Adoption and utility of digital scribes in clinical practice - A scoping review.

BACKGROUND: Digital scribes use automatic speech recognition to transcribe a clinician-patient conversation and use generative artificial intelligence (AI) technology to summarise the transcript into relevant documentation templates. OBJECTIVE: To survey and summarise recent literature published on the factors affecting the adoption of digital scribes, and the impacts of digital scribes on patients, clinicians, and health organisations. METHODS: Following the PRISMA-ScR guideline, MEDLINE, CINAHL, Web of Science, SCOPUS, and EMBASE were searched for original research papers or case studies that described and evaluated the implementation or use of digital scribes in real-life healthcare settings. Themes and sub-themes were mapped to the updated Consolidated Framework for Implementation Research (CFIR) and the CFIR Outcomes Addendum. RESULTS: Of the 4772 studies screened, 29 were included in this review. Digital scribes were generally regarded as acceptable (n = 11) and usable (n = 8), but concerns over the accuracy of notes generated by the scribes were also reported (n = 9). Impacts of digital scribes included improved clinician wellbeing (n = 12), reduction in documentation burden (n = 18), and improved patient-clinician interaction (n = 10). Limited studies examined the impact of digital scribes on broader health organisation outcomes, such as cost and productivity (n = 3). DISCUSSION: The fast pace at which digital scribes are being adopted warrants regular updated reviews. Further studies are required to compare the additional benefits of digital scribes over and above human scribes, if any, the role of patient trust in the adoption of digital scribes, and how digital scribes perform in various clinical settings. CONCLUSION: Digital scribes could reduce clinicians' documentation burden, but their adoption was limited by accuracy concerns. While patient satisfaction with digital scribes appears positive, this should be a focus for future studies. The cost-effectiveness and financial impact of digital scribes on health organisations should be further explored.