VA to gradually expand medical AI scribe following successful pilots

The Department of Veterans Affairs is planning to expand the use of an artificial intelligence tool that records veteran-doctor conversations with patient consent after a series of rollouts it says have been successful.

The VA first deployed the technology — known as ambient AI scribes — in October 2025 at 10 medical centers across the nation. After a series of pilots over the past year, the tools are now available to all VA Patient Aligned Care Teams’ primary care providers, behavioral health interdisciplinary program practitioners, physical medicine rehabilitation practitioners and medical and surgical specialists. 

“Each time they do a pilot with some volunteers to make sure it's working well for that particular discipline, and then after that they'll do some specialty testing on certain features with an early adopter group,” Dr. Rebecca Gladding, acting deputy chief of psychiatry at the VA Greater Los Angeles Healthcare System, told Nextgov/FCW.

The department plans to bring ambient scribes to select outpatient care providers and broaden its use through an enterprise contract this year. Dr. Gladding told Nextgov/FCW that expanding the technology to inpatient settings is not currently part of department plans because “it’s a lot more complicated, a lot more data” than outpatient settings.

When asked how the VA decides to scale the use of ambient scribes, a department spokesperson said it “evaluates candidate specialties against both the data and the clinical fit with the goal of relieving administrative burden for as many clinicians as possible and giving them more time to engage with veterans.” 

VA providers are currently using ambient scribes from Abridge and Knowtex to record conversations with veterans, allowing them to look at their patients rather than their computer screens. The recordings — which veterans must verbally consent to after an explanation from their providers — are turned into electronic health record notes. Veterans can opt out of the technology at any point, including mid-visit.

Abridge is the only vendor whose ambient scribe is live at VA medical centers, operating on both legacy VistA and new Oracle-based EHRs, according to vice president of partner experience Reba Schenk. The company deferred to VA when asked about uptake and usage of its ambient scribe but noted its technology is deployed at 70 VA sites and over 300 U.S. health systems.

Knowtex’s technology has been used in 10 Veterans Integrated Service Networks, or VISNs, and 79 VA medical centers in the past six months, reaching more than 7,000 clinician users and saving over 450,000 hours of EHR documentation time, the company told Nextgov/FCW.

The company has a user adoption rate of 88% with an average satisfaction rating of 4.48 out of five across over 5,100 ratings, which — along with a Kansas City pilot — shows a “successful partnership and implementation at national scale,” the company added.

Pilot results

Pilot data show veterans report better care when a provider uses an ambient scribe, and clinicians report feeling less burnt out by EHR documentation needs.

In the three-month Kansas City pilot, for example, veterans reported a 95.8% satisfaction rate, which is almost 3 points higher than before the evaluation period. Survey results also showed about 95.4% of veterans felt providers’ explanations were clear and 95% of veterans felt they could trust their primary care team. Those numbers are about 2.3 points and 2.9 points higher than before the evaluation period, respectively.

Over 986,000 VA primary care appointments, including in-person, phone and video visits, have used ambient scribes with vendors reporting veterans have declined the use of the technology less than 1% of the time since October 2025, according to Dr. Gladding. 

In early ambient scribe deployments, VA clinicians reported lower cognitive load, reduced after-hours documentation burden, improved focus during encounters, less mental fatigue with documentation demands and streamlined note documentation workflows, according to a VA spokesperson.

The VA did not provide data on the quality of ambient scribe-generated notes, though a recent Veterans Health Administration-funded study found AI-generated notes had lower quality scores than human-generated ones across five standardized care cases.

Getting quality notes is “where the learning curve is when you first start using it,” Dr. Gladding said, noting there are several quality checks in place for ambient scribes.

She said clinicians review and approve ambient scribe notes before they are added to EHRs. During the review, clinicians can check conversation transcripts to ensure they are accurately captured by notes. Dr. Gladding added that VA providers have internal conversations around prompt engineering to ensure ambient scribe notes are to clinicians’ liking.

Before providers deploy ambient scribes, they must complete a “one-time prerequisite” ethics training and a technology setup training within VA’s Talent Management System, according to a VA spokesperson. They may also choose to take vendor-specific training, they added.

For ambient scribes, “we have a lot of change management and literacy and training around for our healthcare providers on how to use that tool specifically and how to get the most value out of it,” said Dr. Kimberly McManus, VA’s acting chief AI officer, at the GovCIO Media and Research Health IT Summit earlier this month.