Does AI-Powered Clinical Documentation Enhance Clinician Efficiency? A Longitudinal Study

Nuance's Dragon Ambient eXperience (DAX) Copilot is an artificial intelligence (AI)-driven ambient clinical documentation software platform. Atrium Health, a large multisite academic learning health system, was the first to use DAX Copilot. This study evaluates outcomes for participating clinicians after DAX implementation.

In this longitudinal study, 112 primary care clinicians using DAX were recruited between June and August 2023 along with a control group of 103 clinicians from similar practices not using DAX. Primary outcomes of electronic health record (EHR) use and financial impact were assessed over 180 days using linear mixed models. Within the DAX group were two subgroups: active users (who transferred ≥25% of DAX notes) and high users (who transferred ≥60% of DAX notes). We performed exploratory analyses to compare the control group with DAX subgroups, in addition to subgroup analyses stratified by patient volume and clinician specialty.

After controlling for length of intervention, age, gender, provider type, years of practice, and baseline outcome, we did not find statistical significance in the primary analyses of EHR and financial metrics. Exploratory analyses suggested that small decreases in documentation hours could result from high DAX usage (means ratio [MR] 0.93, 95% confidence interval [CI] 0.88 to 0.98) and from implementing DAX with low-volume clinicians (MR 0.91, 95% CI 0.83 to 0.99) and with family medicine clinicians (MR 0.91, 95% CI 0.85 to 0.98).

AI-powered ambient clinical documentation software has been promoted as a promising strategy to alleviate the documentation burden faced by outpatient clinicians. However, our findings suggest that the tool did not make clinicians as a group more efficient. Future studies can further investigate the utility of DAX for clinician subgroups and alternative implementations with improved clinical adoption. (Funded by Wake Forest University Health Sciences; ClinicalTrials.gov number, NCT06329427.).