Augmedix Epic Integration in 2026: How Commure Ambient Connects to Epic
CTO & Co-Founder
CTO & Co-Founder at Nirmitee.io. Architects healthcare integrations across FHIR, SMART on FHIR, ABDM and NHCX, writing from production experience taking hospital software from sandbox to go-live.
Augmedix connects to Epic today as part of Commure, which completed its acquisition of Augmedix on October 2, 2024. Commure's ambient suite is listed in Epic's Toolbox program for Ambient Voice Recognition, so clinicians can record in Epic Haiku and review the draft note in Epic. Two other routes exist as well: an appointment-based sync and a Chrome extension.
This guide is for the health system IT teams and AI scribe product teams who have to make that connection work. It covers who owns Augmedix now, each route into Epic, what your Epic team still has to build (the part our Epic integration services team usually runs), and how a product team can build on Commure's scribe API and file notes into Epic through FHIR. If you are still choosing between Epic's own scribe and a third-party one, start with our Epic AI scribe guide, which compares the options.
Key takeaways
- Augmedix is a wholly-owned subsidiary of Commure since October 2, 2024. Its stock was delisted from Nasdaq when the merger closed.
- Commure announced on April 30, 2025 that its Ambient Suite is integrated with Epic Haiku as part of Toolbox, in the Ambient Voice Recognition category.
- Outside Haiku, Commure Ambient sends notes to Epic through an appointment-based sync or a Chrome extension. Both list Epic as a supported EHR.
- Commure publishes an OpenAPI spec for its Ambient AI Scribe API. A product team can generate notes there and write them into Epic itself with DocumentReference.Create (Clinical Notes).
- Epic's note create API takes plain text only and needs an encounter. Rich text notes go through the HL7 v2 MDM interface instead.
Who owns Augmedix now?
Commure owns Augmedix. Commure announced on October 2, 2024 that it had completed the acquisition, that Augmedix would operate as a wholly-owned subsidiary, and that Augmedix stock would be delisted from Nasdaq.
The product names have shifted since then. In January 2025 Augmedix still sold Augmedix Go, Augmedix Assist and Augmedix Live, and said Augmedix Go "integrates with over 50 EHRs, including Epic, Oracle Health, and MEDITECH." Commure's documentation now describes three tiers called Commure Ambient AI, Commure Ambient Assist and Commure Ambient Live. The Apple App Store listing for "Commure Ambient - Live" is published by Augmedix Operating Corporation. So when a buyer searches for an Augmedix Epic integration in 2026, the product they will be quoted is Commure Ambient.
Augmedix had Epic experience before the merger. In its March 27, 2023 results release, the company said it was "integrated with a select number of EHRs, including an EPIC integration with a major health system."
The three Commure Ambient tiers
The tier decides how much human help sits behind the note, and that changes what lands in Epic. Commure's support model page lists these differences.
| Tier | Who drafts the note | Orders and discrete data | EHR integration |
|---|---|---|---|
| Commure Ambient AI | AI only, self-service | Not included | Bi-directional |
| Commure Ambient Assist | AI, then a medical documentation specialist edits | Pends labs, imaging and order sets for review; discrete data entry | Bi-directional |
| Commure Ambient Live | AI plus a dedicated specialist before, during and after the visit | Same as Assist, with a dedicated specialist | Bi-directional |
All three tiers also suggest CPT, E&M, level of service, HCC and ICD-10 codes, according to the same page. For an Epic build, this means that with Assist or Live, people outside your organization will touch pended orders and discrete fields in your Epic environment, so your security and access review needs to cover them.
How does Augmedix integrate with Epic?
Augmedix, as Commure Ambient, reaches Epic through three routes: the Epic Toolbox integration inside Haiku, an appointment-based sync, and a Chrome extension. A fourth route serves nurses inside Epic Rover. Which one your sites use decides where the clinician records, where the note lands and what can go wrong.
Each route puts the note in Epic at a different point, so each one needs its own test plan.
Route 1: Epic Toolbox, inside Haiku
Commure's Ambient Suite is integrated with Epic Haiku as part of Toolbox, in the Ambient Voice Recognition category. Commure announced this on April 30, 2025 and said the listing is available in Toolbox on Epic Showroom. Commure describes Toolbox on Showroom as being "for products in specific categories that follow Epic recommended connection practices for a category."
In this route the clinician records in Haiku, Epic's mobile app for clinicians. Commure says that once notes are captured in Haiku, they flow into Epic Hyperdrive for final review and editing. Commure says this keeps clinicians in their Epic workflow. Commure lists two products under this route: Commure Ambient Notes, "a fully automated AI solution integrated with Haiku, listed in Epic Toolbox," and Commure Ambient AI, which it says covers the full ambient feature set with EpicCare, mobile and web.
Toolbox is the same Epic program that other ambient vendors use. Suki, for example, announced in May 2023 that it had integrated with Epic "using Epic's ambient APIs." Those ambient interfaces are not part of Epic's public FHIR catalog. We checked the 719 APIs listed on fhir.epic.com on October 30, 2026 and none of them is an ambient API. So the Haiku route is set up between the vendor and your Epic team under Epic's program, and the public FHIR APIs are not a way to copy it.
Route 2: Appointment-based sync
The appointment-based integration imports the clinician's appointments into Commure Ambient and writes the finished note back to the matching chart. Commure's documentation describes the steps. The clinician starts a recording from an appointment in the Visits tab, opens the generated scribe on mobile, web or the Chrome extension, and clicks the EHR button. The note goes to the linked patient chart in 5 to 30 seconds, and the sections of the note, such as History of Present Illness, are already mapped to text fields in the chart.
The main risk is a scribe linked to the wrong visit. Commure's fix is to unlink the appointment, link the correct one, and regenerate the note if the patient details are wrong. Your pilot should test that path on purpose. A note filed to the wrong patient is a privacy incident that your compliance team has to log and correct.
Route 3: Chrome extension
The Chrome extension writes the note into whatever note field is open on the same browser tab. The clinician opens the chart, goes to the note or encounter field, opens the extension, and presses the EHR button. Commure asks users to leave the mouse alone while the sync runs.
Two behaviors matter for Epic teams. First, the extension must detect the text field it will write to, so it raises an error on the wrong page. Second, syncing the same note twice does not overwrite it. The second sync appends below the first. Commure recommends finishing all edits inside Commure Ambient and syncing once. This route depends on the clinician's Epic session running in a Chrome tab, so confirm how your users open Epic before you plan on it.
Route 4: Nursing in Epic Rover
Commure announced Commure Ambient for Nursing on November 17, 2025. It runs inside Epic Rover, Epic's mobile app for nurses, and turns the conversation into structured flowsheet and LDA (lines, drains and airways) suggestions that appear in Epic for the nurse to review and file. Commure tied it to Epic's Ambient Voice Recognition Toolbox. If your project includes inpatient nursing, treat this as a separate build with its own flowsheet mapping.
How an Augmedix note gets into Epic, step by step
A Commure Ambient note reaches Epic in one of two ways outside Haiku: through a linked appointment or through the Chrome extension. The flowchart below shows both, with the failure points Commure's own documentation calls out.
Most sync problems come from the wrong visit or a second sync, and both are caught before the clinician signs.
- Record from the visit. Start from the appointment in the Visits list so the scribe is linked to the right patient and encounter.
- Check the link. If the patient or visit is wrong, unlink and relink before you sync, then regenerate the note.
- Edit in Commure Ambient. Finish all edits there. Edits made after a Chrome extension sync will not replace what already went to Epic.
- Sync once. Click EHR. Commure says this takes 5 to 30 seconds.
- Review and sign in Epic. The clinician stays responsible for the note and signs it in the chart.
What your Epic team still has to build
A Toolbox listing shortens the Epic work but does not remove it. Your Epic analysts and security team still have to set up access, note types, matching and audit, and test them on your own build. Here is the list we use when we scope an ambient scribe go-live on Epic.
| Area | What to decide or build | Who usually owns it |
|---|---|---|
| Haiku and Rover access | Which users and departments get the ambient feature, and on which devices | Epic security and ambulatory or inpatient analysts |
| Note types and templates | Which Epic note type each Commure template files to, and how sections map | Clinical documentation analysts with clinical leads |
| Appointment and encounter matching | How a recording ties to the right visit, and what happens on walk-ins and add-ons | Interface team and vendor |
| Sign-in and user lifecycle | Single sign-on with SAML 2.0 and automatic user provisioning with SCIM 2.0, both of which Commure supports | Identity team |
| Consent | How the patient agrees to recording, and where that is recorded in Epic | Compliance and clinical leadership |
| Contract and data use | Business associate agreement, audio retention, and whether data is used for model training | Legal and privacy |
| Audit and monitoring | Which user filed which note to which patient, and alerts for failed syncs | Security and the integration team |
| Downtime | What clinicians do when Epic, Haiku or the vendor is down | Clinical operations |
We run this list with your analysts, so the vendor, your Epic team and your security team test the same scenarios before go-live.
Building your own product on Commure Ambient and Epic
A product team can generate notes with Commure's scribe API and file them into Epic itself through FHIR. Commure publishes an OpenAPI 3.1 spec titled "Ambient AI Scribe API," with a sandbox server at api.sandbox.commure.com/ambient/scribe. Epic publishes the note write API as DocumentReference.Create (Clinical Notes) on fhir.epic.com. Joining the two is a standard SMART on FHIR build, and it is the route to use when ambient documentation is a feature inside your own app.
The app owns the Epic write-back, so it also owns retries, duplicates and the audit trail.
What Commure's scribe API offers
Commure's spec covers authentication, note generation, templates and long audio uploads. These are the calls a scribe product needs.
| Call | What it does | Detail from the spec |
|---|---|---|
POST /v1/auth/token | Gets a JWT | OAuth2 password flow, form-encoded, header auth-server: cognito |
POST /v1/scribe | Starts note generation | Multipart; needs template_id and date_of_service; send an audio file (up to 100 MB) or a transcript of at least 10 words, not both |
GET /v1/scribe/{scribe_id} | Returns status and the notes | ai_tasks holds note_text and note_json per template |
/v1/chunking/sessions | Uploads long audio in chunks | Create a session, PUT each chunk, then complete it |
/v1/templates | Manages note templates | Create, list, read, update and delete |
/v1/summaries | Summarizes text | Submit text, then poll for the result |
The password flow means your backend holds a Commure user's credentials or a service account. Keep them in a secrets vault, never on the device, and map each Epic user to a Commure user through /v1/users/external-id/{external_id} so the audit trail lines up on both sides.
What Epic accepts when you write the note
Epic's DocumentReference.Create (Clinical Notes) R4 API files a plain text note to an open or closed encounter. The rules below come from Epic's specification, and each one shapes your design.
- Plain text only.
contentTypemust betext/plain, and the decoded content cannot be RTF or HTML. Epic saves only the first attachment. - Encounter required.
context.encountermust be a clinical encounter that can hold a note and belongs to the patient. - Preliminary or final.
docStatus: preliminaryfiles the note as incomplete so the clinician can edit and sign it in Epic. Anything else is filed as signed. For an AI draft, send preliminary. - Note type. Use a supported LOINC code, such as Progress Note 11506-3 or History & Physical 34117-2, or the organization's own note type ID. The API cannot create Discharge Instructions or Patient Instructions.
- Pre-charting. From the February 2025 version of Epic, notes can be filed during pre-charting, and those must be preliminary.
- Rich text. If the note needs formatting, Epic points to the HL7 v2 Incoming MDM (Transcriptions) interface instead, which can also match encounters more loosely.
Here is the request your app sends after the clinician approves the draft. The IDs are placeholders.
POST https://{epic-host}/api/FHIR/R4/DocumentReference
Content-Type: application/fhir+json
Prefer: return=minimal
{
"resourceType": "DocumentReference",
"docStatus": "preliminary",
"type": {
"coding": [{ "system": "http://loinc.org", "code": "11506-3", "display": "Progress note" }]
},
"subject": { "reference": "Patient/{patient-fhir-id}" },
"author": [{ "reference": "Practitioner/{practitioner-fhir-id}" }],
"content": [{
"attachment": {
"contentType": "text/plain",
"data": "{base64 of note_text}"
}
}],
"context": { "encounter": [{ "reference": "Encounter/{encounter-fhir-id}" }] }
}Epic answers 201 Created with the new note's address in the Location header. Store that ID next to the Commure scribe_id. If the request times out, search before you retry with GET DocumentReference?encounter={id}&category=clinical-note&docstatus=preliminary, so a slow network does not leave two drafts on the same visit.
The note_json output is useful even though Epic's note API only takes text. Use it to render sections in your own review screen, then flatten to note_text for filing. For more on how notes are written across EHRs, see our guide to FHIR DocumentReference for clinical notes in Epic, Oracle Health and athenahealth.
Where Augmedix fits next to Epic's own AI scribe
Epic now ships its own ambient documentation, called Chart with Art, so an Epic-only health system has a native option to compare against Commure. A third-party scribe still makes sense when your sites run several EHRs, when you want human-assisted tiers like Assist or Live, or when nurses need ambient flowsheet documentation in Rover. We cover that choice in our Epic AI scribe comparison of Chart with Art, Abridge, Dragon Copilot and custom scribes, and the wider market in our AI medical scribe comparison.
Questions to ask Commure before you sign
Get written answers from Commure to these questions before the Epic build starts.
- Which route will our sites use: Haiku Toolbox, appointment-based sync, Chrome extension, or a mix? Which departments get which?
- Which Epic note types and sections will each template file to, and can our analysts change that mapping?
- For Assist and Live, who can pend orders or enter discrete data in our Epic, from where, and how is that audited?
- How long is audio kept, where is it stored, and is any of our data used to train models?
- What happens when a recording is linked to the wrong visit after the note has synced?
- Which Epic version and Haiku version does the integration need, and who tests Epic upgrades?
- What does Commure monitor on its side, and how are failed syncs reported to our team?
Keep the answers in your project file. They are the same questions your HIPAA privacy officer will ask later.
How Nirmitee helps with Augmedix and Epic projects
We help in two ways. For health systems rolling out Commure Ambient on Epic, we run the integration review: route choice per department, note type mapping, consent capture, audit and the test plan your Epic analysts sign off. For AI scribe product teams, we build the Epic side of your product: SMART on FHIR launch, encounter matching, FHIR note write-back, an HL7 MDM fallback for rich text, and the monitoring that catches failed writes.
Our AI scribe EHR integration service covers Epic, Oracle Health and athenahealth, and our AI medical scribe development team builds custom scribes when a vendor product does not fit. For broader work, see our healthcare interoperability solutions and AI agents for healthcare. Book a 30-minute scoping call and bring your route, your Epic version and your go-live date.
Sources
- Commure, "Commure Completes Merger with Augmedix," October 2, 2024 (augmedix.com press release)
- Commure, "Augmedix Awarded Vizient Contract for Ambient AI Documentation Solutions," January 13, 2025
- Augmedix, fourth quarter 2022 results release, March 27, 2023 (SEC exhibit 99.1)
- Commure, "Commure's AI-Powered Ambient Suite Achieves Epic Toolbox Designation for Ambient Voice Recognition," April 30, 2025, and the companion blog post
- Commure, "Introducing Commure Ambient for Nursing in Epic Rover," November 17, 2025
- Commure Ambient documentation: Appointment-Based Integration, Chrome Extension Integration, Support Models, Overview, SSO and SCIM pages, and the Ambient AI Scribe API OpenAPI spec, checked October 30, 2026
- Apple App Store, "Commure Ambient - Live" listing
- Epic on FHIR, DocumentReference.Create (Clinical Notes) (R4) and DocumentReference.Search (Clinical Notes) (R4), checked October 30, 2026
- Suki, "Suki Launches Ambient API Integration with Epic," May 17, 2023
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Frequently Asked Questions
Does Augmedix integrate with Epic?
Is Augmedix owned by Commure?
Where does an Augmedix note land in Epic?
Can we build our own app on Commure's scribe API and write notes into Epic?
Can Epic's FHIR API take a formatted AI note?
