The first randomized controlled trials for ambient AI have finally arrived, and NEJM AI just gave us the strongest evidence yet that scribes deliver… minimal time savings.
The first study was a mixed bag. UCLA researchers assigned 238 physicians across 14 specialties to one of two scribes – Microsoft DAX and Nabla – or usual care for two months.
- Nabla ended up saving about 23 seconds per visit, while DAX shaved off a whopping 5 seconds (which wasn’t even statistically significant).
- Both scribe groups did however report less burnout and reduced cognitive burden than the usual care controls.
The second study told a similar tale. Physicians at the University of Wisconsin that used Abridge’s AI scribe for 6 weeks trimmed their daily documentation time by 22 minutes.
- Still not a world-changing difference, but the UW physicians also saw significant positive improvements in work exhaustion and well-being.
But wait, there’s more. While those studies didn’t go as far as to suggest a cause for the lackluster time savings, a separate well-timed study from Navina offered a possible mechanism.
- Scribes capture clinical conversations. Those conversations only inform a piece of the note, and those notes are only a piece of the workflow.
- Navina found that incorporating patient medical histories into ambient documentation dramatically improves both note completeness and quality, which also seems like a great way to help physicians avoid lengthy manual chart reviews to fill any remaining gaps.
Then why do scribes get rave reviews? That’s a mystery that’s still up for debate.
- It’s worth noting that “average time savings” include plenty of physicians who barely used the scribe. UCLA only had about a third of physicians pick up the tools, while UW was close to a best-case scenario at 71%.
- It’s also possible that physicians enjoy not having to hold the visit in their head until they can finish their note, and getting rid of that burden is as magical as actual time savings.
The Takeaway
Not everything that can be measured matters, and not everything that matters can be measured. AI scribes might not be productivity tools quite yet, but physicians are clearly finding plenty of reasons to love them until they get there – even if more time isn’t one of them.
