How effective is artificial intelligence software for medical documentation?
Clinical Applications
Dr. Schwarzenberger is the former physician editor of DermWorld. She interviews the author of a recent study each month.
By Kathryn Schwarzenberger, MD, FAAD, December 1, 2024
In this month’s Clinical Applications column, DermWorld Physician Editor Kathryn Schwarzenberger, MD, FAAD, talks with Karolyn A. Wanat, MD, FAAD, about her JAAD International paper ‘Artificial intelligence-driven digital scribes in clinical documentation: Pilot study assessing the impact on dermatologist workflow and patient encounters.’
DermWorld: You and your co-authors sought to investigate the efficacy of using artificial intelligence (AI)-driven digital scribe technologies — specifically, Dragon Ambient eXperience (DAX) — in an academic and community-based dermatology setting. Why did you pick this topic?
DermWorld: How did you study the efficacy of this AI software for medical documentation?
Dr. Wanat: We performed qualitative surveys and analyzed the data from the EMR to see if the technology would have a positive benefit — both in how the clinicians felt as well as in an actual decrease in time spent in the EMR.
DermWorld: What were your findings regarding the accuracy of using this technology for medical documentation? How did its use affect administrative load?
Dr. Wanat: Overall, the medical documentation was accurate — although sometimes lengthier than our notes would normally be. Most clinicians felt they could be more “in the moment with the patient” as opposed to typing to ensure they had details, and overall felt better with the administrative load. It is not perfect but was quite helpful to have information documented that could be edited.
DermWorld: What did you find regarding the cost-effectiveness of utilizing AI-driven documentation software versus a human scribe?
Dr. Wanat: Quite comparable and even better and reliable (i.e., the AI driving documentation does not have to be re-trained, does not call in sick, etc.).
DermWorld: How effective was the AI scribe technology in adjusting to individual physician language, formatting, etc.? Did the AI customization improve over time?
Dr. Wanat: The documentation improves over time — and the more someone uses it, the better it does. The goal is for the technology to adapt to each individual physician. In the initial stages more feedback is required and then things continue to improve.
DermWorld: Beyond patient satisfaction surveys, did you assess whether the use of the technology directly improved patient outcomes or care quality? For instance, did clinicians feel they had more time to spend with patients due to reduced documentation burdens?
Dr. Wanat: We do not have quantitative data on patient outcomes or care quality — although having this information available to review immediately after patient encounters can be helpful to ensure accuracy. The overall feeling of clinicians is that they like having it because they had more of that interactive time with patients and spent less time documenting in the note during and after the visits.
DermWorld: Given the limitations you mentioned (e.g., small size and single institution), do you believe these results might translate to smaller, non-academic settings?
Dr. Wanat: I think as the technology improves and the ability of the digital scribes to assist with additional aspects of a visit (order entry, patient instructions) improves, the technology will be quite useful for all clinics, allowing for streamlined EMR documentation and more time with patients. In-person scribes are not something that we have and may continue to have a role. However, those individuals are often in transient positions and having this technology as a consistent presence may be beneficial.
Karolyn Wanat, MD, FAAD, is a professor of dermatology and section chief of adult dermatology at the Medical College of Wisconsin. Her paper appeared in JAAD International. Dr. Wanat has no relevant financial and/or commercial conflicts of interest.
Disclaimer: The views and opinions expressed in this article do not necessarily reflect those of DermWorld.
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