• Technologies for Reducing Documentation Burden

    Technological innovations offer promise in reducing and even eliminating documentation burden. Choosing a medical documentation solution that is right for you is a personal preference, but it’s also about weighing the costs, risks, and time it takes to use daily.

    Below are five major technologies to help you reduce clinical documentation burden:

    Medical scribes
    Virtual scribes
    Medical speech recognition
    Ambient speech recognition
    Artificial intelligence (AI) assistants

    Medical scribes

    $2500–$4500 per month

    Medical scribes shadow the physician, document the note, and perform other administrative tasks. Medical scribes are efficient but can be costly for private practices or individual health care professionals. They also are hard to scale and can put physicians at risk of malpractice due to possible function creep.

    Medical scribe companies >>

    • Delegating documentation and other administrative tasks to an in-person scribe takes burden off the physician

    • Not broadly used in family medicine or primary care due to costs and investment required (pre-med, medical students)

    • Increased productivity; reduced documentation burden
    • 57% increase in patient face time
    • 27% decrease in EHR time

    Virtual scribes

    $1000–$1200 per month

    Virtual scribes and transcriptionists reduce intrusiveness by removing the third party from the exam room, but their usefulness is threatened by costs, note turnaround times, offshore data transmission, and security risks.

    Virtual scribe companies >> Augmedix,  Aquity, Athreon,  ScribeEMR, SkywriterMD

    • Cheaper than medical scribes and have no retention issues

    • Performs only patient charting
    • Not real-time; up to 24-hour delay
    • May incur added hardware costs

    • Up to 85% burnout reduction
    • 1.1 hour/day EHR time reduction
    • 1 hour/day documentation reduction

    Medical speech recognition

    Enterprise: $25–$75 per month
    Single physician: $200 per month

    Medical speech recognition (MSR) technology allows you to dictate your notes instead of typing. Dictation devices can help improve health outcomes and patient understanding of care plans, but they don’t fully relieve physicians of documentation burden due to the work they require to run at optimum.

    Medical speech recognition companies >> Dragon Medical, MModal, KLAS Ranking

    • Established technology option with greatly improved accuracy

    • Similar to dictation but physician must navigate EHR and edit

    • 79% of users were satisfied with MSR
    • 77% reported improved efficiency

    Ambient speech recognition

    $1800 per month

    Ambient speech recognition technology “listens” to the caregivers’ and patient’s conversation with the physician throughout the encounter, including history and exam details, and works with an external staffed service to create a visit note.

    • Shows promise in decreasing burden and enhancing care and visit documentation efficiency


    • Ambient discussion in exam room is personal; MDM is purposeful and may not be done in the exam room


    • 79% of users reported better documentation quality
    • 70% saw reduced burnout and fatigue
    • 81% of patients saw greater physician focus

    AI assistant

    $150–$200 per month

    AI-powered, voice-enabled digital assistants can help physicians complete documentation and other administrative tasks. Although AI assistants still have room to develop, they are the only documentation solutions on the market that show promise in totally automating the EHR documentation process.

    • Mobile assistant allows physician to step away from EHR and let assistant interact
    • Consumer-friendly features and cost
    • Some AI assistants use a "human in the loop" to edit and correct the transcription while the AI assistant learns

    • EHR integration is essential and vendors have been slow to support, but progress is being made 


    • 72% reduction in documentation time
    • 40% decrease in after-hours work, including weekend work
    • 20% increase in practice satisfaction


    Innovation Lab: Using an AI Assistant to Reduce Documentation Burden in Family Medicine

    The AAFP launched a series of Innovation Labs to identify and demonstrate innovations essential to optimizing the family medicine experience. The initial phase provided proof that using an AI assistant can significantly reduce documentation burden and family physician burnout. Adoption was assessed based on the number of participants agreeing to buy the solution and the impact realized during the lab trial.

    Differences between AI and medical speech recognition

    Unlike AI, legacy MSR systems did not leverage deep learning needed to perform voice-to-text conversion or have natural language understanding. Although newer MSR solutions have progressed in these areas, AI assistants better understand natural language and can detect intent (i.e., commands from the user). Whereas voice recognition solutions require the user to specify where dictation should be placed in the EHR note, AI assistants’ built-in model of documentation recognizes embedded commands and knows where to place text. This ability enables the physician to generate a note without having to navigate or edit in the EHR.