Abstract
Commercial AI scribes cost \$99-600 per physician per month, operate as opaque systems, and do not return data to institutional infrastructure, limiting organizational control over data governance, quality improvement, and clinical workflows. We developed Berta, an open-source modular scribe platform for AI-enabled clinical documentation, and deployed a customized implementation within Alberta Health Services (AHS) integrated with their existing Snowflake AI Data Cloud infrastructure. The system combines automatic speech recognition with large language models while retaining all clinical data within the secure AHS environment. During eight months (November 2024 to July 2025), 198 emergency physicians used the system in 105 urban and rural facilities, generating 22148 clinical sessions and more than 2800 hours of audio. The use grew from 680 to 5530 monthly sessions. Operating costs averaged less than \$30 per physician per month, a 70-95% reduction compared to commercial alternatives. AHS has since approved expansion to 850 physicians. This is the first provincial-scale deployment of an AI scribe integrated with existing health system infrastructure. By releasing Berta as open source, we provide a reproducible, cost-effective alternative that health systems can adapt to their own secure environments, supporting data sovereignty and informed evaluation of AI documentation technology.
Abstract (translated)
商业AI文书助手每名医生每月费用为99至600美元，其系统运作不透明，且不向机构基础设施返还数据，从而限制了组织对数据治理、质量改进和临床工作流的控制。我们开发了Berta——一个用于AI辅助临床文档记录的开源模块化文书平台，并在阿尔伯塔省卫生服务局（AHS）内部署了定制化实施方案，该方案与其现有的Snowflake AI数据云基础设施相集成。该系统将自动语音识别与大语言模型相结合，同时将所有临床数据保留在安全的AHS环境中。在八个月期间（2024年11月至2025年7月），198名急诊科医生在105个城市和农村医疗机构中使用该系统，产生了22148次临床会话和超过2800小时的音频。使用量从每月680次会话增长至5530次。平均每名医生每月运营成本低于30美元，相比商业替代方案降低了70%至95%。AHS已批准将系统扩展至850名医生。这是首个与现有卫生系统基础设施集成的省级规模AI文书助手部署。通过将Berta作为开源项目发布，我们提供了一个可复现、成本效益高的替代方案，卫生系统可将其适配至自身安全环境，从而支持数据主权以及对AI文档技术的知情评估。
URL
https://arxiv.org/abs/2603.23513
