AI scribes cut documentation times

In a new study published in JAMA, researchers analyzed data from clinicians at five academic health centers who were provided access to AI scribes between June 2023 and August 2025. Ambulatory clinicians were able to use AI scribes for a minimum of 12 weeks, including six weeks before adoption and six weeks after. Each health system introduced the AI scribes in their own way, and clinicians were able to choose how and when they used the tools.

In total, 8,581 clinicians participated in the study, including 1,809 who chose to use AI scribes and 6,771 who chose not to. Almost 75% of participants were attending physicians while 18.1% were advanced practice clinicians, and 7.8% were resident physicians. Of the participants, 24.4% were in primary care, 62.4% were in medical specialties, and 13.2% were in surgical specialties.

Overall, the researchers found that using AI scribes was associated with 13.4 fewer minutes in the EHR and 16 fewer minutes charting. The groups that saw the most benefit from using AI scribes were primary care physicians, advanced practice providers, female clinicians, and clinicians who used the tools in at least half of their patient encounters.

Clinicians who used AI scribes more frequently saw greater reductions in EHR and documentation time. Clinicians who used AI scribes for more than 50% of their patient visits reduced their total EHR time twice as much and their documentation time three times as much as clinicians who used AI scribes less frequently.

The time saved on EHRs and documentation also allowed clinicians to have 0.49 additional patient visits per week, or around one additional patient every two weeks. This additional patient visit also contributed a "statistically significant, but nominal" $167.37 in additional monthly revenue per clinician.   

"Ambient documentation use is expanding rapidly across U.S. healthcare, making it essential to study how these technologies are impacting clinicians in real time," said Lisa Rotenstein, the study's lead and corresponding author from the University of California, San Francisco (UCSF).  "Our study demonstrates the impact of AI scribes in diverse real-world implementations at multiple sites. It also emphasizes the value of helping clinicians become comfortable with the technology so that they are reaping its full benefits via frequent use."

According to Carol Chouinard, VP and provider technology practice lead at Optum Advisory*, ambient listening technologies like AI scribes are currently being used in both personal and professional settings, but they are not one-size-fits-all and not being used uniformly across organizations — an important context for the study. 

How AI scribes are raising healthcare costs

According to healthcare economists, an "unintended consequence" of AI scribes may be higher healthcare costs, especially as health system leaders look to maximize the financial value of the tools.

Mac Boyter, a senior research director at KLAS, said that one chief medical information officer (CMIO) originally described AI scribes as "magic" that brought joy back to medicine but is now pushing for the technology to provide "coding uplift" to gain higher reimbursement for patient visits and other functions, like ordering prescriptions or follow-up lab tests.

"Every CIO I talk to, every CMIO of health systems, every CFO, is saying, 'Yeah, our clinicians love ambient tools. But I need to see the money. We need to see revenue generation or cost savings, we need to see operational efficiencies, workflows,'" Boyter said. 

"The investors, the health plans, and the providers, in private, were like, 'OK, well, it's quite clear scribes are increasing coding intensity. One hundred percent,'" said Caroline Pearson, executive director of the Peterson Health Technology Institute.

According to Pearson, health insurers can choose to pay the increased costs, downgrade expensive visits to less-expensive tiers, or decrease their provider reimbursement rates overall. Currently, many health insurers have implemented programs to identify "outlier" bills for Level 4 and 5 visits and pay for one level lower, which can lead to an average difference of $50 per visit.

However, Chouinard also noted that patients, as well as self-pay companies, could influence healthcare costs by selecting providers that offer better experiences and clinical outcomes.

Overall, health economists say that the "AI coding arms race" between providers using AI scribes and other tools to maximize codes and insurer algorithms working to minimize payments is a zero-sum game that will likely negatively impact vulnerable providers the most.

"The winners will be the most sophisticated providers that can use these tools most effectively. They're not gonna be the downtrodden single PCP that is taking care of a neighborhood that is [designated as] critical access care," said Daniel Polsky, a professor of health economics at Johns Hopkins University. "That's not where these technologies are being adopted. They're being adopted [by] the haves, not the have-nots."

"Getting bang for our buck in healthcare will require attention to every part of healthcare not delivering value," he added. "This is the attitude that has created a low value health system. We should all be responsible stewards in our part of the health system elephant."

*Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.