Title:  Using an EHR Ambient Note Opportunity Score to Identify Safety Net Ambulatory Care Providers and Clinics that May Benefit from Ambient AI Scribe Technology

Author: Efren Aguilar, Adrienne Martinez-Hollingsworth PhD RN PHN WAN, Douglas Bell, MD PhD, Christina Jung MD, Jeffrey Arroyo MD

Area of Concentration (Petal): Health, Justice, and Advocacy

Specialty: Clinical Informatics

Keywords: FQHC, Clinical Informatics, Ambient AI Scribe, Minority Health, Safety Net

Background: Rising demands for Electronic Health Record (EHR) documentation has increased physician burnout, especially in safety net settings which serve historically divested communities. Implementing ambient AI scribes for direct EHR transcription may reduce burnout, improve patient outcomes, and decrease staff turnover. Yet, there is a paucity of data on selection of fertile test sites for AI scribe technology in Federally Qualified Health Centers (FQHCs) where workforce challenges post-pandemic require novel strategies for provider recruitment and retention.

Objective: To explore a method for identifying physicians in FQHC clinics likely to demonstrate a benefit from AI scribe technology using the EPIC EHR Ambient Note Opportunity (ANO) Score.

Methods: Provider and clinic selection was based on EHR ANO Score, which evaluates after-hours charting, same-day visit closures, and manual note-typing. ANO scores were collected from providers in the nation’s largest FQHC system, located in the Western United States (N=677). ANO scores closer to the maximum score of three indicate greater potential benefit.

Results: All providers ranged in ANO scores of 0.0355 – 2.855. We are recruiting four clinics with an average ANO score above the cutoff, 1.649. The four clinics' average scores ranged from 1.649 – 1.736. Across clinic providers (N=99), individual provider ANO scores ranged from 0.138 to 2.805. One additional clinic outside the cutoff will be recruited for logistical purposes.

Conclusions: Pinpointing sites is instrumental in establishing efficacy and ultimately decreasing administrative burden for providers. The ANO score offers additional Provider Efficiency Profile (PEP) data, which may support the development of predictive models that identify providers most likely to benefit from an AI scribe, enabling cost-effective roll-out.

Lessons Learned: Ambient AI system implementation in the EHR required IT security clearances, baseline data collection, and a clear ROI outline; additional factors beyond the ANO scores will be considered during roll-out.

Summary: Providers/clinics selected via ANO scores will participate in a pilot study to evaluate changes in PEP data before-and-after the intervention. Pilot data will inform a larger study.