Ambient documentation appears to reduce clinician workload
A hybrid ambient documentation program combining generative artificial intelligence with a virtual scribe was associated with less after-hours work, faster note completion, and better financial productivity within 50 days for primary care clinicians.
Ambient documentation reduced primary care clinicians' work after hours and improved note completion and financial productivity, a recent study found.
Researchers at a health care system in Massachusetts performed a retrospective study from July through December 2024 to evaluate the effects of a hybrid ambient clinical documentation program that used generative artificial intelligence to draft clinical notes and a virtual scribe to review the notes, finalize them, and integrate them into the EHR.
The main outcomes over the studied 50-day period included work after hours or “work outside work,” defined as 5:30 p.m. to 7:00 a.m. on weekdays and all weekends and holidays; delayed documentation, defined as the proportion of notes that were open for at least two business days; and financial productivity, defined by work relative value units. The study results were published Nov. 17 by the Journal of General Internal Medicine.
Of 181 attending physicians and advanced practice clinicians across 14 adult primary care practices who were eligible for the study, 66 (36%) clinicians caring for 108,224 patients voluntarily enrolled in the hybrid ambient clinical documentation program. Clinicians who opted in were more likely to be female (72.7% vs. 60.9%) and to have larger patient panels (691.1 vs. 544.4). After program activation, after-hours work initially increased by 32.1% (95% CI, 25.5% to 39.1%) on day 10 but had decreased by 41.7% (95% CI, 29.4% to 51.8%) by day 50 versus baseline. Odds of delayed note closure had decreased by 66.5% (95% CI, 64.7% to 68.3%) at day 10 and 66.0% (95% CI, 57.8% to 72.5%) at day 50, while financial productivity had increased by 1.5% (95% CI, −0.2% to 3.2%) and 12.1% (95% CI, 5.7% to 18.9%) at the respective time points.
The study looked only at academic primary care in one health care system, and the results could have been subject to selection bias, the researchers noted. They wrote that their study is one of the largest and most rigorous evaluations of the effects of an ambient documentation tool on clinician documentation and productivity and “offers actionable insights into optimizing AI tools to support clinicians and improve care by focusing on [work outside work] and documentation delay as proxies for burden and well-being.”