Clinician Experiences With Ambient Scribe Technology to Assist With Documentation Burden and Efficiency

Timely evaluation of ambient scribing technology is warranted to assess whether this technology can lessen the burden of clinical documentation on clinicians.

To investigate the association of ambient scribing technology with efficiency, quality, and perceived burden of clinical documentation in the outpatient setting.

This prospective, single-group pre-post quality improvement study was conducted between April and June 2024 in the outpatient setting of an academic health system in Philadelphia, Pennsylvania. Participants included physicians, nurse practitioners, and physician assistants. Data were analyzed from July to August 2024.

Access to an artificial intelligence-driven ambient scribing tool for outpatient notes.

The primary outcomes were time in notes per appointment, same-day appointment closure, after-hours work time, perceived burden of clinical documentation, and comments on clinicians' experiences using ambient scribing. A mixed-effects model was used. Both objective metrics and survey feedback were obtained. Targeted perspective questions, designed to assess clinician-perceived patient engagement and perceived documentation burden, were assessed on a 7-point Likert scale. Standard System Usability Scale (SUS) and net promoter score (NPS) formulas were used to analyze usability and recommendability data.

This study included 46 clinicians from 17 different medical specialties, with a mean (SD) of 11.1 (8.7) years in practice. From baseline to post intervention, use of the ambient scribing tool was associated with 20.4% less time in notes per appointment (from 10.3 to 8.2 minutes; P < .001), 9.3% greater same-day appointment closure (from 66.2% to 72.4%; P <.001), and 30.0% less after-hours work time per workday (from 50.6 to 35.4 minutes per workday; P = .02). Targeted perspective questions showed more favorable scores. Open-ended qualitative feedback from clinicians showed a range of positive, negative, and mixed feedback regarding their use of ambient scribing technology. SUS scores showed that the ambient scribing tool was easy to use. NPSs reflected the mixed qualitative feedback.

In this quality improvement study, the use of ambient scribe technology was associated with greater efficiency of outpatient clinical documentation, lower mental burden of documentation for clinicians, and greater sense of engagement with patients during outpatient appointments. Additional studies exploring urgent care settings, examining patient experience, and comparing multiple tools will be important to better understand the effect of ambient scribing on ambulatory care.