Special Topic Burnout: Ambient Artificial Intelligence Scribes in Pediatric Primary Care: A Mixed Methods Study.

Abstract

Objective: Quantify the effect of ambient artificial intelligence (AI) scribe technology on work experience, clinical operations, and patient experience in pediatric primary care.

Methods: We conducted a 12-week study of 39 clinicians within a large pediatric primary care network. Clinician experience was measured using a custom survey instrument which included a combination of discrete and free-text responses. Qualitative analysis of free-text responses provided additional context and identified key facilitators and barriers to optimal usage. Proprietary EHR efficiency measures and utilization data were used to further quantify clinician experience, adoption, and operational effects. Patient experience was measured using a vendor-supplied survey instrument.

Results: AI scribe technology was used in 32% of eligible encounters (6,249 of 19,264). Survey responses demonstrated significant heterogeneity in clinician experience. The most commonly reported benefits were reduction in self-perceived cognitive burden (21/39), ability to finish work sooner (18/39), and ability to enjoy clinical work more (18/39). No significant change in EHR efficiency measures around documentation time, afterhours EHR time, total EHR time, or visit closure rates were observed. Clinicians reported AI scribes were most helpful for urgent care visits and for summarizing the history of present illness. Areas of improvement specific to pediatric primary care include suboptimal performance in summarizing and organizing content relating to preventive and behavioral health visits. Patient survey responses showed no difference in Net Promoter Score and related patient experience questions between ambient and non-ambient encounters.

Discussion: A subset of clinicians reported self-perceived improvements in work experience despite unchanged EHR efficiency measures. Heterogeneity in clinician experience suggests that benefit from ambient technology likely depends on personal and contextual factors. Enhancements to note organization and facility with pediatric well visit and behavioral health content could improve the utility of this tool for pediatric primary care.