{"id":136221,"date":"2025-05-27T15:12:09","date_gmt":"2025-05-27T15:12:09","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/136221\/"},"modified":"2025-05-27T15:12:09","modified_gmt":"2025-05-27T15:12:09","slug":"openai-powered-medical-coding-model-that-outperforms-physicians","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/136221\/","title":{"rendered":"OpenAI-powered medical coding model that outperforms physicians"},"content":{"rendered":"<p>Dr. Priti Patel, CMIO at John Muir Health, uses Ambience before starting a patient encounter.<\/p>\n<p>Courtesy of Ambience Healthcare<\/p>\n<p><a href=\"https:\/\/www.cnbc.com\/ai-effect\/\" target=\"_blank\" rel=\"noopener\">Artificial intelligence<\/a> startup Ambience Healthcare on Tuesday announced a new medical coding model that outperforms doctors by 27%.<\/p>\n<p>Ambience uses AI to draft clinical notes in real-time as doctors consensually record their visits with patients. The company used tools from <a href=\"https:\/\/www.cnbc.com\/2025\/05\/23\/openai-employees-thwarted-in-efforts-to-donate-equity-in-ai-startup.html\" target=\"_blank\" rel=\"noopener\">OpenAI<\/a> to build the new model.<\/p>\n<p>The startup is part of a <a href=\"https:\/\/www.cnbc.com\/2024\/03\/16\/himss-2024-ambient-clinical-documentation-steals-the-show.html\" target=\"_blank\" rel=\"noopener\">fiercely competitive<\/a> market that has taken off as health-care executives search for solutions to help reduce staff burnout and daunting administrative workloads.\u00a0<\/p>\n<p>The company&#8217;s new model can listen to patient encounters and identify ICD-10 codes, which are internationally standardized classifications for different diseases and conditions. There are about 70,000 ICD-10 codes that are regularly updated and used to facilitate billing and other reporting processes in health care.\u00a0<\/p>\n<p>Ambience said its new ICD-10 model can reduce billing mistakes and help clinicians and professional coders work more efficiently. The model notched a &#8220;27% relative improvement over physician benchmarks,&#8221; according to a release on Tuesday.\u00a0\u00a0<\/p>\n<p>&#8220;We&#8217;re not replacing doctors or coders,&#8221; Brendan Fortuner, Ambience&#8217;s head of engineering, told CNBC in an interview.<a href=\"https:\/\/www.linkedin.com\/in\/bfortuner\/overlay\/about-this-profile\/\" target=\"_blank\" rel=\"noopener\"> <\/a>&#8220;What we&#8217;re doing is we&#8217;re liberating them from administration, and we&#8217;re fixing mistakes that help make health care better, safer, more cost-effective.&#8221;<\/p>\n<p>More CNBC health coverage<\/p>\n<p>Documenting ICD-10 codes has traditionally been a labor-intensive task in health care, but it&#8217;s a crucial way to track outcomes, mortalities and morbidities in a standardized way, said Dr. Will Morris, the chief medical officer of Ambience.<\/p>\n<p>&#8220;If you think about it from a data perspective, it&#8217;s how you can compare and contrast clinician A to B, or health system A to B,&#8221; Morris said in an interview. &#8220;It&#8217;s the cornerstone for quality.&#8221;<\/p>\n<p>Ambience&#8217;s technology is used at more than 40 health-care organizations, like Cleveland Clinic and UCSF Health. It has raised more than $100 million, according to PitchBook, from investors including Kleiner Perkins, Andreessen Horowitz and the OpenAI Startup Fund.\u00a0<\/p>\n<p>The company is reportedly seeking fresh capital at a valuation of over $1 billion, according to a report from <a href=\"https:\/\/www.theinformation.com\/articles\/abridge-talks-raise-5-billion-valuation-ai-health-startups-draw-investors\" target=\"_blank\" rel=\"noopener\">The Information<\/a>. Ambience declined to comment on the report.\u00a0<\/p>\n<p>Ambience trained its new AI model using OpenAI&#8217;s reinforcement fine-tuning technology. This technology allows companies to tune OpenAI&#8217;s best reasoning models for very specific domains, like health care.\u00a0<\/p>\n<p>To validate the model, Ambience tested it against a &#8220;gold panel&#8221; set of labels, the company said. The labels were established by a group of expert clinicians who evaluated complex clinical cases and came to an agreement on what the right codes were.\u00a0<\/p>\n<p>Zoom In IconArrows pointing outwards<\/p>\n<p>Ambience&#8217;s AI platform for compliant documentation, CDI, and coding.<\/p>\n<p>Courtesy of Ambience Healthcare<\/p>\n<p>The company then recruited 18 different board-certified doctors and compared their performance on ICD-10 coding accuracy to the model&#8217;s performance. That comparison showed the Ambience technology performed 27% better than the physician baseline.\u00a0<\/p>\n<p>&#8220;It shows for the first time that an AI system can actually surpass clinician experts at a very, very important administrative task, especially in coding,&#8221; Fortuner said.\u00a0<\/p>\n<p>Ambience already has similar capabilities available for other medical codes like Current Procedural Terminology (CPT) codes, and Fortuner said it&#8217;s exploring how to tackle other areas like prior authorizations, utilization management and clinical trial matching.\u00a0<\/p>\n<p>The company&#8217;s new ICD-10 model will roll out to customers over the summer.<\/p>\n<p>&#8220;Getting it right at the point of care is a fundamental change,&#8221; Morris said.<\/p>\n","protected":false},"excerpt":{"rendered":"Dr. Priti Patel, CMIO at John Muir Health, uses Ambience before starting a patient encounter. Courtesy of Ambience&hellip;\n","protected":false},"author":2,"featured_media":136222,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4316],"tags":[16650,3083,3085,32904,105,20944,4348,3082,2452,53,16,15],"class_list":{"0":"post-136221","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-breaking-news-business","9":"tag-breaking-news-technology","10":"tag-business-news","11":"tag-enterprise","12":"tag-health","13":"tag-health-care-industry","14":"tag-healthcare","15":"tag-internet","16":"tag-media","17":"tag-technology","18":"tag-uk","19":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114580445149193167","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/136221","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=136221"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/136221\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/136222"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=136221"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=136221"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=136221"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}