Improving Clinical Efficiency Using Artificial Intelligence Scribe for Documentation ( <scp>ICE</scp> ‐ <scp>AID</scp> Study): A Retrospective‐Prospective Cohort Study at a Quaternary Children's Hospital and Health Service

AIM: To evaluate the impact of an artificial intelligence medical scribe (AIMS) on clinical documentation efficiency, document quality, clinician-patient interaction, clinician well-being, consumer perspectives, overtime, and transcription costs. METHODS: Retrospective-prospective study of AIMS project cohort including medical, allied health and nursing practitioners at a quaternary children's hospital and health service (HHS). Outcome measures included time-to-finalise outpatient correspondence, clinicians' Reflections survey (1 month), document quality survey using modified Physician Documentation Quality Instrument-9 tool's domains (3 months), System Usability Scale (SUS) (3 months). Patient/consumer experience surveys, overtime and cost analyses. RESULTS: Total 131 participants including 89 medical, 36 allied health and 6 nurse practitioners used AIMS showing significant reduction in median time-to-finalise outpatient letters from 7.9 days (Interquartile range [IQR] 19 days) in pre-AIMS era to 14 min (IQR 6 days) (p < 0.001). In the Reflections survey participants reported improved: patient engagement (62/71, 87%), well-being (80%, 57/71) and work-life balance (66%, 47/71). The document quality survey showed acceptable document quality with median score 4, in 9 of the 10 survey domains (scale 1-to-5, n = 77). Mean SUS score was 74 (n = 77) suggesting above average usability. Study showed transcription cost savings of 16 903 AUD, but no definitive impact on overtime claims. Patient/consumer feedback (n = 333) was highly positive with over 90% reporting improved clinician-patient interaction and welcoming future use of AIMS. CONCLUSIONS: This study showed significantly improved documentation efficiency, acceptable document quality, and reduced transcription costs with significant benefits to clinician well-being and clinician-patient interaction with the use of an ambient AI medical scribe. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12625000432415.