Burnout among clinicians remains one of the most pressing issues in healthcare, often linked to the demands of electronic health record documentation. Insufficient time for note completion not only adds to workload but also impacts care quality and patient safety. Traditional interventions from scribes to workflow redesign and dictation tools have produced mixed results, often hindered by cost or limited effectiveness. Ambient documentation technology (ADT) has emerged as a new approach, capturing clinician-patient conversations and using artificial intelligence to generate structured notes. Mass General Brigham in Massachusetts and Emory Healthcare in Georgia piloted ADT with the aim of reducing documentation burden. A survey of 1430 clinicians across both centres explored patterns of use and its association with burnout and well-being. Findings suggested that ADT may alleviate cognitive pressure, improve clinical experience and provide a foundation for rethinking documentation practices across specialties.
Adoption and Use of Ambient Documentation
The pilots enrolled clinicians across a range of roles and disciplines. Physicians represented the majority of participants with advanced practice practitioners also included. Specialties spanned primary care, surgery, urgent and emergency care, hospital medicine and subspecialties. At Mass General Brigham, nearly half of respondents reported using ADT in at least half of their encounters while at Emory more than 40% said they used it for most or all of their notes. Despite differences in survey methodology, both centres recorded high likelihood-to-recommend scores, with a median of 8 out of 10. These results indicate strong satisfaction even as usage varied.
Patterns of adoption also highlighted the types of visits where ADT was considered most useful. Clinicians noted that structured, information-heavy encounters benefited most whereas some visit categories such as paediatric assessments and psychiatric evaluations presented challenges for the technology. This variability suggests that implementation strategies may need to be tailored to the clinical context. Even so, enthusiasm for adoption was evident across specialties, underlining the perceived value of the tool in easing the administrative load.
Self-reported usage data pointed to pragmatic use of ADT rather than uniform integration into all encounters. Some clinicians reserved the technology for more complex visits while others used it routinely. Importantly, the positive impact on burnout and well-being did not appear restricted to heavy users, hinting at the possibility that even partial adoption could make a meaningful difference in workload management.
Impact on Burnout and Well-being
Survey findings revealed significant improvements in indicators of burnout and well-being. At Mass General Brigham, burnout prevalence dropped from more than half of clinicians at baseline to less than one-third at both the 42-day and 84-day checkpoints. While professional fulfilment scores rose modestly, the decline in burnout was both substantial and statistically significant. Emory observed a different but complementary pattern: the proportion of clinicians reporting a positive effect of documentation practices on well-being increased from less than 2% to more than 30% within 60 days.
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These changes were striking given the relatively short evaluation periods. They also demonstrated that positive outcomes could emerge even with partial adoption. Clinicians who reported using ADT for only some visits still experienced measurable improvements, suggesting that relief from cognitive load in select encounters could offset burdens across the working day. This aligns with broader evidence linking documentation pressure with overall job stress and highlights the potential of ADT to address one of the most entrenched drivers of burnout.
While improvements in intent to leave practice were not significant, the overall direction of results indicated that ADT may contribute to clinician retention by easing administrative strain. The potential long-term impact on workforce stability remains an open question but the early findings position ADT as a promising component of a broader strategy to support clinician well-being.
Clinician Feedback and Areas for Improvement
Qualitative survey responses provided further insight into the experience of using ADT. Many clinicians described gains in efficiency, greater satisfaction with their practice and enhanced interactions with patients. They reported feeling able to focus more directly on conversations rather than dividing attention between the patient and the electronic health record. For some, the technology improved the quality of documentation itself, generating notes that were more comprehensive than they might have produced unaided.
However, the feedback also revealed limitations. Certain visit types such as well-child checks or psychiatry encounters were less well supported. In these contexts, clinicians found the generated notes less accurate or less relevant to their needs. Some reported that editing ADT-generated text could add time rather than reduce it, showing that effectiveness depended on workflow alignment. Others commented on formatting and content organisation, suggesting refinements that could make notes more usable across teams.
Despite these challenges, satisfaction scores were consistently high and many clinicians expressed optimism about the potential of ADT to evolve. The contrast with long-standing dissatisfaction with electronic health record usability was notable. While not universally beneficial, the technology demonstrated sufficient value to be seen as transformative by many users. The results also underscored the importance of continued development, ensuring that future iterations are better adapted to specialty-specific requirements and integrated more seamlessly into practice.
The pilots at Mass General Brigham and Emory suggest that ambient documentation technology can meaningfully reduce clinician burnout and enhance documentation-related well-being. While the findings were constrained by limited response rates and may reflect the views of more enthusiastic users, the consistent improvements across two large institutions point to the promise of this approach. Broader adoption will depend on addressing specialty-specific limitations, improving usability and validating benefits across more diverse clinical environments. If these conditions are met, ADT could represent a significant step towards reducing administrative burden, improving clinician experience and ultimately strengthening patient care.
Source: JAMA Network
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