Imagine sitting in a room where your smart assistant is always on — but never in the way.

It listens passively, filters out the noise, and steps in when you need it.

That’s ambient listening. 

And in healthcare, it’s not just another new technology, it’s a shift in how we manage care.

In this post, I’ll break down what ambient listening really means, how it works behind the scenes, why it’s a game-changer for clinicians, and how it sets the stage for something bigger.

Let’s get into it.

What is Ambient Listening Technology?

Ambient listening is AI-powered voice recognition technology that captures, processes, and interprets clinical conversations in near-real time.

These tools don't need explicit prompts or manual input — and in clinical settings, this means automatically turning doctor-patient dialogue into structured medical documentation.

Now, let’s bring that to life.

Imagine you’re in the exam room. Your patient’s talking. You’re listening, asking follow-ups, making clinical decisions in your head.

But instead of scrambling to jot it all down or trying to remember everything later for dictation, something else is handling the note.

It’s listening quietly in the background, filtering out the small talk, understanding what matters, and turning it into a clean and structured SOAP note.

The history of ambient listening technology

The ambient clinical voice tackles that invisible nuisance clogging your work day — as Dr. Abraham Verghese put it:

"The despair I hear comes from being the highest-paid clerical worker in the hospital: For every one hour we spend cumulatively with patients, studies have shown, we spend nearly two hours on our primitive Electronic Health Records, or “E.H.R.s,” and another hour or two during sacred personal time." — Dr. Abraham Verghese, The New York Times

You didn't sign up for a career in data entry. But EHR requirements are long, necessary — and a hassle.

The concept of an ambient AI in healthcare was widely introduced in the late 2010s, and by 2020, several studies were surveying its impact on clerical burden.

This only increased over time — this chart illustrates the growing number of studies published by notable groups as we entered the 2020s.

The benefits of ambient listening

Ambient AI is like having a medical scribe in the room. But this one never interrupts, never needs training, and never burns out. 

Think of it like your smartphone’s voice assistant. But instead of playing music or setting alarms, it’s capturing clinical context and turning it into clean, usable clinical documentation.

And it doesn’t just hear. It understands.

It pulls out symptoms, medications, diagnoses, treatment plans, and turns that raw conversation into a high-quality note that fits neatly into your EHR.

How ambient listening works (behind the scenes)

Ambient listening might feel like magic. But under the hood, it’s a powerful combination of technologies working in sync.

At its core, it uses a blend of speech recognition, natural language processing (NLP), and machine learning to understand and structure human conversations.

Here’s what’s actually happening during a clinical visit:

• Always-on recording: The system starts by passively capturing audio from the room using a device—usually a tablet, smartphone, or even a ceiling mic. It doesn’t need a wake word or manual trigger.
• Speech-to-text conversion: As the conversation happens, the system uses automatic speech recognition (ASR) to convert spoken words into text. It transcribes multiple speakers in real time, even in noisy environments.
• Speaker identification & context detection: Using advanced diarization (that’s the fancy term for “who said what”), the artificial intelligence figures out whether the doctor or patient is speaking. It also identifies clinical context: symptoms, conditions, medications, plans.
• Structuring the note: Once the conversation is transcribed, the system organizes it into a structured format like a SOAP note. This isn’t just a transcript; it’s a usable clinical note.
• Clinician review & handoff: Before finalizing, the note is handed back to the health care provider (either inline in the electronic health record or in a companion app) for quick review, edits, and sign-off.

All of this happens within minutes or instantly, depending on the system.

And because it’s built on continuous learning, the AI improves with time. It picks up on your phrasing, your specialty, even your preferences for documenting certain findings.

What ambient listening looks like in practice

Let’s say you’re a primary patient care physician seeing a patient with shortness of breath.

You ask about symptoms. Listen. Do an exam. Talk through options.

Meanwhile, your ambient listening tool is silently working in the background.

By the time you wrap up, it’s already drafted:

• A structured HPI with the patient’s words
• Objective findings from your physical exam
• An assessment and plan based on what you recommended
• Orders for labs or imaging, if mentioned
• Follow-up instructions

According to a 2024 study at Emory Healthcare, after using an ambient tool for just 60 days:

• 71% of clinicians said it met their documentation needs (up from 42%)
• 58% reported higher productivity
• 35% said they’d recommend it to peers

Ambient tech didn’t just work. It changed both their personal and professional lives for the better.

All you have to do is glance at the note, tweak if needed, and sign off.

You didn’t dictate. You didn’t type. You just had a real conversation.

That’s the beauty of it.

The future of ambient listening (and why it's just getting started)

This AMA with Dr. Brian Hoberman, MD at The Permanente Federation offers a look into how ambient listening is evolving. 

When asked about where ambient listening is headed, Dr. Brian Hoberman said:

“A couple generations from now, physicians will practice differently in ways we can’t even fully imagine today.”

And he’s not talking about sci-fi fantasies. He’s talking about what’s already unfolding inside Kaiser Permanente.

After fully rolling out ambient scribing across their system, they’re already seeing the next frontier: smarter, more specialized AI that does far more than just draft notes.

Here’s what’s coming, directly from the people building it:

Smarter support for specialists

One of the early limitations? The tech wasn’t tuned for every specialty.

For example, oncologists needed AI that could pull forward prior visit details and carry over complex histories. Mental health clinicians needed systems that could document therapy sessions in a way that fits behavioral workflows—not just medical ones.

Now, Kaiser is working closely with vendors to build specialty-specific models that learn how different doctors work—and adapt.

Synthesized patient summaries

In the future, ambient tech won’t just record the visit—they’ll help clinicians understand the full story faster.

Dr. Hoberman shared a recent example: a complex patient who was new to the system. He spent a significant amount of time manually reading specialist notes to get up to speed.

In the future, he sees ambient tech summarizing that journey automatically—pulling in highlights, surfacing key patterns, and making it easier to provide better care on day one.

Ambient AI as a thinking partner

Today, the job of ambient AI is clear: augment clinicians. 

Remove the burden of note-taking. Save time. Improve face-to-face interactions.

But the future? It’s bigger.

Dr. Hoberman envisions a world where ambient systems co-pilot clinical decisions—flagging critical context, recommending actions, and helping clinicians focus on the human side of care.

As he put it:

“Ambient lets people turn their attention to the things that humans are best at—instead of banging out a note while trying to listen to someone.”

And the best part? It’s not theoretical. It’s already being built.

At Kaiser, the pace of adoption has been fast—because the tech works, doctors want it, and the value is clear.

Ambient listening isn’t just a documentation tool. It’s becoming the foundation for a new way of practicing medicine.

Introducing the intelligent health record (IHR)

If ambient listening is the “what,” the Intelligent Health Record is the “what’s next.”

Because here’s the truth: even with AI scribes and speech-to-text breakthroughs, clinicians are still stuck toggling between EHRs, inboxes, labs, orders, templates, and endless admin landmines. It’s like giving someone a smarter fax machine and calling it innovation.

The real unlock? Rethinking the whole system.

That’s what the IHR is.

What is the IHR?

The Intelligent Health Record is Freed’s vision for the future of clinical software. 

It’s not a smarter EHR. It’s an AI-native system of record—built from the ground up to understand, assist, and evolve alongside clinicians.

It doesn’t just record what happens. It actively helps.

Think of it like this: if the EHR was designed for billing and compliance, the IHR is designed for care. It listens like an ambient scribe, learns like a real assistant, and supports the clinician with every action they take.

This isn’t a prettier UI on top of legacy code. It’s a new foundation.

Here’s what it looks like — now, next, and later.

Now: clinician love

We're starting with an AI scribe to help clinicians regain their time. Freed captures conversations automatically, suggests the next step, drafts the note, and flags missing codes.

And it does it all without taking your focus off the patient.

It’s ambient listening (leveled up) with real-time clinical support baked in.

What's next: Crush the clinical burden

Next, the IHR expands beyond the room.

It helps manage the flood of follow-up tasks like referrals, prior auths, inbox messages, patient questions, and document handoffs. It automates the mess that eats up hours.

The goal? A system that quietly clears your plate so you can focus on the work only you can do.

Later: The open garden

In the future, the IHR will become something bigger.

Imagine an ecosystem where developers, researchers, and health systems can build apps on top of a real-time, structured health record. 

One that’s always up to date, always context-aware, and never trapped in a silo.

Think: an app store for clinical tools. Only instead of games and widgets, you get diagnostic models, patient education plugins, triage assistants, and more.

Bottom line? We’re not redesigning the EHR. We’re replacing the need for one.

The IHR isn’t just a new way to take notes. It’s a new way to work.

Final thoughts

Ambient listening isn’t a fad. 

It’s a step toward a future where clinicians are supported (not buried) by technology.

And with the IHR, we’re taking the next leap.