Leung Tiffany I, Coristine Andrew J, Benis Arriel
JMIR Publications, 130 Queens Quay East, Unit 1100, Toronto, ON, M5A 0P6, Canada, 1 4165832040.
Department of Internal Medicine (adjunct), Southern Illinois University School of Medicine, Springfield, IL, United States.
JMIR Med Inform. 2025 Aug 1;13:e80898. doi: 10.2196/80898.
The administrative burden of clinical documentation contributes to health care practitioner burnout and diverts valuable time away from direct patient care. Ambient artificial intelligence (AI) scribes-also called "digital scribes" or "AI scribes"-are emerging as a promising solution, given their potential to automate clinical note generation and reduce clinician workload, and those specifically built on a large language model (LLM) are emerging as technologies for facilitating real-time clinical documentation tasks. This potentially transformative development has a foundation on longer-standing, AI-based transcription software, which uses automated speech recognition and/or natural language processing. Recent studies have highlighted the potential impact of ambient AI scribes on clinician well-being, workflow efficiency, documentation quality, user experience, and patient interaction. So far, limited evidence indicates that ambient AI scribes are associated with reduced clinician burnout, lower cognitive task load, and significant time savings in documentation, particularly in after-hours electronic health record (EHR) work. One consistently reported benefit is the improvement in the patient-physician interaction, as physicians feel more present during a clinical encounter. However, these benefits are counterbalanced by persisting concerns regarding the accuracy, consistency, language use, and style of AI-generated notes. Studies noting errors, omissions, or hallucinations caution that diligent clinician oversight is necessary. The user experience is also heterogeneous, with benefits varying by specialty and individual workflow. Further, there are concerns about ethical and legal issues, algorithmic bias, the potential for long-term "cognitive debt" from overreliance on AI, and even the potential loss of physician autonomy. Additional pragmatic concerns include security, privacy, integration, interoperability, user acceptance and training, and the cost-effectiveness of adoption at scale. Finally, limited studies describe adoption or evaluation of these technologies by nonphysician clinicians and health professionals. Although ambient AI scribes and AI-driven documentation technologies are promising as potentially practice-changing tools, there are many questions remaining. Key issues persist, including responsible deployment with the goal of ensuring that ambient AI scribes produce clinical documentation that supports more efficient, equitable, and patient-centered care. To advance our collective understanding and address key issues, JMIR Medical Informatics is launching a call for papers for a new section on "Ambient AI Scribes and AI-Driven Documentation Technologies." As editors, we look forward to the opportunity to advance the science and understanding of these fields through publishing high-quality and rigorous scholarly work in this new section of JMIR Medical Informatics.
临床文档的管理负担导致医护人员职业倦怠,并将宝贵的时间从直接的患者护理中转移出来。环境人工智能(AI)抄写员——也被称为“数字抄写员”或“AI抄写员”——正成为一种有前景的解决方案,因为它们有潜力自动生成临床记录并减轻临床医生的工作量,而那些基于大语言模型(LLM)构建的技术正成为促进实时临床文档任务的工具。这一潜在的变革性发展建立在长期存在的基于AI的转录软件基础上,该软件使用自动语音识别和/或自然语言处理。最近的研究强调了环境AI抄写员对临床医生幸福感、工作流程效率、文档质量、用户体验和患者互动的潜在影响。到目前为止,有限的证据表明,环境AI抄写员与临床医生职业倦怠的减轻、认知任务负荷的降低以及文档记录时间的显著节省有关,特别是在非工作时间的电子健康记录(EHR)工作中。一个一直被报道的好处是患者与医生互动的改善,因为医生在临床会诊期间感觉更专注。然而,这些好处被对AI生成的记录的准确性、一致性、语言使用和风格的持续担忧所抵消。指出存在错误、遗漏或幻觉的研究提醒,临床医生的认真监督是必要的。用户体验也各不相同,其好处因专业和个人工作流程而异。此外,还存在对伦理和法律问题、算法偏差、过度依赖AI可能产生的长期“认知债务”,甚至医生自主权潜在丧失的担忧。其他实际问题包括安全性、隐私、集成、互操作性、用户接受度和培训,以及大规模采用的成本效益。最后,有限的研究描述了非医生临床医生和卫生专业人员对这些技术的采用或评估情况。尽管环境AI抄写员和AI驱动的文档技术作为潜在的改变实践的工具很有前景,但仍有许多问题有待解决。关键问题依然存在,包括以确保环境AI抄写员生成支持更高效、公平和以患者为中心的护理的临床文档为目标的负责任部署。为了增进我们的集体理解并解决关键问题,JMIR医学信息学正在为一个关于“环境AI抄写员和AI驱动的文档技术”的新栏目征集论文。作为编辑,我们期待有机会通过在JMIR医学信息学的这个新栏目中发表高质量和严谨的学术作品来推进这些领域的科学研究和理解。
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