A Randomized Controlled Trial of Ambient Artificial Intelligence Scribe Technologies (AIScribe RCT)

University of California, Los Angeles (UCLA)

Status: Active, not recruiting

Conditions: Physician Workflow; Artificial Intelligence (AI)

Treatments: Other: Use Nabla AI Scribe tool provided; Other: Use AI Scribe tool provided by Vendor B

Study type: Interventional

Funder types: Other

Identifiers

NCT06792890

NPR 40703

Details and patient eligibility

About

This is a three-arm pragmatic RCT of 238 outpatient physicians at a large academic health system, randomized 1:1:1 to one of two AI scribe tools or a usual-care control group. The two-month study will observe and compare the effects of each tool prior to system-wide roll out of selected tool (anticipated Spring 2025). We will use covariate-constrained randomization to balance the arms in terms of physician baseline time in notes, survey-measured level of burnout, and clinic days per week.

The primary purpose of the initiative is to improve quality, efficiency, and business operations at University of California, Los Angeles (UCLA) Health, and this initiative is not being done for research purposes. The results of this operational initiative will inform the widespread roll out of AI scribe tools across all providers within the UCLA Health System. Nevertheless, the UCLA study team plans to rigorously examine and publish the impact of this intervention across the health system, which is why the study team pre-registered the initiative.

Full description

This study will assess operational-oriented outcomes across all groups. Notably, all groups will eventually receive all interventions over time in this observational study of a randomized roll out of a QI initiative. Moreover, the primary purpose of this initiative is operational. In other words, based on the results of this initiative, one of these tools will be eventually selected and operationalized widely across the health system.

Enrolled participants are randomized to one of three groups. Randomization was needed to overcome secular trends, seasonal and holiday effects in December, and other factors confounding the relationship between exposure to the AI tools and the outcomes.

The primary aim of this study is to evaluate the impact of two ambient AI scribe technologies on clinician change from baseline time spent on EHR documentation, comparing each scribe to a control group. Secondary objectives include assessing the AI scribes' impact on clinician metrics such as burnout, physician satisfaction, and productivity. Additionally, the study team intends to perform an economic evaluation analysis of the tools to guide business decision making. The study team will also analyze physician reported effects of the AI tools on patient safety, equity, and any unintended consequences of the initiative.

Enrollment: 238 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ambulatory care physicians within the UCLA Health system who held at least one half-day of clinic per week

Exclusion criteria

• Trainee providers (e.g., residents, medical students) and allied healthcare professionals (e.g., RNs, PAs)
• Attendings who work exclusively with trainees

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Single Blind

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238 participants in 3 patient groups

Nabla, Vendor of virtual AI scribe technology

Other group

Description:

Participants in this arm will utilize AI scribe tools from Nabla and will continue their usual clinical documentation processes, supported by the scribe software, which integrates with the EHR and automatically adds the generated text to the note. The Nabla AI scribe tool is transcriptional and does not provide clinical decision support.

Treatment:

Other: Use Nabla AI Scribe tool provided

Vendor B of virtual AI scribe technology

Other group

Description:

Participants in this arm will utilize AI scribe tools from Vendor B and will continue their usual clinical documentation processes, supported by the scribe software, which integrates with the EHR and automatically adds the generated text to the note. The AI scribe tool is transcriptional and does not provide clinical decision support.

Treatment:

Other: Use AI Scribe tool provided by Vendor B

No Scribe

No Intervention group

Description:

Participants in this arm will not have access to AI scribe tools and will continue their usual clinical documentation processes