UI Health Care Shares Journey To Adopt an Ambient Documentation Tool

UI Health Care Took an Agile Governance Approach

After an initial pilot with Nabla in 2024, UI Health Care quickly followed up with an enterprisewide rollout across the 862-bed academic medical center rather than smaller deployments by specialty. A follow-up survey in 2025 found that since adoption of the ambient solution, there was a 26% reduction in burnout and a 14% increase in satisfaction with the electronic health records system. The results were published in a KLAS Arch Collaborative case study. 

Healthcare’s interest in ambient solutions, powered by artificial intelligence, doesn’t seem to be fading any time soon. In fact, compared with the rollout of EHRs, Blum says, ambient tools have been “the fastest adoption of a technology I've ever seen.”

The vendor landscape has changed drastically since 2022, when Microsoft completed its acquisition of leading ambient solution provider Nuance Communications and ChatGPT later launched to the public. Now, there are native generative AI features in EHR platforms such as Epic and Oracle Health. Vendors and providers alike have become more aware of compliance concerns. Amid this transformation, Blum says, UI Health Care has always had a robust governance process for acquiring new technology.

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What set the organization apart was that, earlier, on the cusp of the public generative AI boom, UI Health Care already had a multidisciplinary group with additional AI expertise that could ask specific questions about how a model works, model training, performance characteristics and more so that the health system could make informed decisions about its purchases. If an ambient solution was trained only on a limited data set relevant to one hospital, that was likely not the right product. The group helped UI Health Care stay agile as more refined solutions entered the market.  

This approach worked well in the beginning, Blum says, but as UI Health Care matures its AI governance, it needs to move away from point solutions toward a platform approach.

“There's model drift, there's utilization metrics you need to be looking for, so we're now looking at re-engineering our governance, which had this lightweight, nimble approach, to become more focused on how we acquire solutions that are platform-based, or how we identify where a tool we already have may address the problem rather than just going out and buying another solution. That's a work in progress right now,” Blum says.  

He expects this evolution to continue over the next 12 to 18 months across the entire University of Iowa ecosystem, not just the healthcare segment.

How UI Health Care Narrowed Its Choices

One of the requirements that UI Health Care had for its ambient solution was that the vendor was not allowed to train its models on the health system’s data. Blum says that quickly narrowed the field at the time on who the organization could partner with. 

User-friendliness and adaptability were other features that helped UI Health Care make its decision. The chosen solution was not only easy to adopt, Blum says, but also had potential for wider use beyond clinicians, such as physical therapists.

“It was so lightweight and easy to install because it's a cloud-based product that uses essentially a small HL7 feed and has native Epic interchange,” he adds. “We were up and running in a couple of days. We needed to change very little in our IT environment to make it work.”

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What’s Next for UI Health Care

As UI Health Care continues its AI journey, it’s making intentional decisions to streamline clinical workflows and improve patient care. Alongside early investment into a clinical data intelligence solution, the organization is also exploring AI features offered through EHR platforms.

Blum is especially optimistic about the role AI can play in other administrative tasks (such as claims processing and patient outreach) and how vibe coding has the potential to usher in more innovation through in-house talent.

“I think we're on the verge of going back to being able to build solutions that are maintainable, sustainable and affordable that just previously weren't,” he says. “Folks who don’t necessarily have the technical skill can still build out prototypes, and I think that will enable an era of innovation in healthcare that we haven't seen in probably 20 years because, as provider organizations, we’re so often reliant on vendors. It feels more within reach now.”

The bottom line is that healthcare organizations can’t shy away from adopting new technologies because the next generation of clinicians will expect to have these tools at their disposal.

“I’m an anesthesiologist, and we used to go by anatomic landmarks on a patient’s body to find what we needed, but now we have ultrasound devices that make our work much safer and faster to do,” Blum says. “Similarly, clinicians will expect ambient tools in their practice, and it will lead to faster, safer care delivery.”

UP NEXT: From a clinician perspective, ambient AI is returning the ‘joy back to medicine.’