Ambient AI Should Strengthen the Entire Care Team — Not Just the Physician
By Dr. Matt Sakumoto, Chief Clinical Product Officer, Nabla
Matt Sakumoto is Chief Clinical Product Officer at Nabla, and a virtualist primary care physician in North Carolina. He is also fellowship-trained in clinical informatics at UCSF, with a focus on virtual care and clinician efficiency tools for the EHR. With prior roles as regional CMIO and as a clinician-advisor to many early-stage health tech companies, he is passionate about exploring and implementing effective and evidence-based AI into clinical workflows.
In primary care, no visit is truly one-on-one. Even when it looks that way in the exam room, it’s the product of a coordinated team — medical assistants rooming the patient, nurses reconciling medications, referral coordinators tracking follow-ups, and front-desk staff managing access. Yet our documentation systems have historically centered the physician as the sole author and bottleneck of the clinical story. Ambient AI gives us an opportunity to rethink that model, not just to reduce after-hours charting, but to better support the full care team.
When I practice primary care, I see firsthand how documentation delays affect everyone downstream. If I started a patient on a new insulin regimen, the nurse educator couldn’t begin medication teaching until my note and orders were finalized. If I adjusted heart failure medications, care managers needed clarity in the assessment and plan before calling the patient for follow-up. Even something as routine as coordinating imaging or specialty referrals depended on a complete, signed note. When documentation was delayed until the evening, or worse—days later — the entire care workflow slowed with it and necessary information was sometimes missed.
I remember caring for a patient with poorly controlled diabetes and depression. We initiated a new GLP-1 medication, adjusted antidepressants, and scheduled close follow-up. The nurse educator needed to review injection technique and side effects. Our behavioral health colleague needed clarity on medication changes. The front desk needed explicit follow-up timing. Capturing that complexity accurately, often after a full day of patients, was cognitively taxing and details were easily missed. An ambient AI system that drafts a structured, comprehensive note in real time ensures that the full care plan is visible immediately. It allows the team to move forward the same day, not days later.
Ambient AI also improves the fidelity of team-based documentation. In many visits, medical assistants or nurses capture critical context like worsening symptoms, adherence challenges or social barriers that may not always make it fully into the physician’s final note when time is tight. Sometimes concerning symptoms may be captured that relate to a problem other than the main reason for visit. By capturing the full clinical conversation, ambient systems better reflect the contributions of the entire team. That shared visibility strengthens coordination, accountability, and ultimately patient outcomes.
The promise of ambient AI isn’t just fewer clicks or shorter evenings spent charting. It’s removing documentation as a bottleneck in team-based care. In primary care especially, timely information is what enables nurse educators to teach, care managers to follow up, and coordinators to close the loop. When documentation keeps pace with the visit, the entire team can facilitate smooth transitions of care and patients feel the difference.
