Subjective and Objective Impacts of Ambulatory AI Scribes

OBJECTIVES: To evaluate the association between perceived and actual changes in physician documentation time (DocTime) following implementation of an artificial intelligence (AI) scribe and to determine whether physicians with higher baseline DocTime experience greater reductions in DocTime from AI scribe use. STUDY DESIGN: Retrospective assessment of AI scribe use among 310 ambulatory physicians across specialties who chose to adopt a commercial tool at a large academic medical center. We utilized data from a postimplementation user feedback survey and electronic health record audit log measures of scribe use and DocTime. METHODS: We used an ordered logit model to assess adjusted associations between perceived and actual changes in DocTime in the 12 weeks after AI scribe adoption for the 252 physicians (81.3%) with survey data. Multivariate regression models assessed whether baseline DocTime modified the relationship between level of AI scribe use (percentage of weekly encounters) and DocTime. RESULTS: Although the majority of physicians perceived reductions in DocTime (86.5%) following AI scribe adoption, there was no overall association between perceived reductions and actual changes in DocTime (OR, 0.975; P = .144). In multivariate models, higher levels of AI scribe use were associated with lower DocTime. For each additional 10% of encounters with AI scribe use, DocTime decreased by just over 30 seconds per scheduled hour (P < .001). This effect was modified by baseline DocTime, with less-efficient physicians realizing the majority of time savings. CONCLUSIONS: Although most physicians perceived DocTime reductions from AI scribe use, those realizing the majority of actual time savings were those with higher relative baseline DocTime.