You Jacqueline G, Dbouk Reema H, Landman Adam, Ting David Y, Dutta Sayon, Wang Julie C, Centi Amanda J, Macfarlane Molly, Bechor Eran, Letourneau Jonathan, Choo-Kang Gabrielle, Kim Esther H, Magee Cordula, Lang Brian J, Angelo Laura, Olin Jackson, Frits Michelle, Iannaccone Christine, Rui Angela, Salmikova Ivana, Holland Christopher, Blanchette Bryan, Silverman Rachel, Bates David W, Rotenstein Lisa, Mishuris Rebecca G
Digital, Mass General Brigham, Somerville, Massachusetts.
Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA Netw Open. 2025 Aug 1;8(8):e2528056. doi: 10.1001/jamanetworkopen.2025.28056.
Documentation burden is associated with clinician burnout. To address documentation burden, Mass General Brigham (MGB) in Somerville, Massachusetts, and Emory Healthcare in Atlanta, Georgia, have piloted ambient documentation technology (ADT), which develops artificial intelligence-drafted clinical notes from clinician-patient conversations.
To examine the prevalence of ADT use and its association with clinicians' experience of documentation burden and burnout before and after use.
DESIGN, SETTING, AND PARTICIPANTS: This survey study included clinicians who used ADT for at least 42 days and responded to both the pre- and postsurveys (onboarded February 27 to July 31, 2024, at MGB and July 19, 2023, to July 31, 2024, at Emory).
Ambient documentation technology.
The main outcomes were the proportion of self-reported ADT usage, change in proportion of clinicians meeting the criteria for burnout or a positive outcome of their documentation practice associated with their well-being, and free-text survey comments.
Across MGB and Emory, 1430 clinicians, including 873 at MGB (573 clinicians [65.6%] practiced for >10 years; 478 women [54.8%]) and 557 at Emory (286 clinicians [51.3%] practiced for >10 years; 309 women [55.5%]) were enrolled in ADT pilot studies. The majority of clinicians were physicians (688 [78.8%] at MGB and 418 [75.0%] at Emory). Approximately equal proportions of clinicians practiced in primary care (192 [22.0%] at MGB and 156 [28.0%] at Emory). The response rates to relevant components of the MGB survey was 30.4% (265 of 873 respondents) for the 42-day midsurvey and 22.0% (192 of 873 respondents) for the 84-day postsurvey; for the Emory survey, the postsurvey response rate was 11.1% (62 of 557 respondents). A total of 128 of 264 MGB survey respondents (48.5%) had self-reported using ADT for at least 50% of their patient visits, while 27 of 62 Emory respondents (43.5%) self-reported usage for most or all of their visits. The proportion of MGB clinicians reporting burnout (Professional Fulfillment Index overall burnout score >1.33) decreased from 50.6% to 29.4% (χ2 = 42.4; P < .001) at 42 days and decreased from 52.6% to 30.7% (χ2 = 32.7; P < .001) at 84 days. The proportion of Emory clinicians reporting a positive impact of their documentation practice on well-being (defined as a score of 3-4 for positive or very positive) improved from 1.6% to 32.3% (χ2 = 19.0; P < .001). Qualitative analysis of free-text survey comments revealed that clinicians found improved joy in practice with ADT use and saw opportunities for improved ADT functionality.
Across these survey studies, ADT use was associated with reductions in burnout and increases in perceived well-being. These findings suggest that ADT may enhance clinicians' documentation-related experience and reduce burnout.
文档负担与临床医生职业倦怠相关。为解决文档负担问题，马萨诸塞州萨默维尔的麻省总医院布莱根分院（MGB）和佐治亚州亚特兰大的埃默里医疗集团开展了环境文档技术（ADT）试点项目，该技术可根据临床医生与患者的对话生成人工智能起草的临床记录。
研究ADT的使用普及率及其与临床医生使用前、后文档负担体验和职业倦怠的关联。
设计、地点和参与者：这项调查研究纳入了使用ADT至少42天且对前后两次调查均作出回应的临床医生（MGB于2024年2月27日至7月31日纳入，埃默里于2023年7月19日至2024年7月31日纳入）。
环境文档技术。
主要结局为自我报告的ADT使用比例、符合职业倦怠标准或其文档实践与幸福感相关的积极结果的临床医生比例变化，以及自由文本调查评论。
在MGB和埃默里，共有1430名临床医生参与了ADT试点研究，其中MGB有873名（573名临床医生[65.6%]从业超过10年；478名女性[54.8%]），埃默里有557名（286名临床医生[51.3%]从业超过10年；309名女性[55.5%]）。大多数临床医生为医生（MGB有688名[78.8%]，埃默里有418名[75.0%]）。在初级保健领域执业的临床医生比例大致相等（MGB有192名[22.0%]，埃默里有156名[28.0%]）。MGB调查相关部分的回应率在42天中期调查时为30.4%（873名受访者中的265名），84天后期调查时为22.0%（873名受访者中的192名）；埃默里调查的后期调查回应率为11.1%（557名受访者中的62名）。MGB调查的264名受访者中，共有128名（48.5%）自我报告在至少50%的患者就诊中使用了ADT，而埃默里62名受访者中有27名（43.5%）自我报告在大多数或全部就诊中使用了ADT。报告职业倦怠的MGB临床医生比例（职业成就感指数总体倦怠评分>1.33）在42天时从50.6%降至29.4%（χ² = 42.4；P <.001），在84天时从52.6%降至30.7%（χ² = 32.7；P <.001）。报告文档实践对幸福感有积极影响（定义为积极或非常积极评分为3 - 4分）的埃默里临床医生比例从1.6%提高到32.3%（χ² = 19.0；P <.
