Ambient Artificial Intelligence Versus Human Scribes in the Emergency Department.
Journal:
Annals of emergency medicine
Published Date:
Nov 18, 2025
Abstract
STUDY OBJECTIVE: To compare the use of ambient artificial intelligence (AI) versus human scribes in the emergency department in terms of note quality and time spent in the electronic health record. METHODS: A quality improvement pilot was performed with 5 early adopters from December 2024 to January 2025. Physicians were assigned to a human or AI scribe. Two physicians, blinded to the chart's origin, scored notes using the Physician Documentation Quality Instrument (PDQI-9). We accessed our electronic health record for time metrics and note contributions and compared PDQI-9 scores, time metrics, and note contribution between groups. RESULTS: There were 710 visits, 284 with human scribes (123 adult and 161 pediatric) and 426 with AI-assisted charting (271 adult, 155 pediatric). PDQI-9 scores were similar for adults, but AI scribes scored lower for pediatric patients (41.36 versus 42.25, adjusted risk ratio [aRR] = -1.89 [95% confidence interval (CI) -3.58 to -0.20]). More time in the electronic health record notes section per patient was spent when using AI scribes (adult: 4.3 versus 1.8 minutes, aRR = 2.38 [95% CI 1.85 to 3.05]; pediatric: 3.5 versus 1.6 minutes, aRR = 2.21 [95% CI 1.94 to 2.51]). Note length was similar but physicians contributed significantly more characters per note when using AI (adult: 60.1% versus 30.8%, adjusted mean differences = 32.9 [95% CI 20.8 to 45.0]; pediatric: 62.3% versus 27.1%, adjusted mean differences = 35.2 [95% CI 29.7 to 40.7]). CONCLUSION: In comparison to human scribes, AI scribes were associated with more time spent in the electronic health record notes section, more physician note contribution, and similar to lower quality notes.
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