Patient Attitudes Toward Ambient Voice Technology: Preimplementation Patient Survey in an Academic Medical Center

Abstract

Background: Many institutions are in various stages of deploying an artificial intelligence (AI) scribe system for clinic electronic health record (EHR) documentation. In anticipation of the University of California, Davis Health’s deployment of an AI scribe program, we surveyed current patients about their perceptions of this technology to inform a patient-centered implementation. Objective: We assessed patient perceptions about current clinician EHR documentation practices before implementation of the AI scribe program, and preconceptions regarding the AI scribe’s introduction. Methods: We conducted a descriptive preimplementation survey as a quality improvement study. A convenience sample of 9171 patients (aged ≥18 years) who had a clinic visit within the previous year, was recruited via an email postvisit survey. Patient-identified demographics (age, gender, and race and ethnicity) were collected. The survey included rating scales on questions related to the patient perception of the AI scribe program, plus open-ended comments. Data were collated to analyze patient perceptions of including AI Scribe technology in a clinician visit. Results: In total, 1893 patients completed the survey (20% response rate), with partial responses from another 549. Sixty-three percent (n=1205) of the respondents were female, and most were 51 years and older (87%, n=1649). Most patients identified themselves as White (69%, n=1312), multirace (8%, n=154), Latinx (7%, n=130), and Black (2%, n=42). The respondents were not representative of the overall clinic populations and skewed more toward being female, ages 50 years and older, and White in comparison. Patients reacted to the current EHR documentation system, with 71% (n=1349) feeling heard or sometimes heard, but 23% (n=416) expressed frustrations that their physician focused too much on typing into the computer. When asked about their anticipated response to the use of an AI scribe, 48% (n=904) were favorable, 33% (n=630) were neutral, and 19% (n=359) were unfavorable. Younger patients (ages 18-30 years) expressed more skepticism than those aged 51 years and older. Further, 42% (655/1567) of positive comments received indicated this technology could improve human interaction during their visits. Comments supported that the use of an AI scribe would enhance patient experience by allowing the clinician to focus on the patient. However, when asked about concerns regarding the AI scribe, 39% (515/1330) and 15% (203/1330) of comments expressed concerns about documentation accuracy and privacy, respectively. Providing previsit patient education and obtaining permission were viewed as very important. Conclusions: This patient survey showed that respondents are generally open to the use of an AI scribe program for EHR documentation to allow the clinician to focus on the patient during the actual encounter rather than the computer. Providing patient education and obtaining consent before using AI are important components to gain patient trust. Caution about the results is appropriate, given the low response rate and nonrepresentative profile.