Kakaday Roheet, Herrera Elizabeth Zoe, Coskey Olivia, Hertel Andrew W, Kaiser Paulina
Samaritan Health Services, Corvallis, United States.
Appl Clin Inform. 2025 Mar 17. doi: 10.1055/a-2559-5791.
This pilot study aimed to evaluate the impact of an ambient listening AI tool, DAX CoPilot (DAX), on clinical documentation efficiency among primary care providers in a community-based setting.
We conducted a randomized controlled trial among volunteer clinicians (physicians, nurse practitioners, and physician assistants in family medicine, internal medicine, pediatrics, and urgent care), who were asked to use DAX with a standardized note template (N = 25) or to continue with traditional documentation methods (N = 20) over a three-month intervention period. We evaluated documentation efficiency with both standard and custom Epic metrics to evaluate impact on all visit types as well as specifically problem-focused visits.
Because of heterogeneity in DAX usage, we created post-hoc categories of Low (< 45% of all visits, N=12), Moderate (45-69.9% of all visits, N=6) and High Frequency (≥ 70% of all visits, N=7) DAX users. We observed the largest differences among High Frequency DAX users. For problem-focused visits with clinicians in this group, a median of 50% of note characters were written by DAX, and we observed a 1.4-minute decrease in time spent on notes per visit (p-value: 0.38) and a 35% decrease in the median number of characters per note (p-value: 0.38) from baseline to the end of the study period. The control group metrics were largely uncharged throughout the study.
Our findings suggest that DAX can improve documentation efficiency, particularly among clinicians that use it frequently. Healthcare systems might benefit by using AL-AI tools like DAX but should consider implementation scope and note template features. Future investigations are needed to further explore these trends and their additional implications for outcomes such as burnout.
本试点研究旨在评估一种环境倾听人工智能工具DAX CoPilot（DAX）对社区基层医疗服务提供者临床文档记录效率的影响。
我们在志愿者临床医生（家庭医学、内科、儿科和紧急护理领域的医生、执业护士和医师助理）中进行了一项随机对照试验，要求他们在为期三个月的干预期内使用带有标准化记录模板的DAX（N = 25）或继续采用传统的文档记录方法（N = 20）。我们使用标准和自定义的Epic指标评估文档记录效率，以评估对所有就诊类型以及特定问题导向型就诊的影响。
由于DAX使用情况存在异质性，我们事后将DAX用户分为低频率组（<所有就诊的45%，N = 12）、中等频率组（所有就诊的45 - 69.9%，N = 6）和高频率组（≥所有就诊的70%，N = 7）。我们观察到高频率DAX用户之间的差异最大。对于该组临床医生的问题导向型就诊，DAX生成了中位数为50%的记录字符，并且我们观察到从基线到研究期末，每次就诊记录花费的时间减少了1.4分钟（p值：0.38），每份记录的字符中位数减少了35%（p值：0.38）。对照组的指标在整个研究过程中基本没有变化。
我们的研究结果表明，DAX可以提高文档记录效率，特别是在频繁使用它的临床医生中。医疗保健系统使用像DAX这样的人工智能工具可能会受益，但应考虑实施范围和记录模板功能。未来需要进一步研究来探索这些趋势及其对诸如职业倦怠等结果的其他影响。
