ArticleJournal of general internal medicine2026
Hybrid Ambient Clinical Documentation and Physician Performance: Work Outside of Work, Documentation Delay, and Financial Productivity.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Ambient AI Scribes to Create Educational Feedback Notes for Medical Students: Randomized Trial.JMIR medical education · 2026Trial
- For the record: a narrative review of ambient voice technology in clinical documentation for dentistry and wider healthcare.British dental journal · 2026Review
- Ambient scribes in general practice - help or hindrance?The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Variation in Measures of Electronic Health Record Use Outside Scheduled Hours: A Cross-Sectional Study of Academic Primary Care Physicians.Applied clinical informatics · 2026Article
- Large Language Models in Surgery: Promise, Pitfalls, and Practical Use.Journal of abdominal wall surgery : JAWS · 2026Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundHealthcare systems are under growing pressure to increase clinician productivity while reducing burnout. After-hours electronic health record (EHR) documentation- "work outside of work" (WOW)-is a major contributor to clinician fatigue. While generative AI-powered ambient clinical documentation (ACD) tools offer promise, their real-world impact remains uncertain.
objectiveTo evaluate whether a hybrid ACD program (combining generative AI and a virtual scribe) is associated with changes in (1) WOW, (2) documentation delay, and (3) clinician financial productivity.
designRetrospective study (July 1-December 30, 2024).
participantsIn total, 181 attending physicians and advanced practice clinicians across 14 adult primary care practices within a Massachusetts healthcare system. Sixty-six clinicians (36%) voluntarily enrolled in the hybrid ACD program, which was rolled out using an activation schedule.
interventionThe ACD tool used large language models to generate draft clinical notes that were then reviewed and finalized by a human scribe and integrated into the EHR. Participants received standardized training and technical support. MAIN MEASURES: Outcomes over the 50-day post-activation period included (1) WOW (5:30 pm-7:00 am weekdays; all weekends/holidays); (2) documentation delay (proportion of notes open ≥ 2 business days); and (3) financial productivity (work relative value units, wRVUs). Generalized estimating equations were used, adjusting for clinician and panel characteristics. KEY
resultsACD adoption had a dynamic impact. WOW initially increased by 32.1% (95% CI 25.5%, 39.1%) on day 10 but decreased by 41.7% (95% CI -51.8%, -29.4%) by day 50 compared to baseline. Documentation delay consistently improved, with the odds of delayed note closure reduced by 66.5% (95% CI -68.3%, -64.7%) at day 10 and 66.0% (95% CI -72.5%, -57.8%) at day 50. Financial productivity increased steadily by 1.5% (95% CI -0.2%, 3.2%) on day 10 and 12.1% (95% CI 5.7%, 18.9%) by day 50.
conclusionACD adoption was associated with reduced after-hours work, faster note completion, and improved financial productivity within 50 days of implementation.
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Registered trials
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