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The Abridge Epic integration—built through Epic’s Partners and Pals (Epic Workshop) program and often called “Abridge Inside”—embeds Abridge AI‘s ambient clinical documentation engine directly into Epic Systems mobile and desktop applications (`Epic Haiku`, `Epic Canto`, and `Epic Hyperspace` / `Hyperdrive`). Rather than running a separate third-party scribe app or copying and pasting text across browser windows, clinicians initiate ambient recording inside Epic Haiku/Canto, review problem-oriented draft notes with Linked Evidence audio-transcript provenance inside Epic Hyperspace, and access contextual point-of-care clinical decision support through Abridge’s collaboration with Wolters Kluwer’s UpToDate.
How to Use Abridge in Epic: Step-by-Step Haiku, Canto, and Hyperspace Workflow
In health systems where Epic Ambient Module and Abridge Inside are enabled for ambulatory, emergency department, or inpatient encounters, clinicians execute a five-stage native workflow:
Step 1: Select the Patient Encounter in Epic Haiku or Canto
Log into Epic Haiku (iOS or Android smartphone) or Epic Canto (iPad) using your enterprise credentials and FaceID/biometric authentication. Navigate to your daily clinic schedule or Emergency Department Track Board / Inpatient Patient List and tap the scheduled patient encounter. Because Abridge runs inside Haiku’s native ambient framework, the patient’s Enterprise Master Patient Index (EMPI) context, Encounter CSN (Contact Serial Number), and specialty department context are bound automatically—eliminating wrong-chart transcription errors.
Step 2: Obtain Patient Consent and Start Ambient Recording
Before tapping the microphone button, obtain verbal or written patient consent for ambient AI recording in accordance with institutional policy and state wiretapping/two-party recording laws. Inside the Haiku encounter header, tap the Ambient / Abridge recording icon:
- Screen-Lock & Background Audio Capture: Place the smartphone on the exam room desk within 3 to 8 feet of both speakers. Epic Haiku maintains an active background audio session even if the phone screen locks during the physical exam.
- Pause, Resume & Multi-Segment Visits: If you step out of the exam room to review imaging or consult an attending physician, tap Pause and then Resume when returning—or record multiple discrete audio clips under the same Encounter CSN, which Abridge merges chronologically into a single unified draft note.
- Multilingual Encounter Capture: If the encounter is conducted in Spanish or another supported non-English language (with or without a medical interpreter), select the encounter language setting so Abridge captures the multilingual dialogue and generates the structured clinical note in English.
Step 3: End Recording and Trigger Cloud ASR Structuring
At the conclusion of the visit, tap End / Submit Recording in Haiku. The encrypted audio stream is transmitted over TLS 1.2/1.3 to Abridge’s HIPAA-compliant AI medical scribe cloud pipeline, which deletes the local temporary mobile cache once upload confirmation is received and generates the structured clinical draft within 30 to 90 seconds.
Step 4: Pull Draft Sections into Epic Hyperspace / Hyperdrive (`SmartSections` & `SmartLinks`)
Open the patient’s encounter on your workstation in Epic Hyperspace / Hyperdrive. Depending on your health system’s Epic NoteWriter template configuration, the Abridge draft populates your progress note in one of two ways:
- Ambient SmartSections (Automatic Note Template Population): If your standard specialty `.soap` or progress note template contains Epic’s native Ambient SmartSections, opening the note automatically populates the four core clinical blocks: History of Present Illness (HPI), Physical Examination, Results / Data Reviewed, and a problem-oriented Assessment & Plan (A&P), plus a plain-language Patient Instructions section mapped to the After Visit Summary (AVS).
- On-Demand Dot-Phrases / SmartLinks: Clinicians using custom note templates can invoke Epic ambient SmartLinks (dot-phrases configured by the health system’s Epic Willow/Ambulatory build team) to pull specific Abridge-generated sections—such as pulling only the ambient HPI and A&P while retaining a structured specialty flowsheet for the Physical Exam.
Step 5: Verify via Linked Evidence and Sign the Encounter
Inside the embedded Abridge Clinician Editor pane in Hyperspace, review the draft before signing. Clicking or hovering over any clinical sentence, medication dose, or diagnosis in the generated note activates Linked Evidence: the interface highlights the exact speaker-diarized transcript lines and plays back the 5-to-15-second audio clip from the conversation that produced that statement. Once verified and edited, click Accept / Sign in Epic to commit the final text to the legal medical record.
Abridge-Epic Technical Architecture: How Data Flows Between Haiku, Abridge Cloud, and Chronicles
Clinical informatics engineers and CMIOs evaluating Abridge alongside DAX Copilot (Microsoft Dragon Copilot) examine how the integration interacts with Epic’s database and API tiers:
| Workflow Layer | Epic Component | Abridge Component | Security, Provenance & Data-Flow Standard |
|---|---|---|---|
| Mobile Encounter Context & Audio Capture | Epic Haiku (iOS/Android) / Epic Canto (iPad) Ambient SDK | Embedded Abridge Inside audio capture module | Binds audio stream to Epic Patient FHIR ID and Encounter CSN; ephemeral encrypted buffer |
| Speech-to-Text & Clinical Reasoning | Outbound TLS 1.3 stream via Epic Interconnect | Abridge medical ASR, speaker diarization & clinical LLM pipeline | Governed by HIPAA Business Associate Agreement (BAA); separates Subjective vs. Objective vs. A&P |
| Draft Note Delivery to EHR | Epic Incoming Ambient Data APIs / HL7 FHIR `DocumentReference` | Structured section payload (`HPI`, `PE`, `A&P`, `AVS`) + timestamp anchors | Stages draft sections inside Epic Chronicles without overwriting signed notes; requires clinician attestation |
| Hallucination & Omission Auditing | Hyperspace / Hyperdrive embedded web view pane | Linked Evidence (bidirectional sentence-to-transcript/audio index) | Maps every generated medical concept to millisecond audio offsets `[t_start, t_end]` |
| Point-of-Care Clinical Decision Support | Assessment & Plan review workspace | Abridge + Wolters Kluwer UpToDate integration | Surfaces contextual UpToDate evidence and clinical reference topics matched to encounter problems |
Abridge and UpToDate Integration: Point-of-Care Clinical Decision Support (CDS)
A major clinical informatics milestone in ambient documentation is the integration between Abridge and Wolters Kluwer Health’s UpToDate. Historically, ambient AI scribes functioned purely as passive transcription and summarization tools, while clinicians had to open a separate browser tab to search UpToDate for diagnostic workups, guideline-directed medical therapy, or renal dosing adjustments.
Through the Abridge–UpToDate collaboration:
- Contextual Problem Matching: As Abridge extracts the patient’s active symptoms, comorbidities, and differential diagnoses from the encounter dialogue to build the problem-oriented Assessment & Plan, the platform identifies the clinical questions raised during the visit.
- Grounded Evidence Links: Within the clinician review workflow, Abridge surfaces curated, peer-reviewed UpToDate clinical topics and treatment pathways directly tied to the patient’s documented problems—ensuring that clinical decision support is anchored in Wolters Kluwer’s editorial evidence rather than unverified generative LLM pre-training weights.
Practical Best Practices and Governance Rules for Clinicians Using Abridge in Epic
- Verbalizing Physical Exam Findings Aloud: Because an ambient microphone cannot see silent inspection or palpation, clinicians should narrate key positive and negative physical examination findings aloud to the patient during the exam (e.g., “Your lungs are clear to auscultation bilaterally, and there is no lower-extremity pitting edema”) so Abridge populates the Physical Exam section accurately.
- Summarizing the Plan with the Patient: Closing the encounter with a structured teach-back summary of each problem and medication change simultaneously populates both the problem-oriented Assessment & Plan and the patient-friendly After Visit Summary (AVS) instructions.
- Mandatory Clinician Attestation & CMS Compliance: Under CMS Medicare documentation rules, an ambient AI draft is unverified staging text until the billing practitioner reviews, edits, and electronically signs the encounter note. Health systems should audit Linked Evidence utilization and retain audio/transcript logs according to their defined retention window (typically 7 to 30 days for quality assurance before automated purge).
Frequently Asked Questions
How do you use Abridge in Epic?
To use Abridge in Epic under the native “Abridge Inside” integration: (1) Open Epic Haiku (smartphone) or Epic Canto (tablet) and select the patient encounter from your schedule; (2) Obtain verbal or written patient consent according to hospital policy and tap the embedded Ambient / Abridge microphone icon to record the conversation (pausing and resuming if interrupted); (3) Tap “End Recording” when the visit concludes to trigger cloud ASR and clinical note generation; (4) Open the encounter in Epic Hyperspace or Hyperdrive on your desktop, pull the structured HPI, Physical Exam, Assessment & Plan, and Patient Instructions into your note template via Epic Ambient SmartSections or SmartLinks, verify key statements using Linked Evidence, and sign the note.
How does the Abridge and UpToDate integration work inside Epic workflows?
Through the collaboration between Wolters Kluwer Health and Abridge, UpToDate evidence-based clinical decision support (CDS) is surfaced contextually alongside Abridge’s ambient clinical documentation workflow. As Abridge structures the patient’s clinical problems, medications, and differential diagnosis into the draft Assessment & Plan, clinicians can access context-relevant UpToDate clinical topics, diagnostic criteria, and treatment recommendations at the point of care while reviewing their note.
Sources
- Abridge AI, Inc. Abridge Enterprise Ambient AI Platform: Native Epic Haiku, Canto, and Hyperspace Integration & Linked Evidence.
- Wolters Kluwer Health. Wolters Kluwer and Abridge Collaborate to Integrate UpToDate into Ambient Clinical Workflows.
- Tierney AA, Gayre G, Hoberman B, et al. Ambient Artificial Intelligence Scribes to Alleviate the Burden of Clinical Documentation. NEJM Catalyst Innovations in Care Delivery (2024).
