Abridge wants to be the operating system for medicine—and NVIDIA and Eli Lilly are helping build it

The $5.3 billion ambient AI startup is expanding from clinical notes into billing, drug trials, and real-time insurance claims.

On Thursday morning in New York City, Dr. Shiv Rao stood before a room of health system executives and made a case that ambient AI—a technology that began largely as a transcription tool—was ready to do something far more consequential than writing a doctor’s notes.

Abridge, the startup Rao cofounded in 2018, announced a strategic investment from drugmaker Eli Lilly and what it is calling the first AI-native clinician intelligence platform: a system that both documents the patient-clinician conversation and uses it as the foundation for billing, clinical decision support, payer adjudication, and pharmaceutical trial screening. More than 300 health systems—including Northwestern Medicine, Emory Healthcare, and Johns Hopkins—are already live on the platform, supporting upward of 100 million clinical conversations annually and serving more than 250 million patients.

The company’s platform captures conversation between patients and doctors in real time and automatically generates the clinical note, billing codes, and patient summary before the doctor has left the hallway. What’s new is everything that flows from that moment. 

Before the visit, Abridge surfaces care gaps and prior clinical context for the clinician. During the encounter, the tech suggests discussion topics and surfaces relevant clinical guidelines without requiring the physician to switch applications. After the visit, it generates the documentation, flowsheets, and orders—all grounded in the actual words spoken.

“We’ve known all along we wanted to be able to connect the dots across the main stakeholders in healthcare, because the only thing that matters, I think, in terms of AI’s impact on healthcare is business model innovation.” Rao told Fortune. “If we can’t actually improve how healthcare is delivered, how it’s experienced, and how it’s paid for, then we haven’t really moved the needle on the problem.”

Behind the platform expansion is a war chest and a set of strategic bets. Abridge has raised approximately $830 million to date, most recently closing a $316 million Series E extension in April 2026 at a $5.3 billion valuation. NVentures, NVIDIA’s venture arm, is among its backers. 

On Thursday, NVIDIA announced it’s also co-developing with Abridge the first foundation model for clinical conversations: an AI model trained on the specific dynamics of doctor-patient dialogue, not a general large language model adapted for medicine.

Rao also announced a partnership with Artisight—an NVIDIA-backed smart hospital company that uses computer vision to automate patient monitoring and nursing workflows inside hospital rooms. Together, the two platforms give care teams a continuous feed of room sensor data and ambient documentation across an entire hospital stay.

Eli Lilly’s bet tracks closely with its own AI ambitions. The pharma giant is simultaneously building what it has called the industry’s most powerful AI supercomputer in partnership with NVIDIA, and Abridge’s new life sciences module—which can surface clinical trial eligibility from within the clinical conversation itself—represents the kind of patient-facing pipeline Lilly needs to accelerate enrollment for next-generation therapies.

“For us, the most important first priority that we would love to explore, that we are working to explore with them, is around clinical trials,” Rao said.

The ambient clinical intelligence mark Abridge is chasing was valued at $7.24 billion in 2025 and is projected to reach $56.61 billion by 2035. Microsoft, which acquired speech-recognition company Nuance for $19.7 billion in 2022, is the dominant enterprise incumbent. Ambience Healthcare, Suki, and Nabla are all also well-capitalized challengers. But the field is expected to consolidate within the next 12 to 18 months. The question is whether Abridge’s expansion into payments and life sciences creates a defensible moat, or simply a larger target.

“Now the priority is how much impact can we create, and speed is everything, so I think for the foreseeable future we’re just going to focus on the algorithm,” Rao told Fortune. 

The platform’s ambition is also its risk surface. Recording protected health conversations requires updated security assessments, state-specific patient consent, and business associate agreements governing how audio is stored. And AI-generated notes that slip past physician review become part of the permanent medical record—a liability that compounds as the platform moves from documentation into billing codes and clinical orders.

Beneath it all is a deeper governance question. Abridge is now positioning itself as neutral infrastructure connecting providers, payers, and life sciences companies through some of the most sensitive data in medicine: the conversation between a sick person and their doctor.

Whether that trust holds, at scale, is an untested hypothesis.

This story was originally featured on Fortune.com