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Implementation outcomes of AI documentation support in routine clinical practice: A non-randomized controlled trial
Felix A Heilmeyer1, Lisa Lyssenko1, Thomas Reinhard2
1Institute for Digitalization in Medicine, University Medical Center Freiburg, Freiburg, Germany.
This study shows that an AI documentation copilot in electronic health records (EHR) improved physician efficiency. The AI system, using a large language model (LLM), enhanced documentation speed without increasing review burden.
Area of Science:
- Medical Informatics
- Artificial Intelligence in Healthcare
- Clinical Documentation
Background:
- Clinical documentation significantly burdens physicians, impacting efficiency and contributing to burnout.
- Existing AI solutions often use simulated data or require audio input, limiting real-world applicability.
- Evaluating AI in actual clinical workflows is crucial for understanding its practical impact.
Purpose of the Study:
- To assess the effectiveness of an AI documentation copilot integrated into real-world electronic health record (EHR) workflows.
- To measure the impact of the AI copilot on physician efficiency and documentation review burden.
- To determine if AI assistance can reduce clinical documentation workload without compromising quality.
Main Methods:
- A non-randomized controlled trial involving 27 ophthalmology clinicians over 12 months.
- Participants self-selected into an intervention group (AI copilot) or a control group.
- The AI system, a Quantized Low-Rank Adaptation (QLoRA) tuned large language model (LLM), provided inline suggestions for discharge letter conclusions using EHR data.
Main Results:
- Clinicians using the AI copilot demonstrated significantly greater improvements in words-per-minute (WPM) compared to the control group (Δ+7.2 vs. Δ+2.6).
- The intervention group experienced a decrease in document revision frequency (from 1.36 to 1.26 per document), while the control group showed no significant change.
- Statistical analysis confirmed a significant interaction between group and exposure for documentation efficiency (p=0.045).
Conclusions:
- AI documentation assistance integrated into EHR workflows can enhance physician efficiency in real-world clinical settings.
- The AI copilot design helps reduce documentation burden while maintaining quality standards through established supervision.
- This approach supports the viability of AI as a cooperative tool to improve clinical practice without compromising patient safety.
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