Designing for Cancer Care: How AI is Redefining the EMR with Dr. Stephen Speicher, Flatiron Health

When most oncologists think of their EMR’s purpose, they think of documentation. Dr. Stephen Speicher thinks a little differently. 

A pediatric oncologist turned digital health leader as Head of Clinical Oncology and Safety at Flatiron Health, Dr. Speicher sees the EMR as more than a repository of information. He also envisions it as a vehicle for care delivery. 

In this episode of Beyond the Chart, Dr. Speicher and DeepScribe founder and CEO Matthew Ko discuss the role of ambient AI in that EMR evolution. 

“The EMR isn't just where care is recorded it's where care happens," Dr. Speicher explains. That vision underpins his work as Vice Chair of the EHR Association's AI Task Force, where he champions innovation grounded in clinical safety.

From safety oversight to clinical innovation, Dr. Speicher also offers an inside look at how technology is closing the gap between community care and academic advancement.

The Clinical Voice at the Tech Table

One of the most urgent challenges in oncology innovation is bridging the gap between technology and frontline care. Dr. Speicher's background — from practicing pediatric hematology-oncology to studying systems engineering — positions him to do just that.

Flatiron's oncology-specific EMR, OncoEMR, is designed with this type of integration in mind. Clinical input is embedded at every level, from regimen management to safety alerts.

"Clinicians and developers speak different languages. We have to be the translators who make care safer."

The work required to translate between clinical care and technology is deeply human to Dr. Speicher. "I see my role as making sure the needs and desires of the patient and provider are front of mind,” he says. “We're the storytellers in the room.”

Ambient AI in Action: From Insight to Intervention

Flatiron's partnership with DeepScribe puts the “storyteller” philosophy into practice. By integrating DeepScribe's ambient AI into OncoEMR, Dr. Speicher and the Flatiron team go beyond streamlined documentation — they've activated a clinical intelligence that captures a fuller patient picture and improves care.

"We're seeing notes signed faster, charge capture improved, and most importantly, providers excited about a tool that actually works for them." 

For community oncologists, who often treat a wide spectrum of cancers and juggle high patient volumes, this impact represents a leveling of the playing field. "Ambient AI is the bridge between academic advancement and community care,” says Dr. Speicher. “It's helping generalists operate with specialist-level insight."

Scaling Innovation, Safely

Community oncologists may have the most to gain from innovation, but they often have the least time to evaluate and implement it. He says technologists must treat safety and trust as foundational, not optional, and is candid about the responsibilities that come with scale. 

"Lives are on the line. We can't afford to treat safety as a feature. It has to be the foundation."

"The providers we serve assume we've built our tools with integrity. That means transparency, responsibility, and rigorous testing have to be baked in."

With ambient AI evolving rapidly, Flatiron is pushing for industry-specific frameworks that balance innovation with accountability. Ambient AI is all about freeing up clinicians from hours of note-taking — but it must also be about safer care..

A Future Built on Partnership

What sets Dr. Speicher apart is his insistence on two-way empathy between clinicians and technologists.

“The physician, nurse practitioner, front office… they love what they do, and it’s hard work,” said Dr. Speicher. “And it’s actually much harder than you think to build technology. On both counts, I would love a little more empathy.” 

As ambient AI continues to evolve, voices like Dr. Speicher’s will ensure that oncology innovation strikes that balance between being both grounded and visionary. With roughly 70% of cancer care happening outside academic centers, that grounding is more urgent than ever. 

"We need to meet providers where they are, not just with great tech, but with real understanding."

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Watch the full episode to learn more about the merger of technology and empathy in patient care and the role that AI plays.