Keck Medicine of USC is steadily integrating artificial intelligence across its healthcare system, using the technology to analyze research data, pre-screen thousands of patient calls, and, more recently, transcribe all in-person and virtual visits.

Student Health has used Nabla — an AI scribe, which transcribes and parses conversations to draft notes — at both the Engemann and Eric Cohen student health centers since October 2024. The AI listens during patient visits and, without retaining an audio recording, generates notes for providers, Chief Campus Health Officer Dr. Sarah Van Orman said in a Tuesday briefing with campus media.

Students are notified of the AI’s use via hyperlinked text in Student Health’s automated appointment reminder emails and by signs displayed in the student health centers. Those who wish to opt out must tell their provider.

Van Orman said the tool captures about 75% to 80% of what is said and improves providers’ care by allowing them to focus on patients instead of typing notes. 

“If we deploy this carefully, we do have the ability to reduce medical error, to create better documentation and to relieve the [paperwork] burden on healthcare providers,” Van Orman said.  

On top of transcribing conversations, the AI produces assessment plans and patient instructions. The former is the AI’s hypothesis as to what is afflicting a patient, and the latter is a proposed medical treatment plan, which are then edited by providers and manually entered into a patient’s Electronic Health Record. 

“[The AI] pulls from databases about common conditions and they pull in suggested treatments,” Van Orman said. “As a provider, you have to know if those are good or bad, but they do also help scaffold your clinical-decision making.”

Keck Medicine purchased Nabla’s AI tool for its entire healthcare system in 2024, which spans four hospitals and over 100 clinics. Before implementation, various groups within Keck reviewed the AI tool, including Keck’s virtual care and information security committees, Van Orman said.     

“We do want to reassure people about the protections that are in place, that this was very heavily vetted,” Van Orman said. “It’s giving your provider that little boost that they need.”

The transition from physical to EHRs has led to more detailed documentation but also more burdensome paperwork loads, according to the American Medical Association. Van Orman said providers sometimes spend just as much time on documentation as they do in the room with patients. 

The AMA conducts national surveys of physicians’ “pajama time,” which refers to all time spent on administrative tasks outside of official work hours. In 2023, about a third of U.S. physicians reported spending at least six hours outside of work on documentation tasks each week. 

Van Orman said she wrote patient notes by hand for the first decade of her career. She then transitioned to typed electronic notes, and now she uses Nabla’s ambient AI scribe with her own patients. Van Orman said this new AI era is “very exciting,” as both prior methods had their downsides: handwritten notes made large-scale research impractical and many providers defaulted to checking boxes to fill out patients’ EHRs, which lack specificity.   

“[With typing] we started to lose a lot of the nuance and the texture in people’s stories,” Van Orman said. “A patient might have a long description of what’s going on, and it gets boiled down to one sentence: ‘They had pain in their abdomen.’” 

While Student Health does not perform traditional billing, other healthcare providers routinely use the notes that ambient AI scribes make to create more-detailed clinical documentation. The documentation is then used to determine what billing codes should be charged.   

“It’s an emerging field, but it really does, from my perspective at least, [have] the potential of improving the quality of care,” Van Orman said.