Dr. Alicia Jacobs: AI-generated clinical notes can help reduce primary care burnout

This commentary is by Dr. Alicia Jacobs, wellbeing informaticist at the UVM Health Network and ACO physician leader at OneCare Vermont.

Tourists still love to visit picturesque Vermont, yet many new and old residents are considering leaving because they can’t find a primary care provider. Primary care is a precious and strained workforce.

As a family medicine physician and leader in primary care for over 20 years, I have seen and experienced the expanding current of burnout and professional dissatisfaction among primary care providers. Interventions for improving their workload have been few to come by. Then I discovered ambient AI to generate clinic notes: it has brought joy back to my practice.

Primary care clinicians save lives and are essential to keeping communities healthy: communities with more primary care physicians do better and people in those communities live longer . Primary care clinicians minimize the need for specialty care and are the backup when specialists are not available. They take care of all comers and care for entire communities. Through longitudinal trusting relationships, we are healing and therapeutic.

Primary care is having a crisis because rampant burnout has led to a decline in the workforce. Over half of primary care clinicians experience burnout. Burnout increases turnover, early retirement or decreasing the time spent in patient care, leading to a contracture in the overall size of the primary care workforce.

Since 2020, administrative tasks have ballooned for Primary care clinicians, sometimes taking up more than 50% of their time. “Paperwork” is a complex set of frustrating and time-consuming tasks that cause cognitive overload. Many hours spent working in the electronic health record, the push for quality metrics, and meaningless administrative burdens, such as prior authorizations, all prevent us from connecting with patients.

The antidote to burnout is to increase the percentage of time each day a person spends in meaningful work. At the University of Vermont Health Network, we piloted ambient AI products that record a natural conversation between patient and clinician to automatically generate the clinical note.

This approach, focused on helping reduce administrative workload of creating notes, showed that burnout rates in primary care clinicians decreased by an absolute 33% in 8 weeks. No other interventions to reduce burnout have ever worked this well. Now our primary care clinicians can better focus on the care of many Vermonters and northern New Yorkers. These patients directly benefit from this improvement in their providers’ wellbeing.

In terms of feedback, our clinicians say that Ambient AI decreases their cognitive and administrative workload while improving their presence in the room with a patient.  AI has also increased their professional fulfillment (a marker for joy in work).

A secondary study through the Larner College of Medicine at the University of Vermont has shown that the notes are as high-quality as provider-generated notes. Our patients are noticing too: they have given feedback about appreciating better eye contact, less screen time and a calmer experience.

AI is not a cure-all for our woes in healthcare; any new technology has downsides. Clinicians still need to interface with the computer to enter diagnoses, orders, do refills and enter patient instructions. Learning new systems takes time and energy. The abstraction of large language models, computer learning and the occasional hallucinations of generative AI can be hard to understand. Any technology standardizing the rhythm and content of our notes has the potential to diminish clinician voices and personalities.

We will also need to mind how this will impact the next generation of clinicians. However, none of those challenges or shortcomings outweigh the potential for positive transformative change in how we as a healthcare workforce relate to technology. Clinicians have asked for a technology that helps us do what is meaningful for us, and now it exists.

Safely using AI in health care is possible. For me, applying AI has been magical. We can help save the Primary Care workforce by removing one of the obstacles to joyful and sustainable practice and using ambient AI.

Let’s leverage a way to share contracts with AI vendors and to find benefactors to support primary care. We should then continue to find innovative ways to help stabilize this precious primary care foundation to our health care system.

Read the story on VTDigger here: Dr. Alicia Jacobs: AI-generated clinical notes can help reduce primary care burnout .