Ambient Artificial Intelligence in Hand Surgery: Insights, Pearls, and Pitfalls From Real-World Use

Area of Science:

• Medical Informatics
• Surgical Workflow Optimization
• Artificial Intelligence in Healthcare

Background:

• Documentation burden contributes significantly to surgeon burnout, especially in high-volume hand surgery clinics.
• Clinical encounters in hand surgery often involve complex diagnoses and longitudinal care plans.
• Ambient AI tools offer a potential solution by automating transcription and summarization of clinical encounters.

Purpose of the Study:

• To evaluate the impact of ambient AI on clinical documentation in a hand surgery setting.
• To compare the quality and characteristics of AI-generated notes with surgeon-written notes.
• To assess the workflow adaptation and perceived cognitive impact of ambient AI tools.

Main Methods:

• Ambient AI tool implemented across all outpatient visits in a hand surgery clinic.
• Workflow adaptation, documentation quality, and cognitive impact were observed.
• 14 carpal tunnel syndrome notes (7 AI-generated, 7 surgeon-written) were analyzed for word count, readability, and history inclusion.

Main Results:

• AI-generated histories were longer and more linguistically complex than surgeon-written ones.
• Surgeon-written assessments were more readable, structured, and consistent.
• Social history was more frequently documented in AI-generated notes, which also featured structured assessment and plan sections.

Conclusions:

• Ambient AI can aid in creating structured, detailed clinical notes for hand surgery.
• Effective integration necessitates clinician engagement and workflow alignment for accuracy and efficiency.
• Findings underscore the potential and practical challenges of using ambient AI in surgical documentation.