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IF 10.5 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

JAMA Network Open Pub Date : 2025-03-03 DOI:10.1001/jamanetworkopen.2025.1904

Shreya J Shah, Trevor Crowell, Yejin Jeong, Anna Devon-Sand, Margaret Smith, Betsy Yang, Stephen P Ma, April S Liang, Clarissa Delahaie, Caroline Hsia, Tait Shanafelt, Michael A Pfeffer, Christopher Sharp, Steven Lin, Patricia Garcia

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引用次数: 0

摘要

重要性：对环境人工智能（AI）抄写工具进行评估的定性研究十分有限。此类研究通过捕捉生活经验，可以更深入地了解环境人工智能的实施情况：评估医生对环境人工智能抄写工具的看法：这是一项定性研究，采用半结构式访谈，以 "到达、功效、采用、实施、维护/实用、稳健实施和可持续性模型"（RE-AIM/PRISM）框架为指导，使用归纳法和演绎法进行专题分析。参加人工智能抄写员试点项目的医生受邀参加了访谈，试点项目包括社区和教师实践、初级保健和非住院专科。加利福尼亚州一家医疗机构的环境人工智能抄写员试点项目于 2023 年 11 月至 2024 年 1 月进行：主要结果和衡量标准：采用该技术的促进因素和障碍、实际效果以及提高可持续性的改进建议：对来自初级保健（13 [59%]）和非住院专科（9 [41%]）的人工智能试点医生进行了 22 次半结构化访谈，其中包括来自社区实践（12 [55%]）和教师实践（10 [45%]）的医生。促进采用的因素包括使用方便、易于编辑以及对工具质量的普遍积极评价。医生对环境人工智能抄写工具对认知需求（16 条评论中的 16 条[100%]）、时间需求（28 条评论中的 28 条[62%]）、工作与生活的融合（11 条评论中的 10 条[91%]）和总体工作量（9 条评论中的 8 条[89%]）的影响表达了积极的看法。医生对环境人工智能抄写工具对他们与病人接触的影响的看法大多是积极的（56 条评论中的 38 条[68%]）。采用该工具的障碍包括对非英语病人的功能有限，以及没有特定设备的医生无法使用。医生对准确性和风格的看法大多是负面的，尤其是在笔记长度和编辑要求方面。对工具改进提出了一些具体建议，医生们对长期使用环境人工智能抄写工具的潜力持乐观态度：在这项定性研究中，我们发现环境人工智能抄写工具对医生的工作量、工作与生活的融合以及患者参与度产生了积极影响。研究确定了采用的主要促进因素和障碍，以及改进工具的具体建议。这些研究结果表明，环境人工智能抄写员具有减轻临床医生负担的潜力，以用户为中心的建议为改进未来迭代和提高采用率提供了实用指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Physician Perspectives on Ambient AI Scribes.

Importance: Limited qualitative studies exist evaluating ambient artificial intelligence (AI) scribe tools. Such studies can provide deeper insights into ambient AI implementations by capturing lived experiences.

Objective: To evaluate physician perspectives on ambient AI scribes.

Design, setting, and participants: A qualitative study using semistructured interviews guided by the Reach, Efficacy, Adoption, Implementation, Maintenance/Practical, Robust Implementation, and Sustainability Model (RE-AIM/PRISM) framework, with thematic analysis using both inductive and deductive approaches. Physicians participating in an AI scribe pilot that included community and faculty practices, across primary care and ambulatory specialties, were invited to participate in interviews. This ambient AI scribe pilot at a health care organization in California was conducted from November 2023 to January 2024.

Main outcome and measures: Facilitators and barriers to adoption, practical effectiveness, and suggestions for improvement to enhance sustainability.

Results: Twenty-two semistructured interviews were conducted with AI pilot physicians from primary care (13 [59%]) and ambulatory specialties (9 [41%]), including physicians from community practices (12 [55%]) and faculty practices (10 [45%]). Facilitators to adoption included ease of use, ease of editing, and generally positive perspectives of tool quality. Physicians expressed positive sentiments about the impact of the ambient AI scribe tool on cognitive demand (16 of 16 comments [100%]), temporal demand (28 comments [62%]), work-life integration (10 of 11 comments [91%]), and overall workload (8 of 9 comments [89%]). Physician perspectives of the impact of the ambient AI scribe tool on their engagement with patients were mostly positive (38 of 56 comments [68%]). Barriers to adoption included limited functionality with non-English speaking patients and lack of access for physicians without a specific device. Physician perspectives on accuracy and style were largely negative, particularly regarding note length and editing requirements. Several specific suggestions for tool improvement were identified, and physicians were optimistic regarding the potential for long-term use of ambient AI scribes.

Conclusion and relevance: In this qualitative study, ambient AI scribes were found to positively impact physician workload, work-life integration, and patient engagement. Key facilitators and barriers to adoption were identified, along with specific suggestions for tool improvement. These findings suggest the potential for ambient AI scribes to reduce clinician burden, with user-centered recommendations offering practical guidance on ways to improve future iterations and improve adoption.

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来源期刊

JAMA Network Open Medicine-General Medicine

CiteScore

16.00

自引率

2.90%

发文量

2126

审稿时长

16 weeks

期刊介绍： JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health. JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.