Best Practices — athenaAmbient (Beta)

athenaClinicals, athenaOne Mobile and desktop, Ambient Notes (add-on service)

Important
athenaAmbient is only available to clinicians participating in the following testing: athenaAmbient — Our Embedded Ambient Solution Included with athenaOne — Beta.

To optimize stability, accuracy, and patient experience, we recommend the following guidelines:

  • Connect to your Wi-Fi network
    Cellular network issues can disrupt recordings and lead to unexpected mistakes. By connecting your device to Wi-Fi, you can ensure that recordings, transfers, and summary generation will work smoothly. Connect to the strongest Wi-Fi available. Your organization may have a guest network and a private network. Please ensure that you are connected to the private network for optimal connection. You might also prefer to keep your phone in “Do Not Disturb” mode to avoid potential interruptions from incoming calls.

  • Get consent from the patient to record the visit
    Your organization will provide guidance on their official policies for obtaining patient consent for ambient recording.

  • Keep the device near you and the patient and leave it alone
    Clear recordings make the best summaries. Place the device within 1.5 m on a stable surface, choose a quiet space without background noise like fans, air vents, music, or hallway noise, turn off music/TV, reduce echo with soft furnishings, and ensure one speaker at a time.

    • If you are using mobile, place your device on a surface nearby where it can clearly capture both you and the patient. Once you’ve started recording, you don’t need to interact with the device again until you’re ready to pause recording.

    • If you are using desktop, check microphone to ensure good audio capture. Not all desktop computers have a microphone and you may need to use an external microphone.

Speaking with athenaAmbient

athenaAmbient understands natural language, so you can talk to your patients just like you normally would. You don’t have to verbalize punctuation, get your wording exactly right, or speak like a robot to get a quality draft. However, you can improve the accuracy of your AI-generated drafts by following these best practices.

Begin with a preamble

Providing a brief introduction to the visit helps the system understand what you’ll be discussing and can help the native AI personalize your note. Consider starting your first recording for an encounter with a simple preamble like, “Patient is here today for a follow-up appointment related to [condition].”

Try to avoid people talking over each other

As much as possible, try to let people finish talking before responding. If multiple people are in the room, try to identify the speaker and their relationship to the patient. For example, you can say, “Mom, has Jenny had any fevers?” or “Jenny, where does your ear hurt?” This will help the AI correctly attribute the information in your note.

Use verbal cues to guide the AI

Incorporating some verbal cues into your conversation can help direct the AI and ensure important details are captured in the summary. Specific verbal cues include:

  • Specifying location and/or laterality. For example, "So your chest pain radiates to the left shoulder?"

  • Articulating specific actions you’re going to take. For example, “Hop on the table so I can do a physical exam” or “I’m going to order Motrin 800 mg 3 times a day.”

  • Clarifying ambiguous or contradictory statements. For example, "To confirm, you did not feel shortness of breath?"

Describe specific findings, details, or clinical terms that you want to capture

During your exam or review of systems, be clear and specific in your language. This helps ensure that everything is captured correctly. Examples include:

  • During the physical exam:
    “I'm going to listen to your heart and lungs. [clinician listens] I hear a heart murmur; I would grade it a 2/6.”
    “I see that your right knee is swollen. Is it tender when I touch it? [patient nods]. There’s some tenderness when the right knee is palpated.”

  • When discussing the patient’s condition, symptoms, or previous courses of treatment:
    “It looks like we started Lisinopril 10 mg once a day the last time you were in. How is that working for you?”
    “Have you tried physical therapy or steroid shots for the knee issue?”

  • When discussing your plan with the patient:
    “We could try ice and over-the-counter pain relievers for a period of time. We could also try a brace to help with support. There is also the option of surgery. The surgery offers the best option for relief.”
    “I’m ordering Lasix 40 mg twice a day.”
    “I am going to order an echocardiogram; this is an ultrasound of the heart that shows how well the heart is contracting.”

Clearly Verbalize Your Assessment and Plan

At the end of the encounter, clearly and naturally summarize your assessment and plan. You do not need to dictate or speak in note-ready language. The goal is to be explicit about diagnoses, key decisions, and next steps so important clinical details, orders, and follow-up plans are captured accurately. This summary can be shared with the patient in the room or stated after leaving the exam room. Examples include:

  • “Based on what we discussed and the X-rays, this looks like osteoarthritis in your right knee.”
  • “I recommend starting with conservative treatment, a compression brace, and physical therapy, and I gave you a steroid injection today to help with pain.”
  • “You can use ice and over-the-counter pain relievers as needed.”
  • “Let’s plan to follow up in about three months, but call the office sooner if the pain worsens.”