What is an AI-Native EHR and why it matters for ambulatory care
The future of healthcare technology isn’t about merely adding AI to existing systems. It’s about building technology that’s designed from the ground up to work with clinicians, staff, and patients — not around them. That’s what we mean by AI-native healthcare software, and it’s why athenahealth is leading the way in creating an AI-native EHR for ambulatory practices of every size.
But AI can’t thrive in walled-off, on-prem systems. It demands a modern, cloud-based architecture and a single-instance SaaS infrastructure that is both a technical advantage and a fundamental prerequisite for deploying healthcare AI at scale with consistency, safety, and real clinical impact.
What does it mean that an EHR is "AI-native"?
An AI-native EHR means that artificial intelligence isn’t just an add-on, but the foundation of the system. The architecture of the system itself is designed to allow AI to be deeply integrated into every part of the workflow, from clinical documentation to patient scheduling to billing. In an AI-native system, every process is smarter, more predictive, and more automated, resulting in a smoother and more efficient experience for clinicians, staff, and patients.
It's different than the “AI-powered” or “AI-enabled” terms that typically mean that a healthcare tech vendor has taken an existing system and tacked on AI features without rethinking how the system works as a whole.
An AI-native EHR is something different. It’s built from the ground up with AI at its core, embedded into every aspect of the platform. Here’s what sets an AI-native healthcare software apart:
- AI is built in, not bolted on. In an AI-native system, intelligence is woven into the system’s architecture. This means that every workflow, from documentation to billing to patient engagement, benefits from AI-powered enhancements right from the start.
- It anticipates, not just reacts. Traditional AI in healthcare systems often reacts to clinician inputs, such as surfacing alerts when something’s wrong. An AI-native EHR takes it a step further by predicting clinician needs, recommending next steps, and automating repetitive tasks, creating a smarter, more intuitive experience.
- It learns from the network. AI-native systems get smarter over time by learning from the vast amounts of data flowing through their connected ecosystems. This includes providers, payers, and partners, so every insight generated improves outcomes for everyone using the system.
- It keeps clinicians in control. AI tools are designed to complement, not replace human judgment. These features are configurable to match each practice’s comfort and maturity with AI, meaning clinicians stay in control of their decision-making, while AI helps them work faster and more accurately.
In an AI-native system, the AI is always active, anticipating clinician needs and automating repetitive tasks rather than simply alerting users when something goes wrong. Over time, the system learns from the collective data and usage patterns of its entire network, getting smarter and improving outcomes for everyone on the platform.
Why AI-native EHRs matter for ambulatory practices
Healthcare practices today are under pressure from every direction: rising administrative burdens, shrinking reimbursements, and increasing patient expectations. Traditional EHRs add AI as a feature to keep up, but they don’t address the root issues that practices face on a daily basis.
Here’s how an AI-native EHR can help ambulatory practices:
- Save time on documentation and billing. With features like ambient note capture, auto-coding, and predictive task prioritization, clinicians can spend less time on data entry and more time on patient care.
- Accelerate revenue and reduce denials. AI-native EHRs automate complex claim workflows and spot payer rule changes before they disrupt cash flow, helping you get paid faster and reduce denials.
- Engage patients more personally. With AI-assisted communication tools, proactive scheduling, and self-service options, practices can engage with patients in a way that feels personalized and efficient without burdening staff.
- Free up staff and clinicians to focus on care. By automating routine tasks, AI-native EHRs reduce the administrative load on clinicians and staff, letting them focus on providing exceptional care.
What’s the difference between AI-native and AI-powered EHRs?
The key difference lies in how AI is integrated. EHRs with AI capabilities adds features on top of existing platforms. They may offer some tools or functions like decision support or predictive scheduling, but these are added as extra layers on an older system that was not built for AI.
An AI-native EHR, on the other hand, is designed from the start with AI deeply embedded in its architecture. AI is woven throughout the entire system affecting every workflow and aspect of the user experience. This results in a system that’s faster, smarter, and more intuitive because it’s optimized for AI-driven efficiency.
Who benefits most from AI-native EHRs?
Ambulatory practices, clinics, and small health systems that need to simplify operations, speed up revenue cycles, and free clinicians from administrative overload benefit most from AI-native EHRs. These systems are built to improve not just workflow efficiency but also patient care, allowing practices to stay focused on delivering high-quality healthcare.
Smaller and independent practices, in particular, are often overwhelmed by the operational burden of managing their workflows. AI-native EHRs help level the playing field, offering the benefits of sophisticated AI without requiring specialized expertise.
Does healthcare AI replace clinicians?
AI-native systems are designed to support clinicians, not replace them. The AI within the system offers suggestions, predictions, and automations, but the clinician always retains control of the decision-making process. AI helps clinicians make faster and more accurate decisions, but the human touch remains at the core of care delivery.
Rather than replace the critical role that clinicians play in patient care, AI-native systems are designed to complement human judgment, enhance workflow efficiency, and reduce administrative workload.
athenaOne®: The AI-native EHR built for ambulatory care
At athenahealth, we’ve been investing in AI for years, not as a trend, but as a foundation. The result is athenaOne, a truly AI-native, multi-tenant EHR platform purpose-built for ambulatory practices of every size.
athenaOne’s intelligence layer flows across the patient engagement, revenue cycle, practice management and electronic health record capabilities to make every part of care delivery smarter, faster, and more human. From real-time decision support to AI agents curating documents, we’re changing the way practices operate by reimagining how information moves, is interpreted, and used – in ways that lower cognitive load and remove mundane, repetitive, frustrating tasks that machines can do.
Ready to learn more about how AI-native EHRs can transform your practice?
If you’re ready to see how an AI-native EHR can help simplify operations, speed up revenue cycles, and reduce clinician burnout, we’re here to show you. Learn more about AI in athenaOne or Request a Demo to see how it works.