ArticleJAMIA open2026
Comparative effectiveness of ambient documentation tools in primary care tool-specific variations in efficiency, documentation burden, and productivity over time.
Article in JAMIA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
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Abstract
Objectives: To evaluate the comparative effectiveness of ambient documentation tools (ADTs) with distinct architectures (Tablet-Based Virtual Human-Assisted Ambient [Tool A], EHR-Integrated Ambient [Tool B], and Standalone Ambient [Tool C]) on provider efficiency, documentation burden, and productivity in primary care. Materials and Methods: We conducted a real-world comparative-effectiveness study of 163 primary care providers in a large integrated health system (January 2024-June 2025), analyzing 59 130 provider-days. Providers who did not adopt an ADT ( Results: Compared with Tool B, Tool A was associated with increased pajama time (+0.022 hours of after-hours EHR activity per provider-day), higher manual note composition (+0.046 absolute proportion), lower timely visit closure (-0.120 [95% CI, -0.126,-0.115]), and reduced opportunity scores (-0.035[-0.044,-0.027]). Tool C reduced after-hours work versus Tool B (-0.007 hours per provider-day) and relative to both the reference tool and pre-exposure baseline levels (-0.055 hours per provider-day), but was associated with lower timely visit closure (-0.028[-0.036, -0.020]); opportunity scores were not significantly changed (-0.007[-0.018, 0.003]). Effects for Tool C correspond to approximately 30 fewer annual after-hours hours per provider. Conclusion: Tool choice materially shapes real-world outcomes, and tool-specific comparative evaluation is essential to guide evidence-based procurement and deployment decisions.
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