When The Permanente Medical Group (TPMG) rolled out ambient augmented intelligence (AI)—also known as artificial intelligence—scribes in late 2023, it was with an eye toward solving one of medicine’s most entrenched problems: documentation burden. One year and more than 2.5 million patient encounters later, the results are in, and they paint a compelling picture of how AI can help restore the human side of medicine.
TPMG’s recently published follow-up analysis in NEJM Catalyst found that these generative AI scribes not only saved physicians an estimated 15,791 hours of documentation time—equal to 1,794 eight-hour workdays—but also improved patient-physician interactions and enhanced doctor satisfaction. The findings build on TPMG’s 10-week pilot study, published earlier in 2024, which offered early evidence of the technology’s potential.
The Permanente Medical Group is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
“We have an opportunity and obligation to take advantage of innovative AI that improves patient care and augments our physicians’ capabilities, while supporting their wellness,” Kristine Lee, MD, analysis co-author and TPMG associate executive director of virtual medicine and technology, said in a Permanente Medicine release.
From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors—not a burden.
Addressing a documentation crisis
Clinical documentation has long been a leading contributor to physician burnout. Time spent outside normal hours—often called “pajama time”—completing notes, orders and reviews has steadily eroded physician satisfaction and interfered with patient relationships.
Ambient AI scribes aim to reverse this trend by transcribing and summarizing patient-physician conversations in real time, freeing doctors from the keyboard and giving them more face-to-face time with patients.
Unlike clinical decision support tools, the AI scribes don’t provide diagnoses or treatment suggestions. Instead, they passively capture visit conversations and produce drafts of clinical notes, which physicians can edit for accuracy.
“We have now shown that this technology alleviates workloads for doctors,” said Vincent Liu, MD, MSc, a research scientist with the Kaiser Permanente Division of Research and TPMG chief data officer. “Both doctors and patients highly value face-to-face contact during a visit, and the AI scribe supports that.”
During the 63-week evaluation from October 2023 through December 2024, TPMG physicians saw statistically significant reductions in note-taking time, time spent per appointment and pajama time. In all, 7,260 Permanente physicians used the technology across 2,576,627 patient encounters.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
Elevating the patient experience
For both physicians and patients, the impact of AI scribes extended beyond time savings. Physicians overwhelmingly agreed that the technology improved their interactions with patients: 84% reported a positive effect on communication, while 82% said their overall work satisfaction improved. Notably, departments with historically high documentation burdens—such as mental health, primary care and emergency medicine—saw the highest levels of adoption.
Patients noticed the change too. Nearly half (47%) said their doctor spent less time looking at the computer during their visit, and 39% noted their doctor spent more time speaking directly with them. Meanwhile, 56% reported a positive impact on the quality of their visit while no patients reported a negative one.
These results suggest that AI scribes may do more than alleviate clerical overload—they may help restore the fundamental human connection at the heart of medicine.
A clear dose–response relationship
The benefits of AI scribes were most pronounced among the highest users. Physicians in the top third of usage accounted for 89% of all activations and saw more than double the time savings per note compared with lower-frequency users. Before AI implementation, these physicians were already spending more time on notes and clinical review per appointment, making them the most likely to benefit.
Notably, the adoption patterns revealed that age and years in practice were not predictors of usage. AI scribe users had an average age of 47 and were about 19 years out of training, but these factors had no significant correlation with adoption rates. Women physicians were slightly overrepresented among users, particularly in specialties with high documentation burdens.
Sustained usage, even through a vendor transition mid-study, underscored the technology’s value. When TPMG shifted from its initial ambient AI scribe vendor to a new one as part of an enterprise-wide rollout, adoption remained consistent, and usage patterns continued uninterrupted.
Real-time efficiency gains
Quantitative measures supported what physicians reported qualitatively. Compared to non-users, physicians who adopted AI scribes recorded significant reductions in pajama time, work outside 7 a.m. to 7 p.m., time in notes and time in orders.
There was a small increase in time spent on the EHR’s in-basket, but overall, the reductions far outweighed any increases.
Interestingly, after deploying the second vendor’s tool, high users began spending even less time on notes than other users—reversing a trend in which they had previously spent more time pre-AI implementation.
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Overcoming barriers, expanding access
While most physicians embraced the tool, some still hesitated. Among respondents who used the technology infrequently or not at all, barriers included lack of integration with note templates and the perception that editing AI-generated notes took more time than typing from scratch.
These findings suggest that adoption may hinge not only on the tool’s effectiveness but also on how well it integrates into existing workflows. To expand use, TPMG is considering strategies such as better customization and targeted outreach to low-use physician specialties.
“The volume of usage of the AI scribe tool continues to increase linearly in our organization,” the study says. “The overwhelming volume of usage has been driven by high users, and there has been a ‘dose–response’ improvement in workload metrics with high users. However, we have also observed ongoing improvements in metrics for less frequent users.”
Further analysis is needed to understand the utility of AI scribes across different physician specialties and patient populations, but the initial results are promising.
Building a sustainable model
From the outset, TPMG designed its implementation to scale. During the 10-week pilot phase alone, 3,442 physicians used AI scribes in over 300,000 encounters. By the end of the first full year, more than 3,400 physicians had used the technology during at least 100 patient visits.
Importantly, physician satisfaction held steady throughout, even as usage scaled. Surveys conducted among adult and family medicine physicians found that 66% used the AI scribe five or more days per week, and 63% used it at every in-person visit. Use in telemedicine encounters was slightly lower, but still substantial.
“AI scribes continue to demonstrate efficacy in reducing physician workload, in aggregate producing estimated time savings in documentation of more than 15,700 hours for users—equivalent to 1,794 working days—compared with nonusers, over one year of use,” the study says.
Looking ahead at AI-assisted care
TPMG’s ambient AI scribe program offers a compelling model for other health systems considering similar technology. Its success was driven by careful analysis, user-centered implementation, and a commitment to improving both physician well-being and patient care.
While more research is needed to refine use cases and overcome barriers, the core lesson is clear: ambient AI scribes are not a futuristic ideal—they’re a present-day solution with measurable, human-centered benefits.
The authors concluded that AI scribes show great promise to reduce physician workload. Additional research is needed to determine the impact and utility of AI scribes within different physician specialties.
“Rapidly adopting and responsibly integrating AI technologies has the potential to improve the effectiveness and sustainability of health care and can be used to maintain organizational competitiveness,” the study says.
As health systems nationwide look for ways to reduce burnout and re-center the patient-physician relationship, The Permanente Medical Group’s experience may provide both inspiration and a road map.
