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Attendees at HIMSS in Orlando, Florida 2024.

Courtesy of HIMSS

The hottest new technology for doctors promises to bring back an age-old health-care practice: face-to-face conversations with patients.

As more than 30,000 health and tech professionals gathered among the palm trees at the HIMSS conference in Orlando, Florida, this week, ambient clinical documentation was the talk of the exhibition floor. 

This technology allows doctors to consensually record their visits with patients. The conversations are automatically transformed into clinical notes and summaries using artificial intelligence. Companies like Microsoft’s Nuance Communications, Abridge and Suki have developed solutions with these capabilities, which they argue will help reduce doctors’ administrative workloads and prioritize meaningful connections with patients. 

“After I see a patient, I have to write notes, I have to place orders, I have to think about the patient summary,” Dr. Shiv Rao, founder and CEO of Abridge, told CNBC at HIMSS. “So what our technology does is it allows me to focus on the person in front of me — the most important person, the patient — because when I hit start, have a conversation, then hit stop, I can swivel my chair and within seconds, the note’s there.” 

Administrative workloads are a major problem for clinicians across the U.S. health-care system. A survey published by Athenahealth in February found that more than 90% of physicians report feeling burned out on a “regular basis,” largely because of the paperwork they are expected to complete. 

More than 60% of doctors said they feel overwhelmed by clerical requirements and work an average of 15 hours per week outside their normal hours to keep up, the survey said. Many in the industry call this at-home work “pajama time.” 

Since administrative work is mostly bureaucratic and doesn’t directly influence doctors’ decisions around diagnoses or patient care, it has served as one of the first areas where health systems have seriously begun to explore applications of generative AI. As a result, ambient clinical documentation solutions are having a real moment in the sun. 

“There isn’t a better place to be,” Kenneth Harper, general manager of DAX Copilot at Microsoft, told CNBC in an interview. 

Microsoft’s Nuance announced its ambient clinical documentation tool Dragon Ambient eXperience (DAX) Express in a preview capacity last March. By September, the solution, now called DAX Copilot, was generally available. Harper said there are now more than 200 organizations using the technology. 

Microsoft acquired Nuance for around $16 billion in 2021. The company had a two-story exhibition booth in the exhibit hall that was often packed with attendees

Harper said the technology saves doctors several minutes per encounter, though the exact numbers vary depending on the specialty. He said his team gets feedback about the service almost daily from doctors who claim it has helped them take better care of themselves — and even saved their marriages.

Doctors using A.I. to fight burnout: Apps for medical record technology

Harper recounted a conversation with one physician who was considering retirement after practicing for more than three decades. He said the doctor was feeling worn out from years of stress, but he was inspired to keep working after he was introduced to DAX Copilot. 

“He said, ‘I literally think I’m going to practice for another 10 years because I actually enjoy what I do,'” Harper said. “That’s just a personal anecdote of the type of impact this is having on our care teams.” 

At HIMSS, Stanford Health Care announced it is deploying DAX Copilot across its entire enterprise. 

Gary Fritz, chief of applications at Stanford Health Care, said the organization had initially started by testing the tool within its exam rooms. He said Stanford recently surveyed physicians about their use of DAX Copilot and 96% found it easy to use. 

“I don’t know that I’ve ever seen that big a number,” Fritz told CNBC in an interview. “It is a big deal.”

Dr. Christopher Sharp, chief medical information officer at Stanford Health Care and one of the physicians who tested DAX Copilot, said it is “remarkably seamless” to use. He said the tool’s immediacy and reliability are accurate and strong but could improve at capturing a patient’s tone. 

Sharp said he thinks the tool saves him documentation time and has changed how he spends that time. He said he is often reading and editing notes instead of composing them, for instance, so it is not as though the work has disappeared entirely.

In the near term, Sharp said he’d like to see more capabilities for personalization within DAX Copilot, both at an individual and specialty level. Even so, he said it was easy to see the value of it from the start.

“The moment that that first document returns to you, and you see your own words and the patient’s own words being reflected directly back to you in a usable fashion, I would say that from that moment, you’re hooked,” Sharp told CNBC in an interview.

Fritz said it is still early in the product life cycle, and Stanford Health Care is still working out exactly what deployment will look like. He said DAX Copilot will likely roll out in specialty-specific tranches. 

Attendees at HIMSS in Orlando, Florida 2024.

Courtesy of HIMSS

In January, Nuance announced the general availability of DAX Copilot within Epic Systems’ electronic health record (EHR). Most doctors create and manage patient medical records using EHRs, and Epic is the largest vendor by hospital market share in the U.S., according to a May report from KLAS Research

Integrating a tool like DAX Copilot directly into doctors’ EHR workflow means they won’t need to switch apps to access it, which helps save time and reduce their clerical burden even further, Harper said. 

Seth Hain, senior vice president of R&D at Epic, told CNBC that more than 150,000 notes have been drafted into the company’s software by ambient technologies since the HIMSS conference last year. And the technology is scaling fast. Hain said more notes have already been drafted in 2024 than in 2023.

“You’re seeing health systems who have worked through an intentional process of acclimating their end users to this type of technology, now beginning to rapidly roll that out,” he said. 

A company named Abridge also integrates its ambient clinical documentation technology directly within Epic. Abridge declined to share the exact number of health organizations using its technology. It announced at HIMSS that California-based UCI Health is rolling out the company’s solution system-wide. 

Rao, the CEO of Abridge, said the rate at which the health-care industry has adopted ambient clinical documentation feels “historic.” 

Abridge announced a $30 million Series B funding round in October, led by Spark Capital, and four months later, the company closed a $150 million Series C round, according to a February release. Rao said tail winds like physician burnout have turned into a “tornado” for Abridge, and it will use these funds to continue to invest in the science behind the technology and explore where it can go next. 

The company is saving some doctors as much as three hours a day, Rao said, and is automating more than 92% of the clerical work it focuses on. Abridge’s technology is live across 55 specialties and 14 languages, he added. 

Abridge has a Slack channel called “love stories,” which was viewed by CNBC, where the team will share the positive feedback they get about their technology. One message from this week was from a doctor who said Abridge helped them take their least favorite part of their job away and saves them around an hour and a half each day.

“That’s the type of feedback that absolutely inspires everybody in the company,” Rao said.

Suki CEO Punit Soni said the ambient clinical documentation market is “sizzling.” He expects rapid growth to continue through the next couple of years, though, like all hype cycles, he said he thinks the dust will settle.

Soni founded Suki more than six years ago after hypothesizing that there would be a need for a digital assistant to help doctors manage clinical documentation. Soni said Suki is now used by more than 30 specialties in around 250 health organizations nationwide. Six “large health systems” have gone live with Suki in the past two weeks, he added. 

“For four to five years I’ve sat around, basically with the shop open, hoping somebody will show up. Now the entire mall is here, and there’s a line outside the door of people wanting to deploy, ” Soni told CNBC at HIMSS. “It’s very, very exciting to be here.”

Suki’s website says its technology can reduce the time a physician spends on documentation by an average of 72%. The company raised a $55 million funding round in 2021 led by March Capital. It will likely raise another round in the latter half of the year, Soni said.

Soni said Suki is focused on deploying its technology at scale and exploring additional applications, like how ambient documentation could be used to assist nurses. He said the Spanish language is coming to Suki soon, and customers should expect most major languages to follow. 

“There is so much that has to happen,” he said. “In the next decade, all of health-care tech is going to look completely different.”

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How Elon Musk’s plan to slash government agencies and regulation may benefit his empire

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How Elon Musk’s plan to slash government agencies and regulation may benefit his empire

Elon Musk’s business empire is sprawling. It includes electric vehicle maker Tesla, social media company X, artificial intelligence startup xAI, computer interface company Neuralink, tunneling venture Boring Company and aerospace firm SpaceX. 

Some of his ventures already benefit tremendously from federal contracts. SpaceX has received more than $19 billion from contracts with the federal government, according to research from FedScout. Under a second Trump presidency, more lucrative contracts could come its way. SpaceX is on track to take in billions of dollars annually from prime contracts with the federal government for years to come, according to FedScout CEO Geoff Orazem.

Musk, who has frequently blamed the government for stifling innovation, could also push for less regulation of his businesses. Earlier this month, Musk and former Republican presidential candidate Vivek Ramaswamy were tapped by Trump to lead a government efficiency group called the Department of Government Efficiency, or DOGE.

In a recent commentary piece in the Wall Street Journal, Musk and Ramaswamy wrote that DOGE will “pursue three major kinds of reform: regulatory rescissions, administrative reductions and cost savings.” They went on to say that many existing federal regulations were never passed by Congress and should therefore be nullified, which President-elect Trump could accomplish through executive action. Musk and Ramaswamy also championed the large-scale auditing of agencies, calling out the Pentagon for failing its seventh consecutive audit. 

“The number one way Elon Musk and his companies would benefit from a Trump administration is through deregulation and defanging, you know, giving fewer resources to federal agencies tasked with oversight of him and his businesses,” says CNBC technology reporter Lora Kolodny.

To learn how else Elon Musk and his companies may benefit from having the ear of the president-elect watch the video.

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Why X’s new terms of service are driving some users to leave Elon Musk’s platform

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Why X's new terms of service are driving some users to leave Elon Musk's platform

Elon Musk attends the America First Policy Institute gala at Mar-A-Lago in Palm Beach, Florida, Nov. 14, 2024.

Carlos Barria | Reuters

X’s new terms of service, which took effect Nov. 15, are driving some users off Elon Musk’s microblogging platform. 

The new terms include expansive permissions requiring users to allow the company to use their data to train X’s artificial intelligence models while also making users liable for as much as $15,000 in damages if they use the platform too much. 

The terms are prompting some longtime users of the service, both celebrities and everyday people, to post that they are taking their content to other platforms. 

“With the recent and upcoming changes to the terms of service — and the return of volatile figures — I find myself at a crossroads, facing a direction I can no longer fully support,” actress Gabrielle Union posted on X the same day the new terms took effect, while announcing she would be leaving the platform.

“I’m going to start winding down my Twitter account,” a user with the handle @mplsFietser said in a post. “The changes to the terms of service are the final nail in the coffin for me.”

It’s unclear just how many users have left X due specifically to the company’s new terms of service, but since the start of November, many social media users have flocked to Bluesky, a microblogging startup whose origins stem from Twitter, the former name for X. Some users with new Bluesky accounts have posted that they moved to the service due to Musk and his support for President-elect Donald Trump.

Bluesky’s U.S. mobile app downloads have skyrocketed 651% since the start of November, according to estimates from Sensor Tower. In the same period, X and Meta’s Threads are up 20% and 42%, respectively. 

X and Threads have much larger monthly user bases. Although Musk said in May that X has 600 million monthly users, market intelligence firm Sensor Tower estimates X had 318 million monthly users as of October. That same month, Meta said Threads had nearly 275 million monthly users. Bluesky told CNBC on Thursday it had reached 21 million total users this week.

Here are some of the noteworthy changes in X’s new service terms and how they compare with those of rivals Bluesky and Threads.

Artificial intelligence training

X has come under heightened scrutiny because of its new terms, which say that any content on the service can be used royalty-free to train the company’s artificial intelligence large language models, including its Grok chatbot.

“You agree that this license includes the right for us to (i) provide, promote, and improve the Services, including, for example, for use with and training of our machine learning and artificial intelligence models, whether generative or another type,” X’s terms say.

Additionally, any “user interactions, inputs and results” shared with Grok can be used for what it calls “training and fine-tuning purposes,” according to the Grok section of the X app and website. This specific function, though, can be turned off manually. 

X’s terms do not specify whether users’ private messages can be used to train its AI models, and the company did not respond to a request for comment.

“You should only provide Content that you are comfortable sharing with others,” read a portion of X’s terms of service agreement.

Though X’s new terms may be expansive, Meta’s policies aren’t that different. 

The maker of Threads uses “information shared on Meta’s Products and services” to get its training data, according to the company’s Privacy Center. This includes “posts or photos and their captions.” There is also no direct way for users outside of the European Union to opt out of Meta’s AI training. Meta keeps training data “for as long as we need it on a case-by-case basis to ensure an AI model is operating appropriately, safely and efficiently,” according to its Privacy Center. 

Under Meta’s policy, private messages with friends or family aren’t used to train AI unless one of the users in a chat chooses to share it with the models, which can include Meta AI and AI Studio.

Bluesky, which has seen a user growth surge since Election Day, doesn’t do any generative AI training. 

“We do not use any of your content to train generative AI, and have no intention of doing so,” Bluesky said in a post on its platform Friday, confirming the same to CNBC as well.

Liquidated damages

Bluesky CEO: Our platform is 'radically different' from anything else in social media

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The Pentagon’s battle inside the U.S. for control of a new Cyber Force

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The Pentagon's battle inside the U.S. for control of a new Cyber Force

A recent Chinese cyber-espionage attack inside the nation’s major telecom networks that may have reached as high as the communications of President-elect Donald Trump and Vice President-elect J.D. Vance was designated this week by one U.S. senator as “far and away the most serious telecom hack in our history.”

The U.S. has yet to figure out the full scope of what China accomplished, and whether or not its spies are still inside U.S. communication networks.

“The barn door is still wide open, or mostly open,” Senator Mark Warner of Virginia and chairman of the Senate Intelligence Committee told the New York Times on Thursday.

The revelations highlight the rising cyberthreats tied to geopolitics and nation-state actor rivals of the U.S., but inside the federal government, there’s disagreement on how to fight back, with some advocates calling for the creation of an independent federal U.S. Cyber Force. In September, the Department of Defense formally appealed to Congress, urging lawmakers to reject that approach.

Among one of the most prominent voices advocating for the new branch is the Foundation for Defense of Democracies, a national security think tank, but the issue extends far beyond any single group. In June, defense committees in both the House and Senate approved measures calling for independent evaluations of the feasibility to create a separate cyber branch, as part of the annual defense policy deliberations.

Drawing on insights from more than 75 active-duty and retired military officers experienced in cyber operations, the FDD’s 40-page report highlights what it says are chronic structural issues within the U.S. Cyber Command (CYBERCOM), including fragmented recruitment and training practices across the Army, Navy, Air Force, and Marines.

“America’s cyber force generation system is clearly broken,” the FDD wrote, citing comments made in 2023 by then-leader of U.S. Cyber Command, Army General Paul Nakasone, who took over the role in 2018 and described current U.S. military cyber organization as unsustainable: “All options are on the table, except the status quo,” Nakasone had said.

Concern with Congress and a changing White House

The FDD analysis points to “deep concerns” that have existed within Congress for a decade — among members of both parties — about the military being able to staff up to successfully defend cyberspace. Talent shortages, inconsistent training, and misaligned missions, are undermining CYBERCOM’s capacity to respond effectively to complex cyber threats, it says. Creating a dedicated branch, proponents argue, would better position the U.S. in cyberspace. The Pentagon, however, warns that such a move could disrupt coordination, increase fragmentation, and ultimately weaken U.S. cyber readiness.

As the Pentagon doubles down on its resistance to establishment of a separate U.S. Cyber Force, the incoming Trump administration could play a significant role in shaping whether America leans toward a centralized cyber strategy or reinforces the current integrated framework that emphasizes cross-branch coordination.

Known for his assertive national security measures, Trump’s 2018 National Cyber Strategy emphasized embedding cyber capabilities across all elements of national power and focusing on cross-departmental coordination and public-private partnerships rather than creating a standalone cyber entity. At that time, the Trump’s administration emphasized centralizing civilian cybersecurity efforts under the Department of Homeland Security while tasking the Department of Defense with addressing more complex, defense-specific cyber threats. Trump’s pick for Secretary of Homeland Security, South Dakota Governor Kristi Noem, has talked up her, and her state’s, focus on cybersecurity.

Former Trump officials believe that a second Trump administration will take an aggressive stance on national security, fill gaps at the Energy Department, and reduce regulatory burdens on the private sector. They anticipate a stronger focus on offensive cyber operations, tailored threat vulnerability protection, and greater coordination between state and local governments. Changes will be coming at the top of the Cybersecurity and Infrastructure Security Agency, which was created during Trump’s first term and where current director Jen Easterly has announced she will leave once Trump is inaugurated.

Cyber Command 2.0 and the U.S. military

John Cohen, executive director of the Program for Countering Hybrid Threats at the Center for Internet Security, is among those who share the Pentagon’s concerns. “We can no longer afford to operate in stovepipes,” Cohen said, warning that a separate cyber branch could worsen existing silos and further isolate cyber operations from other critical military efforts.

Cohen emphasized that adversaries like China and Russia employ cyber tactics as part of broader, integrated strategies that include economic, physical, and psychological components. To counter such threats, he argued, the U.S. needs a cohesive approach across its military branches. “Confronting that requires our military to adapt to the changing battlespace in a consistent way,” he said.

In 2018, CYBERCOM certified its Cyber Mission Force teams as fully staffed, but concerns have been expressed by the FDD and others that personnel were shifted between teams to meet staffing goals — a move they say masked deeper structural problems. Nakasone has called for a CYBERCOM 2.0, saying in comments early this year “How do we think about training differently? How do we think about personnel differently?” and adding that a major issue has been the approach to military staffing within the command.

Austin Berglas, a former head of the FBI’s cyber program in New York who worked on consolidation efforts inside the Bureau, believes a separate cyber force could enhance U.S. capabilities by centralizing resources and priorities. “When I first took over the [FBI] cyber program … the assets were scattered,” said Berglas, who is now the global head of professional services at supply chain cyber defense company BlueVoyant. Centralization brought focus and efficiency to the FBI’s cyber efforts, he said, and it’s a model he believes would benefit the military’s cyber efforts as well. “Cyber is a different beast,” Berglas said, emphasizing the need for specialized training, advancement, and resource allocation that isn’t diluted by competing military priorities.

Berglas also pointed to the ongoing “cyber arms race” with adversaries like China, Russia, Iran, and North Korea. He warned that without a dedicated force, the U.S. risks falling behind as these nations expand their offensive cyber capabilities and exploit vulnerabilities across critical infrastructure.

Nakasone said in his comments earlier this year that a lot has changed since 2013 when U.S. Cyber Command began building out its Cyber Mission Force to combat issues like counterterrorism and financial cybercrime coming from Iran. “Completely different world in which we live in today,” he said, citing the threats from China and Russia.

Brandon Wales, a former executive director of the CISA, said there is the need to bolster U.S. cyber capabilities, but he cautions against major structural changes during a period of heightened global threats.

“A reorganization of this scale is obviously going to be disruptive and will take time,” said Wales, who is now vice president of cybersecurity strategy at SentinelOne.

He cited China’s preparations for a potential conflict over Taiwan as a reason the U.S. military needs to maintain readiness. Rather than creating a new branch, Wales supports initiatives like Cyber Command 2.0 and its aim to enhance coordination and capabilities within the existing structure. “Large reorganizations should always be the last resort because of how disruptive they are,” he said.

Wales says it’s important to ensure any structural changes do not undermine integration across military branches and recognize that coordination across existing branches is critical to addressing the complex, multidomain threats posed by U.S. adversaries. “You should not always assume that centralization solves all of your problems,” he said. “We need to enhance our capabilities, both defensively and offensively. This isn’t about one solution; it’s about ensuring we can quickly see, stop, disrupt, and prevent threats from hitting our critical infrastructure and systems,” he added.

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