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医生对环境人工智能抄写员的看法。

Physician Perspectives on Ambient AI Scribes.

作者信息

Shah Shreya J, Crowell Trevor, Jeong Yejin, Devon-Sand Anna, Smith Margaret, Yang Betsy, Ma Stephen P, Liang April S, Delahaie Clarissa, Hsia Caroline, Shanafelt Tait, Pfeffer Michael A, Sharp Christopher, Lin Steven, Garcia Patricia

机构信息

Department of Medicine, Stanford University School of Medicine, Stanford, California.

Stanford Healthcare AI Applied Research Team, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California.

出版信息

JAMA Netw Open. 2025 Mar 3;8(3):e251904. doi: 10.1001/jamanetworkopen.2025.1904.

Abstract

IMPORTANCE

Limited qualitative studies exist evaluating ambient artificial intelligence (AI) scribe tools. Such studies can provide deeper insights into ambient AI implementations by capturing lived experiences.

OBJECTIVE

To evaluate physician perspectives on ambient AI scribes.

DESIGN, SETTING, AND PARTICIPANTS: A qualitative study using semistructured interviews guided by the Reach, Efficacy, Adoption, Implementation, Maintenance/Practical, Robust Implementation, and Sustainability Model (RE-AIM/PRISM) framework, with thematic analysis using both inductive and deductive approaches. Physicians participating in an AI scribe pilot that included community and faculty practices, across primary care and ambulatory specialties, were invited to participate in interviews. This ambient AI scribe pilot at a health care organization in California was conducted from November 2023 to January 2024.

MAIN OUTCOME AND MEASURES

Facilitators and barriers to adoption, practical effectiveness, and suggestions for improvement to enhance sustainability.

RESULTS

Twenty-two semistructured interviews were conducted with AI pilot physicians from primary care (13 [59%]) and ambulatory specialties (9 [41%]), including physicians from community practices (12 [55%]) and faculty practices (10 [45%]). Facilitators to adoption included ease of use, ease of editing, and generally positive perspectives of tool quality. Physicians expressed positive sentiments about the impact of the ambient AI scribe tool on cognitive demand (16 of 16 comments [100%]), temporal demand (28 comments [62%]), work-life integration (10 of 11 comments [91%]), and overall workload (8 of 9 comments [89%]). Physician perspectives of the impact of the ambient AI scribe tool on their engagement with patients were mostly positive (38 of 56 comments [68%]). Barriers to adoption included limited functionality with non-English speaking patients and lack of access for physicians without a specific device. Physician perspectives on accuracy and style were largely negative, particularly regarding note length and editing requirements. Several specific suggestions for tool improvement were identified, and physicians were optimistic regarding the potential for long-term use of ambient AI scribes.

CONCLUSION AND RELEVANCE

In this qualitative study, ambient AI scribes were found to positively impact physician workload, work-life integration, and patient engagement. Key facilitators and barriers to adoption were identified, along with specific suggestions for tool improvement. These findings suggest the potential for ambient AI scribes to reduce clinician burden, with user-centered recommendations offering practical guidance on ways to improve future iterations and improve adoption.

摘要

重要性

评估环境人工智能(AI)抄写工具的定性研究有限。此类研究可以通过捕捉实际体验,更深入地洞察环境AI的应用情况。

目的

评估医生对环境AI抄写员的看法。

设计、背景和参与者:一项定性研究,采用以“普及、效果、采用、实施、维护/实用性、稳健实施和可持续性模型”(RE-AIM/PRISM)框架为指导的半结构化访谈,并使用归纳和演绎方法进行主题分析。邀请参与包括社区和教职实践的AI抄写员试点项目、涵盖初级保健和门诊专科的医生参加访谈。2023年11月至2024年1月在加利福尼亚州的一家医疗保健机构开展了此次环境AI抄写员试点项目。

主要结果和指标

采用的促进因素和障碍、实际效果以及改进建议,以提高可持续性。

结果

对来自初级保健(13名[59%])和门诊专科(9名[41%])的AI试点项目医生进行了22次半结构化访谈,其中包括来自社区实践的医生(12名[55%])和教职实践的医生(10名[45%])。采用的促进因素包括易用性、易于编辑以及对工具质量的总体积极看法。医生们对环境AI抄写工具对认知需求(16条评论中的16条[100%])、时间需求(28条评论[62%])、工作与生活平衡(11条评论中的10条[91%])和总体工作量(9条评论中的8条[89%])的影响表达了积极看法。医生们对环境AI抄写工具对其与患者互动的影响的看法大多是积极的(56条评论中的38条[68%])。采用的障碍包括与非英语患者的功能有限,以及没有特定设备的医生无法使用。医生们对准确性和风格的看法大多是否定的,特别是在记录长度和编辑要求方面。确定了一些工具改进的具体建议,医生们对环境AI抄写员的长期使用潜力持乐观态度。

结论和意义

在这项定性研究中,发现环境AI抄写员对医生的工作量、工作与生活平衡以及患者参与度有积极影响。确定了采用的关键促进因素和障碍,以及工具改进的具体建议。这些发现表明环境AI抄写员有减轻临床医生负担的潜力,以用户为中心的建议为改进未来版本和提高采用率提供了实用指导。

相似文献

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Physician Perspectives on Ambient AI Scribes.医生对环境人工智能抄写员的看法。
JAMA Netw Open. 2025 Mar 3;8(3):e251904. doi: 10.1001/jamanetworkopen.2025.1904.

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