Meeting the Challenge of Designing AI Scribes for Specialties

Ambient scribes have proven very popular in primary care, but deploying them in specialist practices requires more work. One EHR vendor that works with specialist offices, Nextech, has launched Cora Scribe, the first capability available within Nextech Cora, the company’s next-generation AI assistant.

Unlike bolt-on, third-party scribes, the company said, Cora Scribe is embedded in the Nextech EHR and maintains a continuous two-way conversation with the patient chart. It captures patient encounters in near real time and streams discrete clinical findings – more than just summary notes – directly into the correct fields in the EHR, helping providers chart more efficiently while staying fully present with their patients, the company said.

Nextech CEO Rusty Frantz responded via e-mail to questions from Healthcare Innovation about this new solution. 

Healthcare Innovation: Can you describe the range of specialties that Nextech works with and how big its installed base is?

Frantz: Nextech delivers intelligent, connected solutions for all kinds of specialty practices, with a large presence in ophthalmology and dermatology. We also have a big footprint in the plastic surgery and medical spa industries. In terms of scale, we support more than 16,000 physicians, 5,550 practices, and over 60,000 office staff members.

HCI: How long has the company been working on AI scribe technology? Is it currently in a pilot phase with customers in certain specialties?

Frantz: We’ve been working on AI scribe capabilities since early 2024. Soon after we started, we realized a general-purpose scribe wouldn’t work for our partners. We needed to design something that fit specialists’ unique workflows.

Our early focus was in ophthalmology. We completed extensive testing on Cora Scribe and are currently engaged in a nationwide, multi-site pilot that includes many of the sub-specialties across ophthalmology. We've spent 18 months in collaboration with ophthalmologists, technicians, human scribes, and practice leaders. That includes 27 practices, 60+ physicians, 50+ scribes, and 120+ technicians.

HCI: What are some ways that the use of AI scribes is different in the specialist office encounter than in primary care? Are there things that make it more challenging to implement?

Frantz: Specialty visits tend to be more complex and highly specialized. They involve specific terminology, structured documentation, and multiple clinical components that need to be captured accurately and consistently. That raises the bar for AI scribing. The technology has to align with how specialists actually practice. Not just generate text, but support established workflows without adding friction.

HCI: Can you describe how this AI would specifically help ophthalmology?

Frantz: Ophthalmology is a clear example of why specialty context matters. Unlike standard patient encounter documentation common in many specialties, ophthalmology requires specific clinical narratives for each eye in the same visit. That significantly increases the complexity of documentation required and exacerbates the drawbacks of general clinical tools. For instance, ophthalmology providers often see recurring patients, such as those with glaucoma or retinal disease, where documentation builds over time — and so does the amount of time spent manually inputting the necessary level of detail. 

Cora Scribe is designed to understand that context and extensive patient history so that it knows whether to add, modify, or resolve findings. Because Cora can be specialized for ophthalmology, it automatically and intelligently charts discrete findings unique to eye care, including intra-ocular pressure, visual field interpretation, optic nerve assessment, and others. This helps providers generate a usable first draft of the note while maintaining the flow of the encounter and reducing documentation work after the visit. Ultimately, our focus is reducing the documentation burden during and after the visit to help providers get to a solid first draft of the note while keeping the flow of the encounter intact. That allows clinicians to stay present with the patient instead of dividing attention between care and documentation.

HCI: What are some anecdotal things you have heard from early users about the time savings or reduced administrative burden?

Frantz: The most consistent feedback we’ve heard isn’t just about time saved in the moment; it’s about what happens at the end of the day. Clinicians don’t want to spend evenings finishing charts or reconstructing visits from memory. Early users have told us that Cora helps them complete documentation sooner and leave the day with fewer unfinished notes. We’ve also heard that when documentation feels less disruptive, it changes the dynamic of the visit, allowing providers to stay more engaged with the patient. One of the most powerful things we’ve heard about our scribe has come from doctors telling us that after working with an AI scribe, they had no idea how distracted they had been due to the cognitive load of both talking to patients and trying to mentally prepare the notes in their head. It’s a major contributor to provider burnout. Cora Scribe helps alleviate some of the mental burden so doctors can be more present and healthier themselves.

HCI: Have you done any quantitative assessments of the time savings?

Frantz: We’re collecting data now, but aren’t quite ready to publish those numbers. However, what we can say confidently is that early users are reporting less after-hours documentation and faster turnaround on completing notes.

HCI: Your press release mentions that ambient scribe is the first aspect of Nextech Cora, the company’s next-generation AI assistant….Are there other aspects of specialist workflow that this technology can help with?

Frantz: Yes, we plan to expand our AI scribe capabilities to other specialties in 2026 and beyond. Even within the ophthalmology workflow, while we’ve started with the technician portions of the chart for AI scribe, we also are actively adding doctor, billing, and other functions. On a broader scale, we see Cora Scribe as ushering in a new era of charting. This is the beginning of truly hands-free documentation that will fundamentally change how doctors interact with their EMR and patient charts for better, more human care.