Impact of an Ambient AI Scribe Among Clinicians and Patients: Real-World Prospective Observational Time-Motion Study.

Background: Ambient artificial intelligence scribes are increasingly used to reduce clinician burnout and cognitive load, although their impact on documentation time remains inconsistent across studies. Most existing real-world impact studies have been conducted in the United States and rely on electronic health record time stamps, which may not accurately reflect actual documentation time. Objective: This study aimed to quantify the impact of ambient scribe technology on clinician efficiency and patient engagement in an outpatient setting using direct observational methods and patient surveys. Methods: We conducted a prospective, within-clinician quality improvement study at a large academic medical center in Singapore from December 2024 to May 2025. Nine clinicians participated in matched observation sessions with and without an in-house ambient scribe tool. Five trained observers used standardized time-motion methodology to capture documentation time, proportion of eye contact, and consultation duration across 169 consultations. Patient surveys were administered following consultations using the ambient scribe. Linear mixed-effects models were used to account for clustering within clinicians. Results: Ambient scribe use was associated with a 15.0% reduction in documentation time per consultation (mean 5.3, SD 2.7 minutes to 4.5, SD 2.4 minutes; P=.04); a 10.6% increase in proportion of eye contact time (mean 69.6%, SD 18.6% to 77.1%, SD 17.7%; P=.009); and no significant change in consultation duration (mean 11.5, SD 6.9 minutes vs 10.9, SD 5.6 minutes; P=.42) or total cycle time per patient (mean 13.7, SD 7.7 minutes vs 13.2, SD 6.3 minutes; P=.57), where total cycle time includes preclerking, consultation, and postconsultation documentation. Effects were consistent across new and follow-up patients. Patient acceptance was favorable: of 39 surveyed patients, 27 (69.2%) agreed that their physician focused on them more during the consultation, and none expressed discomfort with the technology. Conclusions: This evaluation of ambient scribe use in an Asian health care setting demonstrates that experienced users achieved reduced documentation time and improved patient engagement without affecting consultation duration or total time per patient. The technology was also well accepted by patients. Taken together, these findings suggest that ambient scribes reallocate clinician effort toward patient interaction rather than enabling faster patient turnover, supporting their implementation across diverse health care settings.