Brendan Fortuner from Ambience Healthcare and Ben Shahshahani from Cleveland Clinic discuss how AI is transforming medical documentation and coding in a healthcare system that spends $1 trillion annually on administrative tasks. They explore Ambience's technical breakthrough using OpenAI's Reinforcement Fine-Tuning to achieve medical coding accuracy that exceeds human doctors by 12 percentage points, including their specialty-by-specialty approach and solutions to reward hacking behavior. The conversation reveals key insights about AI deployment strategy, including how Cleveland Clinic achieved 75% voluntary adoption across 4,000 physicians after requiring just a single use of the AI scribe. This case study demonstrates what it takes to successfully implement AI tools in complex, high-stakes healthcare environments where user skepticism and regulatory requirements create significant deployment challenges. Oracle Cloud Infrastructure: Oracle Cloud Infrastructure (OCI) is the next-generation cloud that delivers better performance, faster speeds, and significantly lower costs, including up to 50% less for compute, 70% for storage, and 80% for networking. Run any workload, from infrastructure to AI, in a high-availability environment and try OCI for free with zero commitment at The AGNTCY: The AGNTCY is an open-source collective dedicated to building the Internet of Agents, enabling AI agents to communicate and collaborate seamlessly across frameworks. Join a community of engineers focused on high-quality multi-agent software and support the initiative at NetSuite by Oracle: NetSuite by Oracle is the AI-powered business management suite trusted by over 42,000 businesses, offering a unified platform for accounting, financial management, inventory, and HR. Gain total visibility and control to make quick decisions and automate everyday tasks—download the free ebook, Navigating Global Trade: Three Insights for Leaders, at (04:05) Introduction and Backstory (05:20) Ambiance Healthcare Overview (07:53) AI Adoption in Healthcare

(11:11) Documentation Pain Points (Part 1) (16:11) Sponsors: Oracle Cloud Infrastructure | The AGNTCY (18:11) Documentation Pain Points (Part 2) (19:00) Product Architecture Deep Dive (26:23) Technical Evolution and Specialization (Part 1) (32:05) Sponsor: NetSuite by Oracle (33:28) Technical Evolution and Specialization (Part 2)

(33:50) Healthcare Coding Challenges (48:37) Reinforcement Fine-Tuning Implementation (58:13) Task Prioritization Framework (01:08:40) Adoption Strategies Culture (01:12:12) Cost Lessons Grader Selection (01:18:33) Future Directions Patient Products (01:24:53) Closing Thoughts Opportunities

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