AI-Based Ambient Scribes May Reduce Physician Documentation Time, Burnout

TUESDAY, Dec. 9, 2025 (HealthDay News) — Artificial intelligence (AI)-based ambient scribes may reduce documentation time and improve physician well-being, according to a study published online Nov. 26 in NEJM AI.

Paul J. Lukac, M.D., from the University of California, Los Angeles (UCLA), and colleagues examined the impact of ambient AI scribes. Outpatient physicians (238), representing 14 specialties, were randomly assigned (1:1:1) to either one of two AI scribe applications — Microsoft Dragon Ambient eXperience (DAX) Copilot or Nabla — or a usual-care control group. Change from baseline log writing time-in-note was the primary outcome. Secondary outcomes included several survey instruments: Mini-Z 2.0 to assess burnout, work environment, work pace, and electronic health record (EHR) stress; physician task load (PTL) to assess cognitive load related to stress from EHR documentation; and Professional Fulfillment Index-Work Exhaustion (PFI-WE).

The researchers found that Nabla users experienced a 9.5 percent (P = 0.02) decrease in time-in-note versus the control group. DAX users showed no significant change versus the control group (−1.7 percent). Compared with control, there were improvements in total Mini-Z (scale of 10 to 50; DAX, +2.83; Nabla, +2.69), PTL (scale of 0 to 400; DAX, −39.9; Nabla, −31.7), and PFI-WE (scale of 0 to 4; DAX, 0.32; Nabla, −0.23) for users of either scribe. There was one grade 1 (mild) adverse event reported, while clinically significant inaccuracies were noted “occasionally” on 5-point Likert questions (DAX, 2.7; Nabla, 2.8).

“This technology requires active physician oversight, not passive acceptance,” senior author John N. Mafi, M.D., M.P.H., also from UCLA, said in a statement. “The path forward requires embracing innovation while maintaining medicine”s fundamental commitment to patient safety through rigorous evaluation and ongoing monitoring.”

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