In an American Medical Association (AMA) survey report published earlier this year, among the 1,183 respondents, including 464 primary care physicians and 719 specialists, the feedback reflected a rapid uptake of AI. In a survey performed in November 2024, 80% of the respondents said that using AI for documentation of billing codes, medical charts, or visit notes would be relevant to their practice. That was up from 74% in August of 2023 (AMA. https://tinyurl.com/2s36fpzd).
Explore This Issue
July 2025Users of AI for documentation jumped considerably just from August 2023 to November 2024—from 13% of respondents to 21%.
The survey found that 55% were either already using or planning to use AI for documentation in the near term, up from 39% in 2023.
This year’s American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) Report on Artificial Intelligence said easing administrative burden is a key role for AI (Otolaryngol Head Neck Surg. doi:10.1002/ohn.1080).
“A key use case is clinical documentation, the biggest time sink for most physicians in clinic,” the authors wrote. “Increasingly, minimal clinician input is needed to produce highly relevant, accurate documentation while relieving clinicians of a clerical burden.”
Studies have typically shown that physicians tend to save time working in the EHR, although not all of the results are dramatic.
A study from the University of Pennsylvania that included 46 clinicians from 17 specialties found that from April 2024, the pre-technology baseline, to June 2024, the use of an ambient scribing tool was associated with a decrease in time in notes per appointment, from 10.3 minutes to 8.2 minutes, a 20.4% drop. There was a 30% decrease in after-hours work time per workday, a drop from 50.6 minutes to 35.4 minutes a day (JAMA Netw Open. doi:10.1001/jamanetworkopen.2024.60637).
A similar study out of Stanford found that, over three months, the median time per note was reduced by about half a minute with an ambient scribe (J Am Med Inform Assoc. doi:10.1093/jamia/ocae304). A companion study at Stanford found large reductions in task load and feelings of burnout (J Am Med Inform Assoc. doi:10.1093/jamia/ocae295).
But the data don’t always paint a picture of a dramatic boon in time savings for everyone. The Stanford study found that ambient scribes were only used in about half of patient encounters over the study period—9,629 out of 17,428 — and that there was “significant inter-user heterogeneity.”
In a recently published report on its one-year experience with an ambient scribe that involved 2.5 million uses, the Permanente Group found that not all physicians tended to save a large amount of time (NEJM Catal Innov Care Deliv. doi:10.1056/CAT.25.0040).
“High users”—those in the top third by volume—“comprised the vast majority—89% of the total—of ambient AI scribe activations,” the Permanente researchers said. “High users also tended to have more time spent in notes, orders, and clinical review per appointment, while having fewer visits per day, on average, prior to ambient AI scribe deployment.”
These high users saw a reduction of 0.7 minutes—42 seconds—per note, while low users—those comprising the bottom two-thirds of use volume—saw a reduction of just 0.15 minutes—9 seconds—per note.
Reductions were also seen for ambient scribe users in “pajama time” and time spent on documentation between 7 a.m. and 7 p.m. Eighty-four percent of users said it improved their patient interaction, and 82% said it improved their work satisfaction.
Among patients, 39% reported that their doctor was spending more time than usual talking directly to them, and 56% said it improved the quality of their visit.
A March 2025 report from the Peterson Health Technology Institute AI Taskforce—made up of representatives from eight health systems, 10 ambient scribe companies, and other experts in health innovation—said the evidence suggests the early impact to be positive on burnout and cognitive load but mixed on time saved and financial effects (Peterson Health Technology Institute. https://tinyurl.com/2rxxydpf).
“Given the costs and limited evidence to date on return on investment, however, there is a real risk that as ambient scribe adoption continues apace, health systems will implement solutions in ways that add to overall costs of care,” task force members wrote.
Cleveland Clinic went through a rigorous process in 2024, evaluating several platforms across 80 specialties and subspecialties. Earlier this year, Ambience Healthcare’s platform was rolled out across the entire system.
Paul Bryson, MD, MBA, director of the Cleveland Clinic Voice Center, who was involved in the trials of some of the systems, said he has had a good experience. When an encounter is done, he can go into Epic and easily get the note broken down into its component parts.
“When I click in Epic (EHR) my Ambience tab, my HPI (history of present illness) and assessment and plan are right in front of me, and then I can quickly skim it and put it into my note and finish it,” he said.
Dr. Bryson—who still works with human scribes sometimes as he goes through the transition—needs to review the ambient scribe’s notes, but said that it has not been time-consuming.
“The editing hasn’t been real burdensome,” he said. “I feel like the ambient scribe sometimes can capture more extended conversations a little bit better, depending on the human scribe …. Sometimes when you’re having a really long conversation about surgery and post-op and stuff like that, sometimes some things can get lost if somebody’s transcribing for you.”
Training and Implementation
As for the training?
“Five minutes,” Dr. Bryson said. “It’s super quick.”
During the pilot phase, providers reported reduced mental load, faster documentation time, decreased burnout, and less time spent working on documentation outside of work. In addition, providers felt the notes were detailed and improved care coordination across specialties.
Eric Boose, MD, Cleveland Clinic’s associate chief medical officer, said that “during the pilot phase, providers reported reduced mental load, faster documentation time, decreased burnout, and less time spent working on documentation outside of work. In addition, providers felt the notes were detailed and improved care coordination across specialties.”
Andres Bur, MD, associate professor of otolaryngology-head and neck surgery and vice chair for technology, AI, and innovation at the University of Kansas Medical Center, in Kansas City, Kan., said he recently tried several ambient scribe platforms as his center explores its options.
When we have tools that take care of documentation for us, initially you’re going to be very careful to make sure that the scribe is behaving appropriately, that it’s documenting what you say,” he said. But as you see good results, as you start to become more reliant on the tool, then you may be less likely to check. —Andres Bur, MD
Leave a Reply