ABSTRACT
BACKGROUND: The method of documentation during a clinical encounter may affect the patient-physician relationship. OBJECTIVES: Evaluate how the use of ambient voice recognition, coupled with natural language processing and artificial intelligence (DAX™) affects the patient-physician relationship is not known. METHODS: A prospective observational study within a community teaching health system. The primary aim was evaluating any difference on the PDQR-9 scale between primary care encounters in which DAX™ was utilized for documentation as compared to those that did not. A signal arm open-label phase was also performed to query direct feedback from patients. RESULTS: A total of 288 patients were include in the open-label arm and 304 patients were included in the masked phase of the study comparing encounters with and without DAX™ use. In the open label phase patients strongly agreed that the provider was more focused on them, spent less time typing and made the encounter feel more personable. In the masked phase of the study no difference was seen in the rank order of the total PDQR-9 score between patients whose encounters used DAX™ (median 45 [IQR 8]) and those which did not (median 45 [IQR 3.5]; p=0.31). The adjusted odds ratio for DAX™ use was 0.8 (95% CI 0.48-1.34) for the patient reporting complete satisfaction on how well their clinician listened to them during their encounter. CONCLUSION: Patients strongly agreed with the use of ambient voice recognition, coupled with natural language processing and artificial intelligence (DAX™) for documentation in primary care. However, no difference was detected in the patient-physician relationship on the PDQR-9 scale.
ABSTRACT
BACKGROUND: The burden of documentation in the electronic medical record has been cited as a major factor in provider burnout. The aim of this study was to evaluate the association between ambient voice technology, coupled with natural language processing and artificial intelligence (DAX™), on primary care provider documentation burden and burnout. METHODS: An observational study of 110 primary care providers within a community teaching health system. The primary objectives were to determine the association between DAX™ usage and provider burnout scores on the Oldenburg Burnout Inventory (OLBI) as well as the effect on documentation time per patient encounter (minutes). RESULTS: The completion rate for the survey was 75% (83/110) and high DAX™ use (>60% of encounters) was seen in 28% of providers (23/83). High DAX™ use was associated with significantly less burnout on the OLBI disengagement sub-score (MD [Mean Difference] -2.1; 95% confidence interval [CI] -3.8 to -0.4) but not the OLBI disengagement sub-score (-1.0; 95% CI -2.9 to 1.0) or total score (MD -3.0; 95% CI -6.4 to 0.3). Nineteen providers with high implementation of DAX™ had pre and postimplementation data on documentation time per encounter. After DAX™ implementation average documentation time in notes per encounter was significantly reduced by 28.8% (1.8 min; 95% CI 1.4-2.2). CONCLUSIONS: The use of ambient voice technology during patient encounters was associated with significantly reduced documentation burden and primary care provider disengagement but not total provider burnout scores.
