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Remodeling the nursing workflow with ambient voice and AI


The nursing workflow is unique—and any solutions developed for nurses must be purpose-built to integrate with the way in which they work. That’s why we placed the voice of nurses at the center of our ongoing work to design and develop a solution that augments nurses’ daily workflows and is now in the hands of nurses across multiple provider organizations.

Growing demand, excessive documentation requirements, and inefficient workflows are all contributing to nurses’ exhaustion, feelings of burnout, and high turnover rates.

Based on recent conversations I’ve had with nursing executives, one thing is crystal clear: to make a real difference for patients and clinicians, innovation needs to flow throughout the care continuum—and the nursing workflow is no exception. It is the most ubiquitous given nurses comprise the largest workforce in healthcare.

With 32% of nurses planning to exit the US workforce this year1 and the World Health Organization (WHO) predicting a shortage of 4.5 million nurses by 2030,2 the urgency to deliver technology to support the nursing profession is felt more than ever.

Nursing info hub

Empower nurses to efficiently document care

Listening to nurses’ voices

The people who truly understand the intricacies and challenges of nursing workflows are those who live and breathe it every day. To build an innovative solution that’s impactful, nurses and their leadership need to be the guiding light of the process, from design to launch and all the way through to successful adoption by the workforce.

As Lea Ann Arnold, Director of Nursing Informatics at Northwestern Medicine, explains:

“Nurses need to be at the table. They need to be a voice; they need to be able to help technology teams figure out you can’t just put a solution out there. You must get into the actual workflows and understand how nurses work.”

Lea Ann Arnold, Director of Nursing Informatics at Northwestern Medicine

Terry McDonnell, Senior Vice President and Chief Nursing Executive at Duke Health, agrees: “The number one key in ensuring that any technology is going to be successful or useful for nurses is to really involve nurses in the design.”

“Setting nurses up for success and making sure that they are part of the solution is crucial. We cannot expect them to accept a solution just because we think it is the way to do it. We need to bring nurses along with the decision and make sure they feel that they understand how to use the technology,” said Tammy Daniel, Senior Vice President and Chief Nursing Officer at Baptist Health of Northeast Florida.

AI in the nursing workflow

AI is rapidly evolving technology, and it’s crucial that its powers are extended to nursing workflows. Nurses need to manage their workloads in a way that doesn’t lead to increased stress and burnout, allowing nurses to focus their energy on patient care.

“It’s so critical for our nurses to understand AI,” says Arnold. “Then they start to realize that that adding AI is not meant to replace the human factor, but it’s really meant to augment and take off that work that could be done by a machine.”

Microsoft is committed to empowering customers with cutting-edge tools designed to harness the power of generative AI. Our dedication to innovation continues in our latest investment in industry-specific solutions that enable businesses to adopt and integrate AI technologies swiftly and efficiently. We are seizing the remarkable opportunity that AI presents in healthcare, propelling the industry towards a transformative future.

Creating a purpose-built solution with nurses at the table

Though physicians and nurses work closely together to treat and care for patients, the working day of a nurse looks very different to that of a physician, and nursing documentation workflow is likewise separate and distinct. Nurses are mobile during their shift, moving between rooms to see their patients. They have bedside conversations and capture patient information in highly structured formats such as flowsheets.

Microsoft has been on a multi-year journey to address the challenge of nursing documentation and complex workflows with sophisticated AI to build a solution we’ve deployed at multiple customers.

We gathered feedback from hundreds of frontline nurses, nurse managers, and executives. Our team has spent hours shadowing nurses during their shifts to see how they carry out their tasks and to discover where the greatest points of friction exist throughout their day.

We established the ambient category five years ago for physician documentation and now hundreds of organizations use our AI capabilities for clinical workflow. We are building on that success and defining the standard for AI in nursing.

“Patients are complex, and we need to think about how we’re going to document differently—because ultimately the value of nursing is back at the bedside, it is not the taxing work of documenting in a flowsheet. With the work that Microsoft has done with providers, I was very excited to be chosen as one of the pilot sites to truly inform that roadmap.”

Gretchen Brown, Chief Nursing Information Officer at Stanford Health Care

We are actively collaborating with several leading healthcare organizations—including Advocate Health, Baptist Health of Northeast Florida, Duke Health, Intermountain Health Saint Joseph HospitalMercy, Northwestern MedicineNYU Langone Health, Stanford Health Care, and Tampa General Hospital—and building an AI solution that addresses nursing documentation by completing flowsheets supported by ambient technology, allowing nurses to focus less on paperwork and more on their patients.​ Many of these organizations have already deployed a preview version as we further optimize the capabilities before making them generally available.

Tapping into our proven track record with Dragon Medical and electronic health record (EHR) embedded workflows, our initial work in this space builds on a longstanding strategic relationship and joint development collaboration with Epic.

Explore the potential of AI for nursing

Nursing is on the brink of significant innovation. We see this with the momentum of virtual nursing, where health systems are investing in technologies focused on supporting nursing care teams. We aim to meet the immediate pain point of documentation and, in time, fundamentally reshape the experience of nurses, helping to evolve that experience into something intuitive and efficient, where the non-patient care work can be facilitated by cutting edge technologies working in the backdrop, returning the human connection of patient and nurse to the forefront.

As I engage in the dialogue between nursing leaders and industry innovators, I have no doubt the future will be transformed. Collectively, we have the ambition and the conviction to point these breakthrough technologies at our most critical problems, in support of some of the most essential members of the healthcare industry: our nurses!

1Surveyed nurses consider leaving direct patient care at elevated ratesMcKinsey, 2022.

2Nursing and midwiferyWorld Health Organization, 2024.

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Mary Varghese Presti, BSN, MPH

VP, Portfolio Evolution & Incubation, Microsoft Health & Life Sciences

As VP, Portfolio Evolution & Incubation, Health & Life Sciences at Microsoft, Mary Varghese Presti leads the development of generative AI-based workflows for care team members, including nurses. Mary is a senior healthcare technology executive with over 25 years of experience leading growth and innovation in public and privately held healthcare technology and life sciences companies worldwide. Mary started her career as a pediatric nurse at Johns Hopkins and leveraged that clinical experience as a touchstone as she expanded to strategy, biopharma and technology. She received her bachelor’s degree in nursing from the University of Pennsylvania and her master’s degree in health policy from Johns Hopkins University.

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