Artificial intelligence-powered documentation does not enhance clinician efficiency but may improve their work-life balance, according to a study published in the New England Journal of Medicine.

Researchers at Atrium Health in Charlotte, North Carolina, and the Wake Forest University School of Medicine conducted a study in mid-2023 comparing 112 primary care clinicians who used Nuance’s Dragon Ambient eXperience (DAX) Copilot clinical documentation software with a control group of 103 clinicians who did not use the tool.

DAX Copilot is an AI-enabled scribe software integrated with electronic health records (EHR). It creates a preliminary clinical note by “listening” to the conversation between a clinician and a patient during their visit.

The purpose of this tool is to reduce administrative burdens, allowing clinicians to concentrate more on patient care. In doing so, AI-powered clinical documentation tools could help mitigate physician burnout and enhance the efficiency of health care delivery.

Home health providers are hoping AI tools can do the same for their nurses.

At the beginning of the day, clinicians log into the EHR and open DAX through a link. Before entering a patient’s room, they launch the smartphone application and begin recording while still outside the room to capture the patient’s name, reason for the visit and other relevant information.

Once the visit concludes, the clinician stops the recording, and the application generates the preliminary note within 30 seconds. The draft is available for review either in the smartphone app or in a preview window on the computer. Both options allow the clinician to edit the note. However, research indicates that most clinicians do not use this editing feature. Typically, they transfer the note to the EHR using voice commands or the “copy” button and make further edits within the EHR before finalizing the note.

The primary outcomes of EHR usage and its financial impact were evaluated over 180 days. The DAX group divided participants into two subgroups: active users and high users. Active users transferred approximately 25% of DAX notes, while high users transferred around 60%.

Exploratory analyses indicated that high DAX usage could lead to small reductions in documentation hours, mainly when implemented with low-volume clinicians and in family medicine practices.

“In this evaluation, we found no statistically significant differences in EHR-related and financial metrics between DAX users and the control group,” the researchers wrote. “However, exploratory results suggested that modest reductions in documentation time could occur when using DAX at a high utilization level or when targeting specific clinical subgroups. Overall, these findings imply that the efficiencies gained from AI-enhanced documentation may reduce burnout indicators for a subset of clinicians and potentially on a broader scale if DAX is adopted widely. However, implementing DAX in its current form will unlikely lead to substantial productivity gains for health care systems.”

Users agree AI aids work-life balance

While researchers couldn’t identify significant improvements in documentation or financial metrics, a subset of clinicians noted that the tool saved them time. Instead of seeing more patients, this extra time allowed them to get more sleep, reduce their work hours at home, and personalize and focus on existing patient encounters. These changes may contribute to better patient outcomes and greater satisfaction, not to mention better work-life balance.

To that end, Kathy Hoffman, chief clinical officer at Pinnacle Home Care, told Home Health Care News earlier this year that using an AI-powered language model has helped streamline operations, saving time on documentation and giving clinicians more downtime at home.

“We have been able to cut the start of care time down to 87.3 minutes from 119 minutes, so huge savings for clinicians,” she said. “In home health, because there’s so much documentation, we usually find that most clinicians are going home and trying to document in the evening. Therefore, it’s creating a difficult work-life balance for them and untimely documentation.”

Pinnacle Home Care is an Oldsmar, Florida-based home health provider.

“They’re able to give more face time to the patient, able to interact better with that patient…to drive patient satisfaction,” Hoffman said.

Trent Smith, CEO of Oklahoma City-based Accentra Home Health and Hospice, also launched Apricot to create efficiencies in the business and eradicate turnover. This generative AI tool gives time back to home health nurses by cutting documentation time by “over 85%,” according to the company.

While the tool was initially created for internal use, Smith found it more valuable after talking with a nurse who said it reduced documentation time and allowed her to spend quality time with her daughter after work. Since then, other home health agencies have begun using Apricot.

In June, Smith told Home Health Care News that Apricot was on track to serve more than 800 nurses and 20,000 patients monthly.