Ambient AI scribe technology works well for many doctors at the physician-owned and -governed Hattiesburg Clinic, and they are welcome to use it if they wish. For some, however, the digital tool doesn’t fit into their workflow, so they are free to continue practicing without it.
Hattiesburg Clinic CEO Bryan N. Batson, MD, credits an organizational culture that values physician choice and autonomy for the success it has seen in lowering physician burnout rates and raising professional satisfaction.
“We benefit from physicians who are generally pretty happy,” Dr. Batson said during an AMA Integrated Physician Practice Section (AMA-IPPS) education session held as part of the 2024 AMA Annual Meeting in Chicago.
Dr. Batson, who holds the small and medium group seat on the section’s governing council, shared the results of a pilot Hattiesburg Clinic used to test the use of ambient scribes, which are powered by augmented intelligence (AI)—often called artificial intelligence.
He noted that his 300-physician health system has a reputation for being among the first to give digital health tools a try.
“Historically we've been pushed as an organization to adopt early, and ‘if somebody else out there in the country has access to it, I want it,’ is a recurrent theme for us,” Dr. Batson said.
“We have put technology as a priority for us as an organization,” he added. “Technology's been an important part of our strategy we've grown over the last several years.”
Using the microphone on a secure smartphone, the ambient AI scribe transcribes—but doesn’t record—patient encounters and then uses machine learning and natural-language processing to summarize the conversation’s clinical content and produce a note documenting the visit that physicians can approve with or without editing.
“It's not like a pure dictation of everything that happened, it actually organizes it for you into a fashion that makes sense,” Dr. Batson said.
It was also noted that Hattiesburg Clinic has been awarded Epic Gold Stars Level 10 for four years in a row, and that it has earned and maintained Stage 7 certification, the highest level of recognition from the Healthcare Information and Management Systems Society’s Outpatient Electronic Medical Record Adoption Model.
Hattiesburg Clinic, which represents 40 specialties, spanning 17 counties in 70 locations across Mississippi, is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Easing documentation burdens
“We historically have provided pretty much every option you can have for documentation: templates, remote scribe, in-person scribe, all of the above,” Dr. Batson said. “So, as we looked at ambient AI scribes, we wanted to provide options.”
In addition to those who volunteered to participate in the test, Dr. Batson said physicians who have struggled with a lot of “work-after-work time” were invited to participate.
After launching the pilot with 35 physicians, the pilot eventually grew to 68 physicians and seven nonphysician providers. Participants were given at-the-elbow training by someone with clinical experience in using ambient scribes.
“There is some training of the physician needed because, as you're doing a physical exam, you need to say things out loud that you previously had not said,” Dr. Batson explained.
Participants were given the product from one vendor for an initial three-month trial before switching over to try the scribe from another company.
“That way we could learn about the experience with both,” Dr. Batson recalled. “Then we studied what happened with these physicians who participated in this trial. After the trial period, they were given a choice: Which one do you want to go with?”
There are now about 40 physicians using and paying for ambient AI scribes, and Dr. Batson said that, as of the beginning of mid-July, the ambient scribes had generated more than 39,000 clinical notes.
“This was a positive for a large number of physicians in our organization as a new tool to have in the toolbox for documentation that did appear to improve job satisfaction and reduce job stress,” Dr. Batson said. “But it's not a solution for everybody yet. This technology is evolving very quickly, and we anticipate continued improvement through time.”
Getting personal time back
Dr. Batson declined to mention the companies whose scribes were tested in the pilot and said they were chosen because it appeared they had the technical capability for the best workflow integration with the Hattiesburg Clinic’s EHR.
“There were some stumbling blocks along the way early in this adoption,” he said, adding later that “we worked with the vendors to deliver on some of their promises.”
General trends mentioned by Dr. Batson included less stress related to documentation and less “pajama time” or time spent on documentation tasks after work hours.
Both also led to lower burnout rates. Job satisfaction received a 17% boost when using the first vendor and 13% when using the second.
“Across the board, good results for those who continued through the pilot and did the pre- and post-surveys,” Dr. Batson said. “We learned that it works for a lot of physicians, but not everybody.”
Physicians were also asked if they were able to add a patient to their schedule if they wanted because they were spending less time on documentation and were able to spend more clinical time. For those using the first vendor, 43% said they could, while 26% said they could with the second vendor.
Others, however, kept their normal workload—which now didn’t take as much time as it used to.
Patients must consent to the use of the technology during their visit, and one physician let her patients know how much their blessing to use the ambient scribe was appreciated.
“Within two weeks, we had a pediatrician go on social media … to put a thank you message out there to her patients,” Dr. Batson said.
“She just said a general thank you and said that her family thanked them too because she had an hour back every day that she was able to spend with her family that she previously did not have,” he added. “Want to talk about a win right out of the gate? That had more people saying, ‘I want to try this.’ That was a big momentum shift for us.”
