Transforming Medical Documentation with Ambient Scribes
Written by: Gaurav Kaushik and Cheryl Reifsnyder, PhD
Ambient artificial intelligence , or ambient AI, is a subset of AI technology designed to be proactive, reactive, and intuitive, enabling it to solve problems in real time. “Ambient” refers to these solutions’ ability to remain in the background until triggered.
Within the healthcare industry, ambient AI has broad applications. Most notably, ambient AI scribes show particular promise because this technology has the potential to relieve many of healthcare’s greatest challenges and bring providers back to what attracted them to medicine in the first place which is to focus on their patients.
An ambient scribe is a solution that captures and transcribes real-time patient-provider interactions, then synthesizes the visit transcript and clinical context to create clinical notes. Ambient scribes are not simply dictation tools or remote scribes. These solutions are designed to enhance and simplify providers’ clinical workflows by automatically generating accurate, complete clinical documentation at the point of care.
In this article, we explore how ambient scribes are transforming the medical documentation process—and, as a result, transforming the care experience for both patients and providers.
Ambient AI in healthcare
Today’s healthcare professionals spend an immense amount of time on documentation. One study found that physicians spend an average of 16 minutes 14 seconds using EHRs per patient visit. Another revealed that office-based physicians spend over 5 hours using EHRs per 8 hours scheduled with patients. In a third report, researchers demonstrated that up to 78% of the time physicians interact with EHRs is spent writing and reviewing notes.
However a pilot study, at Stanford, demonstrated an ambient scribe’s early promise for reducing clinicians’ documentation burden. Researchers found:
- About 96% of physicians reported the technology easy to use
- 78% of physicians reported that the technology expedited clinical documentation
- About two-thirds of physicians reported time savings
In another recently published study, researchers evaluated the clinical utility of an end-to-end ambient AI tool—again yielding promising results:
- AI produced higher quality documentation, as evidenced by higher Sheffield Assessment Instrument for Letters (SAIL) scores
- Consultations utilizing ambient AI tools were 26.3% shorter on average without impacting total patient interaction time
- Clinicians using the ambient AI tool reported reduced task loads and enhanced experiences
How ambient scribes work?
Ambient scribes function by ambiently listening to patient encounters using a secure microphone or recording device. The tool uses “speech-to-text” technology to create real-time encounter transcripts without generating audio recordings. The ambient scribe then uses machine learning (ML) and natural language processing (NLP) to develop clinical notes documenting the visit and summarizing key content. The software generates this clinical note within minutes for clinician review and finalization.
Ideally, ambient scribes integrate directly with the practice’s EHR. This enables the scribe to generate clinical notes directly into the patient’s EHR record.
With their ability to transcribe physician-patient encounters and create accurate, complete clinical notes, ambient scribes can immensely benefit healthcare professionals who interact with patients, including nurses, primary care physicians, specialists, and other provider types.
Benefits of ambient scribes
Ambient scribes provide numerous benefits for today’s healthcare industry.
Decreased provider burnout
In Medscape’s 2021 physician survey, 42% of physicians reported feeling burned out. This number has been increasing and linked to the high administrative burden clinicians face today. EHR-based clinical documentation is an increasing time requirement for physicians and a major driver of provider dissatisfaction and burnout. Clinicians often spend hours daily documenting patient care, a task that often extends past the end of the working day.
However, ambient scribes can help reduce clinician burnout by eliminating much of their documentation burden. Ambient scribes automate the documentation process, reducing the cognitive load and stress of documentation for physicians and freeing them to spend more time on patient care.
Time savings
A recent ambient AI scribe pilot program found the solution’s use saved most physicians an average of an hour per day at the keyboard. The ambient scribe tool also reduced the amount of time physicians spent:
- Working in the EHR
- Documenting patient visits after hours
- Creating medical notes
Improved efficiency
Ambient AI tools simplify clinicians’ workflows in multiple stages by taking over the bulk of the clinical documentation process. This helps improve practice efficiency, which leads to other benefits as well. For instance, providers can focus more completely on patients rather than dividing their attention between patients and screens.
Increased efficiency, and enhanced patient focus combine to help providers improve the quality of patient care as well as improve their overall workflow.
Improved accuracy
By applying ML to patient encounters, ambient scribes can augment clinicians’ overall capabilities. One example is the scribe’s capacity to improve the quality of clinical notes. Ambient scribes capture details of patient-provider conversations and tailor the clinical notes to accommodate nuances of each physician’s style and specialty. Clinical notes no longer suffer from the omissions seen with manual notetaking.
Ambient scribes can also enhance medical coding accuracy; some can accurately capture and propose relevant codes to include in the clinical documentation.
Improved provider-patient interactions
One of the most significant benefits of an ambient scribe is its ability to enhance provider-patient interactions. Most physicians spend substantial portions of each patient visit entering EHR data. This data-entry time prevents physicians from giving patients their full attention, negatively impacting effective and empathic communication and care.
An ambient scribe allows providers to focus on patients rather than their EHR screens. Greater face-to-face interaction enhances patient engagement and increases patient satisfaction.
In their ambient scribe pilot program, the Permanente Medical Group found scribe use resulted in:
- Enhanced physician-patient encounters
- Improved patient care by personalizing patient encounters
- 7% of patients reporting spending more time with their provider
- 81% of patients reporting that their providers spent less time looking at the computer screen
Challenges and concerns of ambient scribes
Privacy and security
Evaluating the underlying technology used by ambient scribes before employing any system is critical. For healthcare use, scribe technology must meet minimum security, data privacy, and HIPAA compliance requirements. When considering ambient scribe technology, here are some key questions to ask:
- What are the solution’s data storage practices?
- How does the solution process data?
- What security measures exist to protect patient privacy?
- What data was used to train the solution’s large language model?
Interoperability
Another essential consideration is interoperability: How well does the ambient scribe solution integrate with your practice’s EHR? Evaluating the degree of a solution’s EHR integration will enable you to determine whether the solution can support your desired workflows.
Accuracy and reliability
Finally, evaluating an ambient scribe’s reliability and accuracy is critical. If the vendor has evaluated their solution’s accuracy and reliability, ask how these were assessed. What measures were used to determine the solution’s accuracy? What data can support their claims?
One known accuracy issue with generative AI solutions is their potential to “hallucinate” or present false information without a sound basis. For example, in the Permanente Group’s pilot study, one physician discussed issues with a patient’s hands, feet, and mouth; the ambient scribe recorded this discussion as the patient’s diagnosis with hand, foot, and mouth syndrome. Take time to understand the frequency with which such hallucinations could occur.
Cost
Although ambient scribe technology could add a new expense for your practice, ambient scribes provide numerous cost-saving opportunities. For instance, giving physicians faster access to real-time patient data can enable faster diagnoses and decision-making. Ambient scribes can provide opportunities for improved, real-time data analysis, improving physicians’ ability to recommend appropriate preventive measures or diagnose conditions they might have missed without the scribe’s assistance. These, in turn, can lead to increased cost savings.
Ambient scribe technology also provides cost savings simply by increasing a practice’s operational efficiency.
Ambient scribes: the future of medical documentation?
AI has already transformed the healthcare industry in areas ranging from administrative flow to inventory management to improved patient diagnoses. However, previous AI iterations lacked contextual awareness. Ambient AI is capable of recognizing more nuance in its environment.
Ambient scribes can transcribe and interpret healthcare documentation, freeing physicians from the need to record detailed notes during patient encounters. Instead, providers can communicate more naturally with patients while ambient AI operates behind the scenes, automatically transcribing conversations into digital format. The ambient scribe can capture nuances of a provider’s speech to generate clinical notes that seamlessly integrate into the patient’s EHR.
Veradigm is deeply committed to the evolving role of AI in healthcare, with its promise to bring a broad range of benefits to both providers and patients. Veradigm is dedicated to supporting and encouraging the development of AI solutions that will improve the practice of healthcare and is already using AI to enhance the efficiency and efficacy of some of our existing solutions and continually looking for new opportunities to use AI to further improve our products and services.
Ambient AI tools capable of integrating with Veradigm solutions can be found listed in the Veradigm App Expo. Be on the lookout for an upcoming blog post with more details about ambient AI scribe integrations compatible with the Veradigm EHR, or contact us today to learn more about how Veradigm is supporting ambient scribe technology.