Evaluation of an Ambient Artificial Intelligence Documentation Platform for Clinicians
Abstract
Importance: The increase of electronic health record (EHR) work negatively impacts clinician well-being. One potential solution is incorporating an ambient artificial intelligence (AI) documentation platform. Objective: To understand clinician experience before and after implementing ambient AI. Design, Setting, and Participants: This quality improvement study was a pilot evaluation with before and after survey and EHR metrics conducted at a large health care organization in Northern and Central California. Clinicians were purposively sampled to be representative of region and specialty. Ambient AI was implemented in April 2024 with EHR data from 3 months before and after implementation. Data were analyzed from May to September 2024. Exposure: Ambient AI access. Main Outcomes and Measures: Metrics of time were examined in notes per appointment, off-hour EHR activities, documentation note length, progress note length, NASA Task Load Index (NASA-TLX) score, mini-Z burnout question, and overall experience. Results: Among 100 clinicians (53 male [53.0%]; mean age, 48.9 years), 58 clinicians (58.0%) were in primary care and 92 clinicians had EHR metrics. Mean time in notes per appointment significantly decreased from 6.2 to 5.3 minutes (P < .001), with a bigger decrease for female vs male clinicians. Mean NASA-TLX scores all decreased after using ambient AI: mental demand (12.2 to 6.3), hurried or rushed pace (13.2 to 6.4), and effort to accomplish note writing (12.5 to 7.4) (all P < .001). More primary care clinicians (85.8%) reported that ambient AI improved overall satisfaction at work compared with clinicians in medical (36.4%) and surgical (50.0%) subspecialties (P < .001). Conclusions and Relevance: This study found that ambient AI was associated with improved overall experience and time in notes for clinicians but with varying outcomes by sex and specialty.
Clinical implications
This quality improvement study at Sutter Health evaluated Abridge ambient AI with 100 ambulatory clinicians. Key findings: mean time in notes decreased from 6.2→5.3 minutes per appointment (P<.001), with larger reductions for female clinicians. NASA-TLX scores for mental demand, hurried pace, and effort all decreased significantly (P<.001). Burnout decreased from 42.1% to 35.1% (not significant, P=.12). Primary care clinicians reported higher satisfaction (85.8%) compared to medical (36.4%) and surgical (50.0%) subspecialties. Clinicians reported improved ability to give patients undivided attention (57.9% to 93.0%, P<.001). Overall experience score was 7.8/10 and recommend to others was 8.5/10. Off-hour EHR work did not significantly change. Documentation and progress note length increased, potentially reflecting more comprehensive notes.