Joshua Liu, MD

Cedars Sinai Deploys Live Patient‑Context AI for Clinical Decision Support

Cedars Sinai clinicians are the FIRST to use OpenEvidence to integrate live patient context from Epic and access personalized CDS AI. My 6 thoughts on what this means for the industry: First, the gist of what was announced: → Clinicians can ask questions in natural language and receive answers grounded in both research guidelines AND the specific patient in front of them (the holy grail of CDS AI!) → Patient context includes prior procedures, comorbidities, medications, allergies, and longitudinal health data - not just a summary snapshot → The system operates agentically: it interprets the clinical question, dynamically pulls relevant EHR data, evaluates current literature, and synthesizes a context-aware answer → Cedars-Sinai is also going to display its own protocols and guidelines alongside the medical literature, so clinicians can see both Alright my 6 thoughts: 1/ This reduces the friction to clinicians at Cedars Sinai trying OE. If you were using one of the other CDS AI tools before, you’d be hard pressed to now. You just save so much more time. 2/ It’s inevitable that Epic will just build the same integration with OE, UpToDate, Doximity and others directly into the chat bar interface (new Epic Toolbox category soon?) - where clinicians already do all their other actions with Epics AI clinician assistant “Art”. The pitch from Epic will be “why would you want to open up a separate tab every time you want to ask an AI assistant to do something?” - and they’d be right. When the output from the CDS AI is mostly plain text, it’s not so important for the CDS AI to own the UI/UX. 3/ But if this happens, then the CDS AI tools will be no different than the AI model products in general (ie OpenAI, Anthropic) - Epic will just let health systems switch them in and out. Oh, and of course, the CDS AI tools will pay the Epic App Store fee for this. 4/ Which means if you are a CDS AI tool and you want doctors to stay in your window, you have to offer something useful beyond a chat interface. Then again, if you’re getting faster distribution because Epic facilitates more native integrations with your CDS AI model - do you care to own the UI/UX? 5/ If you’re OE, Doximity, UpToDate - your goal should be to do as many of these EHR integrations as possible to prove you are the CDS AI model of choice. Put yourself in pole position for Epic to make you their default CDS AI model and be willing longterm to give up ownership of the UI/UX to Epic - because, well, they already own it. 6/ What does this mean for the AI scribe tools like Abridge that incorporated CDS into their product? Maybe they need to make CDS AI also available outside the live clinical encounter and become the default instead of OE - because won’t physicians want to use the same CDS AI during the encounter that they use outside of it (or do they not care)? But none of this matters if health systems choose to make Epic the interface for all this.