Randomized Trial Protocol: Epic Generative AI Chart Summarization Tool to Reduce Ambulatory Provider Cognitive Task Load

Abstract Background EHR documentation and chart review contribute to clinician workload and burnout. To alleviate pre-charting burden, Epic has released a new generative AI chart summarizer tool, which has become widely adopted; however, its impact has not been examined in randomized trials. Objective To evaluate whether access to an Epic generative AI chart summarization tool reduces cognitive task load among ambulatory providers compared with usual care. Methods Two-arm, parallel-group randomized controlled trial among ambulatory clinicians across multiple specialties. Clinicians will be randomized 1:1 to tool access versus usual care for 90 days. The primary outcome is change in a 4-item physician task load (PTL) adapted for the pre-charting task. Exploratory outcomes include EHR-derived time metrics (Caboodle and Signal), professional fulfillment/burnout (PFI), usability (SUS), clinician satisfaction, aggregated patient experience item from CG-CAHPS, and reported safety related metrics. Ethics and Dissemination Analyses will use clinician-level survey responses and aggregated EHR metrics; no patient-level protected health information will be included in the analytic dataset. Results will be disseminated via preprint and peer-reviewed publication. Article summary – Strengths and limitations of this study This study is a 3-month pragmatic randomized controlled trial evaluating a native EHR-embedded generative AI tool that summarizes prior clinical notes for ambulatory encounters. The primary outcome uses a validated cognitive task load instrument adapted specifically for pre-charting activities. Exploratory outcomes include objective EHR-derived time metrics, validated psychometric measures of burnout and professional fulfillment, and clinician-reported survey measures assessing perceived usefulness of the tool. The trial is single-centered, which may limit generalizabilty, and the intervention is optional-use and unblinded, which may attenuate observed effects and introduce performance bias.