Guiding the Safe and Effective Integration of Ambient Digital Scribes into Primary Care

The adoption of electronic health records (EHRs) has significantly contributed to primary care provider (PCP) burnout, with documentation burdens shifting administrative tasks from support staff to physicians, reducing career satisfaction, straining patient relationships, and lowering care quality. High PCP EHR use is strongly linked to exhaustion, stress, and burnout, contributing to a 50 percent burnout rate among PCPs—among the highest across clinical specialties. PCPs spend over half their workday on EHR tasks, including 1.4 hours after clinical hours, making documentation the single most time-consuming activity. Generative AI technologies, particularly ADSs, offer a promising solution by using speech recognition and natural language processing to create structured clinical notes, potentially reducing documentation time and alleviating administrative burdens. Early studies suggest that ADSs can be faster than traditional methods and may decrease burnout; however, concerns about bias, transcription accuracy, and their impact on patient-doctor interactions remain. Despite these risks, ADS adoption is accelerating, with major organizations integrating these tools nationwide. Yet, smaller, resource-constrained hospitals may face challenges in adopting this technology.

Researchers will study ADS implementation, identify barriers and facilitators, and develop evidence-based guidelines to support safe and effective use of ADSs in diverse healthcare settings.

The specific aims of the research are as follows:

• Identify the barriers and facilitators to successful ADS implementation through the lens of systems engineering.
• Develop a prototype guide for the safe and effective integration of ADSs into primary care.

The researchers will leverage data from an earlier implementation of ADSs to identify PCPs who experienced the greatest and least benefits from ADS adoption using a mixed-methods approach. They will conduct qualitative interviews with these PCPs to uncover barriers and facilitators to implementation, and with patients to explore how ADSs impact their primary care experience and perceptions of the technology. Using a systematic approach, the team will develop a prototype guide with evidence-based insights for safe and effective ADS integration, co-designed with internationally recognized experts in primary care, healthcare technologies, patient safety, and AI, to support implementation across diverse healthcare organizations.

This research addresses the safety and workflow challenges arising from the rapid adoption of ADSs in primary care. By developing a prototype guide for their safe and effective implementation, it offers essential insights into how this AI-driven technology will transform workflows. Tailored for healthcare organizations of all sizes, the guide aims to ensure effective adoption and reduce disparities, especially in rural areas. Addressing the high burnout rates among PCPs linked to documentation burdens, the study will advance understanding of ADSs’ safety, efficacy, and usability. Ultimately, it will empower clinical and operational leaders with practical strategies while laying the groundwork for future research to refine these guidelines.