Evaluating the Impact of Ambient AI on Documentation Efficiency and Clinician Burnout in Primary Care Settings

This clinical trial aims to evaluate the effectiveness of an ambient listening AI product, DAX CoPilot, in improving clinical documentation efficiency and reducing clinician burnout in primary care settings. Researchers will compare results from a group who was given a license to use DAX CoPilot to a group who was not given a license. Participants in the DAX group will use DAX CoPilot system for EHR documentation and participants in the control group will use use standard EHR documentation methods. Participants will also be asked to complete surveys and assessments related to their views on technology and experiences of burnout.

Study Overview

• Status: Completed
• Conditions: Burnout; Clinical Documentation Efficiency
• Intervention / Treatment: Behavioral: DAX CoPilot Group

Detailed Description

This pilot study aims to evaluate the effectiveness of an ambient listening AI product in improving clinical documentation efficiency and patient satisfaction, reducing clinician burnout in primary care settings, and improving operational implementation strategies by harnessing end-user psychology. Employing a randomized, prospective design, the study involved 25 clinicians who were given an ambient listening AI product (DAX CoPilot) after a 1 month baseline period and asked to use it for clinical documentation with a focus on problem-focused visits over a 3-month period, with a control group of 20 clinicians continuing traditional documentation methods. The primary outcomes include changes in documentation efficiency (measured through metrics such as time spent on documentation per patient) and clinician burnout (assessed using the validated Mini-Z 2.0 burnout inventory). Secondary outcomes involve patient satisfaction with clinicians' use of the AI tool and examining end-user technology acceptance among clinicians using a survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT). The study aims to provide insights into the potential of AI-assisted documentation tools in enhancing clinical workflow and addressing the growing concern of clinician burnout.

• Study Type: Interventional
• Enrollment (Actual): 45
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Oregon
    • Corvallis, Oregon, United States, 97330
      • Samaritan Health Services

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Licensed Clinicians: Independently licensed clinicians (MDs, DOs, NPs, PAs) who have been actively practicing at Samaritan Health Services for at least 6 months.
2. Primary Care Only: Providers must have a listed specialty of family medicine, internal medicine, or pediatrics, and currently practice primarily in a primary or urgent care clinic.
3. Provider has an Apple iPhone and is willing to install Epic Haiku.

Exclusion Criteria:

1. Inpatient-Only Clinicians: Exclude clinicians who only, or primarily, work in inpatient settings, as documentation needs and challenges may differ significantly from those in outpatient settings.
2. Trainees: Exclude medical students and residents due to their varying levels of experience and dependence on supervisory oversight.
3. Minimum Outpatient Encounters: Exclude clinicians with fewer than 100 outpatient encounters per month to focus on those with a significant workload in outpatient settings.
4. Android Smartphones Users: Clinicians may not use Android, or generally any non-Apple or non-iOS smartphones, given the software limitations of the selected intervention technology.
5. Corrective Action: Exclude clinicians facing dismissal, corrective, or disciplinary action.
6. Scheduled leave longer than 3 weeks during the study period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: DAX CoPilot Group; Participants in this arm were given a DAX CoPilot license and asked to use it for clinical documentation in the EHR.	Behavioral: DAX CoPilot Group; Participants in this group were given a license for DAX CoPilot and asked to use it for clinical documentation.
No Intervention: Control group; Participants in this arm were not given a DAX CoPilot license and were asked to use standard methods for clinical documentation in the EHR.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Documentation efficiency	Compare average documentation, workload, and InBasket metrics (tracked by Epic Signal and through a custom data pull for SHS) before and after the implementation of ambient AI among the intervention and control groups; time in notes per appointment, time in notes per scheduled day, progress note length, note composition, time outside scheduled hours, time outside of 7 AM to 7 PM, pajama time, visits closed same day, time in InBasket per appointment, InBasket message turnaround time	From baseline to the end of the 3 month experimental period

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Burnout	Clinician burnout as assessed using the Mini-Z 2.0 burnout inventory	From baseline to the end of the 3 month experimental period

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient satisfaction	Patient satisfaction with the experience of the clinician using DAX CoPilot via a patient survey after a visit in which it was used	3 months experimental period

Collaborators and Investigators

• Sponsor: Samaritan Health Services

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2024
• Primary Completion (Actual): September 13, 2024
• Study Completion (Actual): September 13, 2024

Study Registration Dates

• First Submitted: September 18, 2024
• First Submitted That Met QC Criteria: September 18, 2024
• First Posted (Actual): September 20, 2024

Study Record Updates

• Last Update Posted (Actual): September 20, 2024
• Last Update Submitted That Met QC Criteria: September 18, 2024
• Last Verified: September 1, 2024

More Information

Terms related to this study

• Keywords: patient satisfaction; randomized control trial; burnout; electronic health record; clinical documentation; scribe; ambient AI; DAX CoPilot; acceptance and use of technology
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Burnout, Psychological
• Other Study ID Numbers: IRB23-072

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No