AI-Powered Ambient Scribe Technology Experiences Among Emergency Physicians: Cross-Sectional, Mixed Methods Pilot...

Health care organizations have started to implement artificial intelligence-powered ambient scribe technology in clinical documentation workflows. Early outpatient studies have shown mixed results. Few studies have evaluated ambient scribes in the emergency department (ED). Due to differences in setting and patient acuity between the ED and ambulatory clinics, there remains a pressing need to research this technology in the ED.

This study aimed to evaluate emergency physicians' (EPs) satisfaction, perceived documentation efficiency, after-shift documentation time, and trust in ambient scribe-generated notes compared with in-person scribes or independent documentation, and to identify ED-specific challenges.

A cross-sectional survey was conducted among 16 board-certified adult and pediatric EPs who were granted access to the ambient scribe technology across 4 EDs. EPs used the ambient scribe for several months before completing a survey with multiple-choice and free-text responses. We performed a mixed methods analysis by summarizing quantitative data through descriptive statistics and performing a practical thematic analysis on free-text responses.

Of the 16 EPs, 14 (87.5%) completed the survey. Among respondents, 9 (64.3%; 95% CI 38.7%-83.7%) reported being satisfied or very satisfied with the ambient scribe, while 3 (21.4%; 95% CI 7.6%-47.6%) expressed dissatisfaction. When given the option, 7 (50%; 95% CI 26.8%-73.2%) respondents preferred the ambient scribe, 4 (28.5%; 95% CI 11.7%-54.6%) preferred in-person scribes, and none (95% CI 0%-20.6%) preferred independent documentation. Among previous users of in-person scribes, 50% (4/8; 95% CI 21.5%-78.5%) favored the ambient scribe. The ambient scribe was reported to improve documentation efficiency (10/14, 71.4%; 95% CI 45.4%-88.3%) and reduce after-shift documentation time (9/14, 64.3%; 95% CI 38.7%-83.7%). However, only 42.9% (6/14; 95% CI 22.3%-69.2%) of respondents trusted the accuracy of ambient scribe-generated notes, compared with 75% (6/8; 95% CI 40.9%-92.9%) who trusted in-person scribes. Few respondents found the ambient scribe helpful for physical examinations (3/13, 23.1%; 95% CI 8.2%-50.3%) or medical decision-making documentation (5/14, 35.7%; 95% CI 16.3%-61.2%). A thematic analysis identified 5 themes: challenges due to the workplace environment, challenges due to the patient population, workflow improvement, workflow harm, and narrow usefulness.

This mixed methods pilot study is among the first to evaluate ambient scribe technology in the ED. Our results add ED-specific insights to literature focused on the outpatient setting. Our findings reveal the potential for enhancing documentation efficiency and reducing administrative burden while highlighting setting-specific challenges. While most EPs preferred artificial intelligence-assisted documentation over independent charting, confidence in documentation accuracy and functionality remains limited compared with human scribes and varies by note component. As the demand for efficiency in emergency medicine continues to grow, scalable solutions such as ambient scribes could play a pivotal role if functionality, reliability, and physician trust can be further optimized.