanging fruit for generative AI," like billing or revenue cycle operations.

"Underneath the covers, we're a rev cycle company," says Rao.

Yes, but: The eventual goal is to use AI "to deliver better, safer, more evidence-based, more equitable care," Wachter says.

"Nobody's going to start with that on that day one. But if you're a one-trick pony, you won't make it," he adds.

What's next: Wachter forecasts that the companies that will "flame out" either "won't get in the front door" of a hospital or will make it in only to be outbid by a slightly cheaper competitor.

"Any of them that have any business smarts ... have very quickly recognized that if all you are is a standalone scribe company, you're dead," says Wachter.

The medical AI scribe bubble is about to burst

The exploding number of medical scribes intended to solve clinician burnout is causing its own burnout.

Illustration of a doctor with abstract shapes and textures.

The <a class="gtmContentClick" data-vars-link-text="exploding number" data-vars-click-url="https://www.svb.com/trends-insights/reports/artificial-intelligence-ai-in-healthcare/" data-vars-content-id="10674600-7326-41be-999f-fd8376bda564" data-vars-headline="The medical AI scribe bubble is about to burst" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.svb.com/trends-insights/reports/artificial-intelligence-ai-in-healthcare/" target="_blank">exploding number</a> of medical AI scribes — created to solve clinician burnout — is causing its own burnout.Why it matters: Neither small clinics nor hospitals want to invest in a clinical documentation tool that turns out to be an emperor with no clothes.

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The medical AI scribe bubble is about to burst

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