What is Ambient Scribing and How Can it Benefit Your Practice

Electronic health records (EHR) are irreversibly embedded in healthcare documentation. EHRs improve efficiency and quality of care and reduce errors, but not all opinions about them are positive.

Clinicians maintain that the time needed for EHR documentation reduces the time spent with patients, diminishing their satisfaction with the encounter. The implementation of EHR has also shifted much clerical work to clinicians, making significant demands on their time. Ambient scribing is an application of artificial intelligence with the potential to reverse some of these issues. 

Entering all the information from several patient visits through the day needs substantial time. This work often spills over beyond clinic hours, negatively impacting work-life balance and contributing to clinician burnout. Such burnout is associated with several undesirable outcomes: 

• Major medical errors
• Diminished patient satisfaction
• Safety incidents
• Increased workforce turnover

Even without these major effects, EHRs reduce the quality of the clinician-patient encounter. Clinicians report reduced eye contact and conversation with patients because of the time needed to type in data during the visit. EHR is here to stay but needs enhancement to serve healthcare better.  

What Is Ambient Scribing?

The idea of helping clinicians with documentation isn't new, of course. Medical transcription was popular a few decades ago, involving dictation by clinicians and transcription by outsourcing facilities. Team-based documentation support, wherein medical scribes work with clinicians and coauthor the notes, has been found to be successful at increasing visit volumes by 10.8% and reducing time spent on documentation by 16.2%.

Ambient scribe replaces a human medical scribe with advanced technology. It captures the audio of the clinician-patient interaction, transcribes it using natural language processing (NLP) and artificial intelligence, and generates appropriate documentation for the patient's record. Ambient scribing performs these tasks in the background with minimal operator intervention. Clinicians can stay more present during the visit, focusing on the patient, giving information and advice, and answering questions. 

The technology uses a smartphone microphone to capture the audio of the clinical encounter. The data is transmitted to the processing server that uses machine learning to transcribe patient visits in real time but doesn't retain audio recordings. Ambient scribing produces high-quality clinical notes for physicians to edit. Hybrid models use a human-in-the-loop approach, enlisting a trained medical scribe to remove errors and omissions. 

Benefits of Ambient Scribing

Ambient scribing is an evolving technology with several benefits for your healthcare organization:

• More time for clinicians to be present during the patient visit
• Superior quality and more effective clinician-patient interaction 
• Reduced personnel expenses by eliminating human scribes
• Reduced burden of after-hours clerical work for clinicians

Patients, Privacy, and Ambient Scribing

Ambient scribing records the clinical encounter to generate clinical notes. Though the tool doesn't retain audio recordings, patient consent is essential. Clinicians must explain the technology to each patient at least once and obtain consent for its use. In addition, clinic waiting areas should have posters that inform patients that clinicians might use AI technology and voice recording to update their medical records. Staff can also provide handouts to patients with this information. 

Though most patients accept this use of technology, a small proportion choose not to allow it. Most patients (71%) reported that their physician spent more time talking to them and 81% felt they spent less time looking at their computer screen. Patients are neutral or very comfortable about using an AI tool. 

Patient privacy and the confidentiality of protected health information are vital concerns. Your entire system must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The smartphones, transmission systems, cloud servers, and computers performing the transcription must all be secure. All identifiable patient data must be protected at every step of any record-keeping or generating system.

Implementing Ambient Scribing

How will your organization handle the transition to ambient scribing? Unlike other technologies, this one has been relatively easy to implement, according to medical practices that have done so. 

• The tool is intuitive, and there isn't much of a learning curve. One large organization was able to onboard thousands of clinicians with a one-hour webinar. 
• Privacy of your patient data is assured. The tool will not use your data for training. 
• Your existing EHR system is already HIPAA-compliant, so your scribe vendor will have little difficulty setting up a secure system.

Ambient Scribing Challenges

As with all new technologies, early adopters stand to gain a lot but must be cautious about the potential problems of a young technology. However, ambient scribing is relatively easy for clinicians to learn and use effectively.

Though ambient scribing is meant to work in the background of a clinical encounter and produce an accurate, comprehensive transcript, it may not always do so. Clinicians must still read through and edit the transcript. A small portion of transcripts contain "hallucinations" — false information generated by the AI system. It may also miss some important issues discussed during the consultation.

Ambient scribing tools are not yet fully integrated with all EHRs. This limits the ease of use and integration into existing workflows.

Clinicians would appreciate the ability to customize the tool for their documentation style, but all ambient scribing systems don't support this.

Regulations about certified medical interpretation services limit the use of ambient AI scribing in patient encounters other than in English.

Though the technology is new, ambient scribing produces remarkably accurate transcripts. Organizations using the technology have found it to be excellent in terms of consistency, freedom from bias, succinctness, organization, and accuracy.

Ambient scribing already has the ability to filter out greetings, talk about families and pets, and other non-relevant conversation content from the clinical transcript. Your clinicians will appreciate that it saves them an hour each day.  

Clinical documentation is an enormous burden for your organization's personnel every day. It impairs physician-patient communication, may worsen the quality of medical care, and leads to clinician burnout and the stability of your medical workforce. Ambient scribing has the potential to improve patient satisfaction, enable clinicians to see more patients, and enhance clinic revenue.   

ChartPath understands the importance of maximizing practice efficiency and giving clinicians more time to focus on what they do best — excellent patient care. Our software solutions effortlessly enhance your organization's efficiency, contributing to better patient outcomes and profitability. ChartPath solutions are flexible and scalable, enabling you to focus on optimizing clinician time and practice growth. You can schedule a demo now!