Deeptech and AI · Research note · 30 Sep 2026
From pilot to a $776 million ceiling: how the largest US health system now buys AI
On 18 September 2026 the Department of Veterans Affairs awarded a five-year, multiple-award contract for ambient AI scribes with a shared ceiling of $775.72 million, per the two awardees, Abridge and Knowtex, and trade press. The award followed eleven months of measured use: more than 986,000 primary care appointments had used an ambient scribe since October 2025. This note sets out what is known, what is vendor-reported, and what a ceiling does and does not mean.
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Every number, and where it comes from
The first five figures in the note.
The full table has 15 rows. Each figure is as published on the date shown, with its denominator.
| Figure | What it measures | Source |
|---|---|---|
| $775.72M | Shared maximum ceiling of the VA's multiple-award ambient AI scribe IDIQ contract across all awardees, five-year ordering period, awarded 18 September 2026 by the VA Technology Acquisition Center. A ceiling, not an obligation. | Knowtex via GlobeNewswire, 25 Sep 2026; Nextgov/FCW, 22 Sep 2026 |
| 2 | Prime awardees: Abridge and Knowtex. | Knowtex via GlobeNewswire, 25 Sep 2026; Nextgov/FCW, 22 Sep 2026 |
| 75+ | VA medical centers where Abridge says its scribe integrates with legacy and new VA electronic health records. | Nextgov/FCW, 22 Sep 2026, citing Abridge |
| 986,000+ | VA primary care appointments (in-person, phone and video) that used an ambient scribe from October 2025 to September 2026; vendors report veterans declined less than 1% of the time. | Nextgov/FCW, 14 Sep 2026 |
| 10 | Medical centers in the initial deployment of October 2025; the tools are now available to all VA PACT primary care providers and to behavioral health, rehabilitation and specialty practitioners, with no completion date given. | Nextgov/FCW, 14 Sep 2026 |
10 more figures in the PDF, each with its source.
Sources
5 primary releases.
- Knowtex via GlobeNewswire, Knowtex, the first frontier AI lab for healthcare, named prime awardee on VA's nine-figure ambient scribe enterprise contract (25 Sep 2026)"The VA Technology Acquisition Center awarded the contract on September 18, 2026. It is a multiple-award IDIQ with a five-year ordering period and a shared maximum ceiling of $775.72 million across all awardees"; "currently deployed in 79 VA medical centers and more than 310 total VA facilities across 10 Veterans Integrated Service Networks"; "More than 7,000 VA clinicians"; "more than 450,000 hours of documentation time"; "88% sustained clinician adoption"; "4.5 out of 5 average satisfaction across more than 5,100 clinician ratings". Investors: Y Combinator, HF0, Stanford StartX Med, Texas Medical Center Innovation, Jeff Dean.globenewswire.com
- Nextgov/FCW, VA selects Abridge ambient scribe under new enterprise contract (22 Sep 2026)"The multi-award contract has a total ceiling of $775.72 million over five years across all vendors who are eligible to compete for task orders"; the VA began piloting scribes from Abridge and Knowtex in October 2025; Abridge says it integrates with legacy and new VA electronic health records at more than 75 medical centers.nextgov.com
- Nextgov/FCW, VA to gradually expand medical AI scribe following successful pilots (14 Sep 2026)"Over 986,000 VA primary care appointments, including in-person, phone and video visits, have used ambient scribes with vendors reporting veterans have declined the use of the technology less than 1% of the time since October 2025"; first deployed in October 2025 at 10 medical centers; Knowtex in 10 VISNs and 79 medical centers, more than 7,000 clinician users, over 450,000 hours saved; 88% adoption, 4.48 out of five across over 5,100 ratings; Kansas City pilot satisfaction 95.8%.nextgov.com
- CSIS Futures Lab, Understanding the US federal government's AI spending (22 Sep 2026)"Federal agencies obligated $4.1 billion across 2,255 AI-related contracts since FY 2019"; "Annual obligations also increased significantly, reaching $1.162 billion in FY 2025"; Department of Defense 83% of total obligations and about 64% of contracts; data from USAspending.gov and SAM.gov.csis.org
- TechCrunch, In just 4 months, AI medical scribe Abridge doubles valuation to $5.3B (24 Jun 2025)"Abridge, an AI startup automating medical notes, has secured a $300 million Series E at a $5.3 billion valuation", led by Andreessen Horowitz with Khosla Ventures participating; the February 2025 round valued it at $2.75 billion.techcrunch.com