Epic, Nuance bring more GPT-4 tools to EHRs

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Nuance Communications, a clinical documentation software company owned by Microsoft, is integrating generative artificial intelligence capabilities into Epic’s electronic health record, the companies said Tuesday.

Nuance’s Dragon Ambient eXperience Express product, which summarizes and enters conversations between clinicians and patients directly into EHRs, will work natively on Epic starting this summer for select providers. The technology will use Nuance’s own AI and OpenAI’s GPT-4 models. Physicians will have to use Epic’s mobile application for the service to work.

In March, Nuance first introduced Dragon Ambient eXperience Express. At the time, the company did not announce specific functionality with any EHR companies. Epic is its first native integration. Nuance said it plans to add the capability for all of Epic’s EHR users sometime in the first quarter of 2024.

“We’re now deepening the integration between DAX eXpress and Epic,” said Nuance’s chief strategy officer Peter Durlach. “It is [a] much tighter integration to the parts of the chart based on how the physician has set up their templates.”

Some Epic users will be able to record conversations directly in the EHR. This capability will input information into a provider’s note template within a few seconds, the companies said. Nuance previously took between two to four hours to deliver results to the health record, which required a human reviewer before AI generated notes went back to the care provider for review.

While the company’s Dragon Ambient eXperience Express product is not replacing its full service offering with human oversight, it is a less expensive, quicker alternative, Nuance said. 

“It’s hard to scale as a pure software product if you have a human in the loop,” Durlach said.

This integration represents Epic’s latest effort to add generative AI capabilities to its EHR system. At the Healthcare Information Management Systems Society conference in April, the EHR giant announced a separate integration with Nuance’s parent company Microsoft to develop two other AI solutions.

The first use case occurs through Epic’s In Basket communication software system. Through the integration with Microsoft, clinicians can use generative AI to create a draft response when communicating asynchronously with patients. The second use case allows providers to use generative AI to source recommendations from Epic’s Slicer Dicer data visualization tool. Typically, users must customize specific data searches on their own. With the generative AI capabilities, users can type something, and the system will automatically recommend different metrics.

Microsoft has invested billions in OpenAI to use ChatGPT and OpenAI’s other technologies in the big tech company’s business applications such as Microsoft Word and Excel. Nuance, which was bought by Microsoft in 2022 for $19.7 billion, is the latest to see its products get powered by OpenAI’s capabilities.  

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