The Promise of AI in Electronic Health Records is Here

Early adopters capitalize on Epic’s generative AI capabilities as its potential grows—while addressing strategy and governance needs.

There is near-universal acknowledgment that generative artificial intelligence (GenAI) represents a revolution in our society with an immense potential impact on most industries, including healthcare delivery. AI overall is at the heart of several megatrends Guidehouse has identified, including the need to accelerate innovation and tech, optimize an adaptable workforce, and maximize data.

However, in our recent report on The State of GenAI, produced in partnership with CDO Magazine, more than three-quarters of data and IT leaders surveyed say their organization is not fully equipped to harness GenAI today.

While the healthcare industry is emerging at the forefront of this new frontier, its leaders recognize the significant obstacles they face in successfully capitalizing on GenAI’s promise. From addressing ethical concerns over data privacy to meeting evolving regulatory compliance, organizations of all sizes anticipate a struggle to integrate GenAI into existing governance structures, business processes, and workflows.


GenAI and EHRs: A Transformational Marriage

One area that can benefit the most from this technology as it evolves is the electronic health record (EHR). For many health systems and providers, the single biggest opportunity for organizational improvement is through optimal EHR operationalization. A well-tuned EHR can provide a significant lift to operating revenue by improving provider and patient engagement, throughput, and productivity.

In just a very short time, AI developments have already demonstrated great potential for transforming how healthcare providers interact with their EHR systems, from clinical and administrative functions to patient self-service and billing solutions. As health systems look at embedding more digital health tools into how they operate, they need just the right balance of culture and technology metamorphosis.

When implemented successfully with full consideration of operational workflows, EHRs can be further leveraged to serve as a comprehensive digital operating system overseeing the multidisciplinary functions involved with providing high-quality, cost-effective patient care while improving caregiver efficiencies and experiences.


Epic’s Pathway to AI Optimization

Leaders need to look no further than industry stalwart Epic Systems to find a host of GenAI features currently embedded in its EHR software and emerging on the horizon to help them achieve that high-efficiency digital operating system. Epic is currently being used by every health system on U.S. News & World Report's best hospitals list, and more than 90% of medical students and residents now train on it.1,2

Because of this marketplace dominance, the company is better positioned to focus on development and integration into its existing EHR platform than seeking outside bolt-on solutions. This all-in-one approach is expected to continue as Epic moves dozens of GenAI capabilities across the EHR from clinical to revenue cycle workstreams.

Guidehouse has been on the forefront of this revolution, supporting clients as they plan for, adopt, and successfully implement Epic’s growing suite of GenAI-powered tools.


Intel for Current and Prospective Adopters

Whether you’re using Epic for your EHR or considering switching vendors, it’s important to know what’s happening now and what’s coming down the pike.3

HIPAA-compliant cybersecurity protections and the latest large language models such as GPT-4, are already in place. With GenAI seamlessly integrated into Epic’s EHR, the system can:4

  • Draft personalized responses to patient messages
  • Gather information from prior nursing shifts and generate hand-off summaries
  • Use ambient listening during patient visits to accurately record information so that providers can focus on listening and interacting without worrying about documenting what’s said
  • Write patient summaries with links to full details in their charts to help clinicians get up to speed quickly
  • Build queries based on plain-language questions through SlicerDicer Sidekick


An Epic Roadmap for 2024 and Beyond

In current development, with anticipated release dates in parentheses, is the ability for Epic’s GenAI-driven software to:

  • Draft utilization review summaries and find clinical documentation improvement opportunities (May 2024)
  • Draft denial appeal letters and queue up orders mentioned during the visit via ambient listening (August 2024)
  • Answer patient billing questions and transform letters, patient instructions, and patient message responses into plain language (November 2024)

The company has also developed its “AI Trust and Assurance Suite”—AI validation software designed to empower healthcare organizations to effectively monitor both customized AI models and ones from third-party vendors. The open-source software will be publicly available later this summer, along with a common monitoring template and data schema to allow for scalability and adaptability as new AI technologies emerge.

As it actively collaborates with giants such as Amazon, Apple, Google, and Microsoft on new features, Epic continues to improve its foundational system to incorporate preconfigured best practices so that providers can focus on other priorities and customization needs. Other use cases being considered include deeper code recommendation automation, level-of-service calculations from clinical details, clinical risk adjustment identification, and content generation for organizational campaigns.


Considerations to Keep in Mind

Of course, any moves toward greater use of GenAI-enabled technology must be done with strong governance in place. As you evolve your organization’s change management strategy, consider where decentralization might activate innovation. Where could new talent for the future of change be beneficial?

For some health systems where Epic is already in place, it may be best to review and adopt its native solutions first, then evaluate external vendors to see where they can effectively fill gaps when necessary while remaining interoperable. In those cases, leveraging the company’s forthcoming AI validation software can provide near real-time metrics and analysis to ensure accuracy and equity.

Most importantly, adopting new EHR solutions requires cultivating an agile culture capable of nimble adaptation. This helps improve teamwork, accelerate invention cycles, and respond more quickly to the rapidly evolving AI and healthcare data landscape.


Optimizing GenAI in Healthcare

With GenAI transforming not just EHR management but the larger healthcare IT landscape, health systems whose IT resources are already often stretched thin need support to avoid becoming overwhelmed.

Guidehouse has helped hospitals, health systems, government agencies, payers, life sciences companies, and retail organizations navigate tech-enabled guardrails, governance, and change management to ensure they can navigate and thrive in this rapidly changing space. This includes optimizing internal processes, empowering employees with data-driven intelligence, and delivering consumer-centric products and services.

Echo Alexzander, Managing Consultant

Ariella Nathanson, Managing Consultant

Matt Onesko, Partner

1. Talaga, Rosie. “Which EHRs Do US News’ Honor Roll Hospitals Use?”, 4 Aug. 2023,
2. Bruce, Giles. “How Epic Won over Academic Medical Centers.”, 24 Oct. 2023,
3. Diaz, Naomi. “A Glimpse into Epic’s 2024 Strategy.”, 29 Dec. 2023,
4. “Cool Stuff Now: Epic and Generative AI | Epic.”,
5. “Epic to Release AI Validation Software.”, 3 Apr. 2024,

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