Is Ambient AI Harder to Build for RNs Than MDs? Abridge CEO Says ‘Yes’

This is a preview of the May 7 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursday mornings.

Good morning, and happy National Nurses Week.

I debated putting an exclamation mark at the end of that sentence. After all, Chipotle is advertising free burritos in honor of the occasion.

Then I read the fine print, which specified that nurses have to register on Chipotle’s website. And only 100,000 of them will be randomly selected for a burrito. And if they are among the lucky winners, they’ll need to verify their status via ID.me. (Seriously. The metaphors write themselves!)

Chipotle aside, this Nurses’ Week is a pretty grim one.

We’ve lost three consecutive years of improvements in job satisfaction, according to Nurse.org’s annual State of Nursing survey, released last month. Forty-three percent of nurses said they are likely to leave the bedside in the next year, and nearly one in four hope to leave the profession altogether. Nearly every metric of fulfillment, contentment and hope—which had all been on the rise in 2023, 2024 and 2025—dropped again in this spring’s iteration of the report.

In 2022, health care could still blame the pandemic for these numbers. But after trending upwards, and then back down, it’s undeniable that COVID-19 was not the only problem.

Only eight percent of surveyed nurses said that good management and leadership was keeping them at the bedside. More than 40 percent said that financial necessity was their primary incentive. Over half report being the targets of violence and aggression in the workplace, and just one-fifth say that their salary allows them to be financially comfortable.

Despite the bad news, there are glimmers of good. The majority of nurses still report that they’re glad they chose the profession.

And the efforts to center the joyful, rewarding parts of the job are expanding. Yesterday, Abridge for Nurses expanded access from several health systems to more than 250. I spoke with nursing leaders in the first few cohorts who reported higher satisfaction from both patients and frontline nurses who started using the AI tool—you can read the whole story here.

The most promising sign, in my opinion, is that health systems aren’t rushing this one. Those that have been using Abridge for the past year are still only live at a handful of units. They reported a careful co-development process that centers nurses’ preferences and input. This should be table stakes, but tenured nurses will tell you that it has not been.

Microsoft’s Dragon Copilot is also expanding its suite of AI tools with “continuous feedback mechanisms” to ensure nurses’ voices aren’t neglected. These are just a few examples—and not enough to warrant an exclamation point—but maybe enough to bring some respite, eventually.

If you’d like to learn more about how tech companies are thinking about nursing, read on to the Pulse Check section for an interview with Dr. Shiv Rao, co-founder and CEO of Abridge.

And if you’re a nurse, or a former nurse, thank you. I’d love to hear from you: what needs to change, beyond technology? How can health systems better support you? Email me at a.kayser@newsweek.com.

In Other News

Major health care headlines from the week

UnitedHealthcare says it’s cutting prior authorization requirements for 30 percent of medical services that previously required the payer’s approval.
- Certain outpatient surgeries and therapies, chiropractic care and diagnostic tests will be eliminated from the prior auth list, according to the company.
- Currently, prior auth is only required for two percent of services covered by UnitedHealthcare’s policies, and on average, 92 percent of requests are approved in less than 24 hours, the company said in a Tuesday news release.
- “We are committed to further improving and refining our processes to make reviews quicker, simpler and more efficient,” UnitedHealthcare CEO Tim Noel said in a statement.
Antidepressants are the latest target of Health Secretary Robert F. Kennedy Jr.’s “Make America Healthy Again” campaign, joining the ranks of vaccines, food dyes and baby formula.
- On Monday, Kennedy outlined an effort to “curb psychiatric overprescribing,” leveraging the “collective expertise” of HHS’ agencies to re-evaluate prescribing patterns for antidepressants, scale non-medicinal mental health treatments and support patients in tapering off the drugs if they are not seeing clinical benefits.
- CMS released guidance for clinicians on the “importance of deprescribing” and further explained the push for non-pharmacological interventions in a “Dear Colleague” letter.
- Antidepressants are among the most commonly prescribed medications in the U.S., according to a large-scale study recently published in BMJ Mental Health. More than 16 percent of U.S. adults reported taking an antidepressant medication during the survey period in 2025, while just over 10 percent were receiving psychotherapy.
- The same study found that “substantially” more adults oppose federal regulations on antidepressants than support them.
- In other health admin news, 41 percent of Americans identify with the “MAHA” movement, according to the latest KFF poll. The Washington Post breaks down the main reasons why—with “hopes for a healthier country” coming in first.
CommonSpirit Health reached a definitive agreement to transfer ownership of an Ohio health system to UPMC.
- Trinity Health System is at the heart of the deal, which includes four hospitals and a group of clinics based in Steubenville, Ohio.
- If the transaction closes as expected this fall, it would mark UPMC’s first purchase in the state of Ohio.
- CommonSpirit has been on a selling spree since reporting an operating loss last year. In February, the Chicago-based system sold its stake in Conifer Health Solutions back to Tenet Healthcare. And in March, it sold one North Dakota hospital to Altru Health System, which has signed a letter of intent to acquire three more CommonSpirit-owned hospitals in the state.
The Leapfrog Group released its spring Hospital Safety Grades yesterday, reporting significant improvements in patient safety across 17 error and infection metrics.
- Leapfrog celebrated major declines across health care-associated infections, including four that were at a peak in fall 2022: CLABSI (down 50 percent since 2022), CAUTI (45 percent), MRSA (42 percent) and C. diff (30 percent). It also noted that 90 percent of hospitals now meet the agency’s standards for computerized physician order entry, and 93 percent are in the green for bar code medication administration.
- Patient experience also got a shoutout. All five patient experience metrics that Leapfrog tracks have improved by one point, on average, since hitting an all-time low in fall 2023.
- A few states received special recognition for climbing the ranks: Florida jumped to 7^th place after coming in 15^th last fall. Montana ranked 5^th, marking its first time in the top five. And Maryland came in 8^th after years of being in the bottom 20 states.
- Notably, however, there were no ‘A’ hospitals in North Dakota, South Dakota, Vermont and Wyoming.
- Click here to see the full state-sorted ranking.

Pulse Check

Executive perspectives on key industry issues

I recently connected with Dr. Shiv Rao, co-founder and CEO of Abridge, to learn more about the company’s bedside care strategy as it grants 250+ health systems access to its AI platform for nurses.

Find a portion of our interview below.

Editor’s Note: Responses have been lightly edited for length and clarity.

How does nursing fit into the ultimate vision for Abridge? When you launched the company, did you consider that nurses might be one of the target demographics?

Absolutely. The original thesis for the company is that health care is about people. It’s about humans. The most important signal that comes from those human interactions is spoken, and those interactions tend to be between both doctors and patients, but also nurses and patients.

And if you think about it, there are way more interactions between nurses and their patients. Especially inside the health system, the hospital, the inpatient institution, nurses are really the scaffolding for everything. Without nurses, nothing would function. Nothing would happen.

So we always knew that we wanted to be able to build there. One way to go after it was to “journey map” the patient’s story inside of a hospital. What happens when they go to the emergency department, to getting transferred upstairs into the hospital, to eventually getting discharged? Who are all the different professionals that they interact with? There are doctors, physical therapists, nutritionists, discharge coordinators, social workers, and—most importantly—there are nurses. The interactions that they have with nurses really are a significant multiple of any other interaction.

We’re now trying to build the system of intelligence across all those interactions. It’s a top priority for us to be able to build with and for nurses, in a for nurses, by nurses sort of way. But we also want to build in a way that allows us to connect into the bigger picture of these other interactions, including with doctors.

The original Abridge documentation tool for physicians was a major success. What was uniquely challenging about building a tool for nurses?

One of the big obstacles is technical, and another one is related to workflow.

On the technical side, it’s more of a structured data extraction challenge than a summarization challenge. When I, as a doctor, see a patient, we create these summaries in a specific format, but they need to be compliant. They need to have all the right information, then be structured and integrated back into the medical record in a certain way.

But they’re more like summaries, whereas with the nursing workflows, it’s more like filling in a spreadsheet.

Nurses might walk in a room and “nurse out loud.” They might talk about how much IV saline is still left in the bag, or how the urinary Foley catheter is doing. They might verbalize the patient’s vital signs: their blood pressure, their heart rate, their temperature.

Our technology’s job is to convert all of that into structured data that maps to specific flow sheet cells inside the medical record. That’s a very different machine learning challenge.

Beyond the technical challenge, there is the workflow challenge. And nursing workflows are really, really complex. They’re walking into rooms and getting paged out and coming back. There are potentially multiple people in the room with them, lots of different voices. They might not always automatically verbalize all of the information that they’re looking to get charted in those flow sheets, so there’s a little bit of change management involved as well.

It’s a very different-looking product, from a problem standpoint.

Was it more difficult to build an ambient documentation tool for nurses than for physicians?

The first version of it? Yes, absolutely. And for all the subsequent versions, it just gets harder.

For example, there’s a significant delta between a first version of a doctor note, and one that is clinically useful, compliant and good for all the different specialties. That gets to be just as challenging as anything.

But to get started with something that a nurse would use and say, ‘This is great,’ to be able to ring that first bell is definitely harder.

How does the demand for AI-powered tools compare from nurses to physicians?

In that sense, they’ve actually had more in common. Nurses are burning out as well. We’ve got a real public health emergency across both doctors and nurses. An [AMN Healthcare survey from 2023] suggested that 30 percent of nurses wanted to leave the profession in the next 12 months.

There is a real challenge to retain nurses and inspire them to stay in the workforce, because they get so much energy from being that scaffolding for the health system and being that first, most important unit on the care delivery team. But they’re also pulled away by clerical work and all the different distractions that get in the way of that purpose.

That’s where we can come in, and that’s where we’ve got a lot of conviction now that it’s time to scale.

Some of the nursing leaders I spoke with this week said that nurses are loving Abridge—but they’re only using it on a couple of units. Why is it so difficult to scale this product across an enterprise?

Different units have different spreadsheets, so you want to build for the spreadsheet that you think can create the most immediate significant impact, and then sort of land and expand from there. It’s not dissimilar to the way that we approach doctor notes—we started with a certain outpatient setting, a certain type of clinician, then very quickly expanded into other specialties, and we continued to expand.

Similarly with nursing, we’re focused on med-surg flow sheets right now. Those are probably only relevant on certain floors, but then from there, we’ll expand very quickly into others.

Is there a way to “bundle” the physician and nursing AI tools? Do you currently view them as complementary, or do you plan to?

It’s usually a different set of stakeholders that we’re speaking to on the doctor side versus the nursing side. And what we try to make clear to both is that when you’ve got both turned on, you will be able to connect the dots across both. There’s something special, something magical in that.

Tell me more about that “connecting the dots” piece. What are the anticipated benefits of having both platforms working together?

Before the nurse walks in the room, if they have a sense of what [the doctor’s] conversation was about that morning, then they have a heads up. “Okay, the patient is having these challenges,” or, “They really want to talk to a discharge coordinator to get out and go to the nursing home.” Whatever it is, they’re coming in with a prepared mind.

My [family member] was in the hospital for hip surgery a few months ago, and I was pretty shocked by how many care team members would come in the room and ask the same exact questions, over and over. It felt like 5,000 paper cuts.

So in this new world, where we’re creating this system of intelligence across all these interactions, every single one of those care team members can come in feeling like they know what has already been discussed, and they can pick up where another person on the team left off. That just helps so much in terms of giving me focus on what I should be unpacking when I walk in.

What are your main goals for Abridge for Nurses as it expands to more sites?

The main goals right now are to expand, like you said, to other settings within the hospital—and also to scale across more health systems, so we can get that much more feedback.

For us, feedback is oxygen, and some of that feedback is qualitative. Some of it is actually the data. Getting feedback from more nurses around edits and adjustments to those cells that we’re populating inside of those spreadsheets can help our models learn faster.

C-Suite Shuffles

Where health care leaders are coming and going

Heather Cianfrocco became the new COO of Highmark Health—the Pittsburgh-based parent company of Highmark, Allegheny Health Network and enGen—on Tuesday.
- Cianfrocco has spent the last 24 years with UnitedHealth Group, most recently serving as executive vice president of governance, compliance and information security. She was CEO of Optum from April 2024 to April 2025, and held various leadership roles throughout her tenure at the company.
Dr. Gregg Nicandri was named the inaugural chief digital and innovation officer at the University of Rochester Medical Center in New York, where he’ll lead its new Digital Strategy and Innovation Office.
- Previously, Nicandri was the academic system’s chief medical information officer. In this flagship position, he’ll be responsible for developing an enterprise-wide digital strategy.
Health Catalyst appointed Aetna President Steve Nelson to its board of directors, where he’ll fill a new seventh seat.
- It’s the second recent leadership announcement from the data and analytics provider. Former CEO and board member Dan Burton stepped down in February, accelerating the promotion of Ben Albert, formerly COO and president, to the top seat.