EHR giant Epic rolled out an AI charting tool on Thursday, giving its customers a built-in tool that listens during appointments, drafts clinical documentation and prepares orders based on what it has heard. The announcement shakes things up for the ambient AI scribe market, which has seen massive growth in the past five years.
Epic’s market dominance is indisputable. Data from last year shows that the company owns 42% of the acute care EHR market, with the next highest-ranking competitor, Oracle Health, commanding just 23%. Epic is also embroiled in a yearslong antitrust lawsuit filed by Particle Health, which alleges that the EHR vendor is stifling competition in the emerging payer platform market.
Essentially, if you walk into any large health system in the U.S., there’s a good chance the staff will be using Epic’s EHR. This means that any time the company launches a tool of its own, the other vendors selling that technology suddenly have to justify their existence, as it’s considerably more difficult to sell a solution to a customer when they already have an in-house option.
Startups selling solutions that are similar to Epic’s new functionality include Abridge, Ambience Healthcare, Suki, Notable, Heidi and DeepScribe.
On Wednesday, KLAS released its annual software and services report, which crowns winners for various software categories within the healthcare industry. Abridge took the top spot in the ambient slot — but it’s unclear how much this ranking will matter now that Epic’s tool has been introduced. Abridge did not respond to MedCity News’ request for comment.
As for Heidi CEO Tom Kelly, he maintains that his company is solving a different problem than Epic.
“Heidi was built as an AI partner for clinicians first, not as a feature embedded within an EHR. Documentation and visit notes are important, but they’re only one part of the much broader layer of support we provide across clinical workflows,” he stated.
Heidi’s focus is on usability and adoption, it tries to give clinicians a platform interface that reflects how they actually practice. The platform’s tasks can range from generating notes to summarizing a clinician’s week or preparing information before it’s sent back to the EHR.
Historically, tools embedded directly in the EHR have focused on structured data entry and form completion, Kelly noted.
“We believe there is growing demand for AI platforms that sit alongside the record and reduce the overall cognitive and administrative burden on clinicians,” he remarked.
Another CEO of an ambient scribe startup, Matthew Ko of DeepScribe, also said that his company is solving a broader problem than Epic’s tool.
“The differentiation isn’t simply whether a note can be generated — it’s whether clinicians actually adopt the system, trust its outputs and use the data beyond documentation to deliver value across the enterprise. In practice, many Epic customers run us alongside Epic because we integrate deeply while addressing needs that Epic’s native tools aren’t designed to prioritize,” Ko stated.
He said he expects adoption to diverge by specialty.
Complex specialties like oncology, cardiology and surgical subspecialties operate within highly nuanced, variable workflows. Ko explained that in these settings, ambient documentation is inherently difficult because the system must accommodate specialty-specific workflows, clinical reasoning, longitudinal medical context and significant variation across providers.
“Driving meaningful adoption in these environments requires deep workflow alignment and continuous iteration, which is difficult to achieve with a generalized solution,” he declared.
Best-of-breed vendors tend to gain an advantage by building products that clinicians trust and consistently use, Ko noted. And as ambient AI evolves beyond documentation into platforms that trigger actions and drive revenue capture, adoption becomes the gating factor for value.
If clinicians don’t fully adopt the product, none of that value materializes, Ko said.
“For health systems focused on capturing the full operational and financial potential of ambient intelligence, especially in complex specialties, there will continue to be a strong role for specialized platforms that function more like an operating system than a single feature,” he remarked.
It’s inevitable that Epic’s move will reshape some buying decisions — but whether health systems standardize on native tools en masse or continue to invest in specialized platforms might come down to clinician adoption and workflow fit.
Photo: Richard Drury, Getty Images
