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Psychiatric Documentation and Management in Primary Care With Artificial Intelligence Scribe Use
Victor M Castro1,2, Thomas H McCoy1,2, Pilar Verhaak1,2
1Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital, Boston.
JAMA Psychiatry
|January 21, 2026
Summary
Artificial intelligence (AI) ambient scribes increase neuropsychiatric symptom documentation but reduce psychiatric intervention likelihood in primary care. Further research is needed to assess the clinical impact of these AI scribe changes.
Area of Science:
- Medical Informatics
- Clinical Documentation
- Artificial Intelligence in Healthcare
Background:
- Widespread adoption of AI ambient scribes in medicine necessitates understanding their impact on clinical practice.
- Current research lacks comprehensive analysis of AI scribes' association with clinician documentation and treatment patterns.
Purpose of the Study:
- To compare the documentation and treatment of psychiatric symptoms in primary care notes generated by AI ambient scribes versus human or no scribes.
- To characterize the influence of AI ambient scribes on the management of neuropsychiatric conditions in outpatient settings.
Main Methods:
- A matched retrospective case-control study analyzed primary care annual visit notes from two major hospital systems.
- Notes were categorized into four groups: AI scribe, human scribe, contemporaneous no scribe, and pre-scribe deployment.
- Sociodemographic and clinical features were used for 1:1 matching, and neuropsychiatric symptom documentation, RDoC levels, and psychiatric interventions were assessed.
Main Results:
- AI-scribed notes showed significantly greater estimated levels of neuropsychiatric symptoms across all Research Domain Criteria (RDoC) domains.
- The likelihood of psychiatric intervention (referral, new diagnosis, or antidepressant prescription) was significantly lower in AI-scribed visits compared to contemporaneous unscribed visits (aOR, 0.83).
- No significant difference in psychiatric intervention likelihood was found between human-scribed and contemporaneous unscribed visits (aOR, 0.97).
Conclusions:
- AI ambient scribes in primary care are associated with enhanced documentation of neuropsychiatric symptoms.
- However, their use correlates with a reduced likelihood of documented psychiatric symptom management.
- Further investigation is required to determine if these documentation and management changes impact patient outcomes.
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