SBMUpdated 23 Oct 2026
Early version, updated weekly. Every claim is dated and sourced. Think something is wrong? Dispute it.
Map / 2. Rides / Selling the finished work

The ambient scribe

R2 RidesSelling the finished workLearning loopRisingScaling
Placement: a judgment drawn from the evidence, open to correction (dispute it).

The model

Definition
AI listens to a clinician-patient encounter and generates the clinical note automatically, sold on a per-clinician subscription basis, displacing manual note-taking and traditional medical transcription services.
In one line
AI listens to the clinical conversation and writes the note, sold per clinician.
What compounds
Every encounter improves the notes; the scribe becomes the entry point for further clinical agents.
Who accelerates
Clinicians recover time for patients. Consent and privacy are the live risk: class actions allege recording without consent.
What it displaces
Medical transcription services and manual note-taking.
Stops working when
If consent litigation raises the cost of deployment beyond the time saved.

Evidence

Companies 4
Evidence items 4
Grades 2A 2B
Latest dated 2026-09-25
Counter-evidence 2

The three labels

2. Rides · loop gain positive. Each step of the curve makes its own loop stronger.

Selling the finished work · money lands in the outcome, not the tool or the hours.

Learning loop · use, data, better product, more use.

Same rung and family

Pay per outcome
Vertical AI priced by the work
Discovery paid by milestone
AI roll-ups of services firms
Driverless rides
Robots as a service
AI-tutored schooling
AI-run insurance

Named companies 4 companies · grade per item

CompanyClaimDateGrSource
Abridge
US · scaleup · best B
 Abridge closed a $300 million Series E led by Andreessen Horowitz and Khosla Ventures, valuing the company at $5.3 billion, four months after its $250 million Series D.2025-06-24BFierce Healthcare
Heidi Health
Australia · scaleup · best B
 Heidi Health raised a $480 million (US$340 million) Series C at a $1.27 billion (US$900 million) valuation, with revenue of $71 million (up from $1.4 million two years prior) and use across 175 million+ patient encounters and 190 countries2026-09-25BInformation Age (ACS)
Microsoft Dragon Copilot
US · public · best A
 More than 100,000 clinicians rely on Dragon Copilot as part of their daily practice, supporting care for millions of patients every month.2026-03-05AMicrosoft (company blog, HIMSS 2026)
Nabla
France · scaleup · best A
 Nabla raised $70 million in Series C funding, led by HV Capital with Highland Europe, DST Global, Cathay Innovation and Tony Fadell's Build Collective participating, bringing total funding to $120 million.2025-06-17ANabla (company press release)

Counter-evidence Reversals, failures and disputes

Class action filed against Sharp HealthCare alleges Abridge's ambient AI recorded over 100,000 patient visits without all-party consent and auto-inserted false consent statements into charts, citing California Invasion of Privacy Act exposure of up to $5,000 per violation2025-11Basil AI (legal-industry blog)
Parallel class actions were filed against Sutter Health and MemorialCare in the Northern District of California in April 2026 over the same Abridge platform and consent practices, seeking nationwide class certification2026-04Basil AI (legal-industry blog)

Sources 5

Fierce Healthcare fiercehealthcare.com · 2025-06-24
Information Age (ACS) ia.acs.org.au · 2026-09-25
Microsoft (company blog, HIMSS 2026) microsoft.com · 2026-03-05
Nabla (company press release) nabla.com · 2025-06-17
Basil AI (legal-industry blog) basilai.app · 2026-04