Appl Clin Inform 2025; 16(05): 1578-1587
DOI: 10.1055/a-2625-0750
Special Topic on Reducing Technology-Related Stress and Burnout

Ambient Artificial Intelligence Scribes in Pediatric Primary Care: A Mixed Methods Study

Authors

  • Naveed Rabbani

    1   Pediatric Physicians' Organization at Children's, Wellesley, Massachusetts, United States
    2   Boston Children's Hospital, Boston, Massachusetts, United States
    3   Harvard Medical School, Boston, Massachusetts, United States
  • Mondira Ray

    2   Boston Children's Hospital, Boston, Massachusetts, United States
    3   Harvard Medical School, Boston, Massachusetts, United States
  • Eleanor Verhagen

    1   Pediatric Physicians' Organization at Children's, Wellesley, Massachusetts, United States
  • Jonathan Hatoun

    1   Pediatric Physicians' Organization at Children's, Wellesley, Massachusetts, United States
    2   Boston Children's Hospital, Boston, Massachusetts, United States
    3   Harvard Medical School, Boston, Massachusetts, United States
  • Laura Burckett Patane

    1   Pediatric Physicians' Organization at Children's, Wellesley, Massachusetts, United States
  • Louis Vernacchio

    1   Pediatric Physicians' Organization at Children's, Wellesley, Massachusetts, United States
    2   Boston Children's Hospital, Boston, Massachusetts, United States
    3   Harvard Medical School, Boston, Massachusetts, United States

Funding M.R. is supported by the Biomedical Informatics and Data Science Research Training Program grant (grant no.: T15LM007092).

Abstract

Objective

Quantify the effect of ambient artificial intelligence (AI) scribe technology on work experience, clinical operations, and patient experience in pediatric primary care.

Methods

We conducted a 12-week study of 39 clinicians within a large pediatric primary care network. Clinician experience was measured using a custom survey instrument which included a combination of discrete and free-text responses. Qualitative analysis of free-text responses provided additional context and identified key facilitators and barriers to optimal usage. Proprietary electronic health record (EHR) efficiency measures and utilization data were used to further quantify clinician experience, adoption, and operational effects. Patient experience was measured using a vendor-supplied survey instrument.

Results

AI scribe technology was used in 32% of eligible encounters (6,249 of 19,264). Survey responses demonstrated significant heterogeneity in clinician experience. The most commonly reported benefits were reduction in self-perceived cognitive burden (21/39), ability to finish work sooner (18/39), and ability to enjoy clinical work more (18/39). No significant change in EHR efficiency measures around documentation time, afterhours EHR time, total EHR time, or visit closure rates were observed. Clinicians reported AI scribes were most helpful for urgent care visits and for summarizing the history of present illness. Areas of improvement specific to pediatric primary care include suboptimal performance in summarizing and organizing content relating to preventive and behavioral health visits. Patient survey responses showed no difference in Net Promoter Score and related patient experience questions between ambient and non-ambient encounters.

Discussion

A subset of clinicians reported self-perceived improvements in work experience despite unchanged EHR efficiency measures. Heterogeneity in clinician experience suggests that benefit from ambient technology likely depends on personal and contextual factors. Enhancements to note organization and facility with pediatric well child visit and behavioral health content could improve the utility of this tool for pediatric primary care.

Protection of Human and Animal Subjects

This project met our institution's definition of clinical operations and quality improvement and was thus exempt from additional Institutional Review Board review.




Publication History

Received: 31 January 2025

Accepted: 30 May 2025

Accepted Manuscript online:
02 June 2025

Article published online:
31 October 2025

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