PDF(Pubmed)
Abstract：
OBJECTIVE: To assess the impact of the use of an ambient listening/digital scribing solution (Nuance Dragon Ambient eXperience (DAX)) on caregiver engagement, time spent on Electronic Health Record (EHR) including time after hours, productivity, attributed panel size for value-based care providers, documentation timeliness, and Current Procedural Terminology (CPT) submissions.
METHODS: We performed a peer-matched controlled cohort study from March to September 2022 to evaluate the impact of DAX in outpatient clinics in an integrated healthcare system. Primary outcome measurements included provider engagement survey results, reported patient safety events related to DAX use, patients\' Likelihood to Recommend score, number of patients opting out of ambient listening, change in work relative values units, attributed value-based primary care panel size, documentation completion and CPT code submission deficiency rates, and note turnaround time.
RESULTS: A total of 99 providers representing 12 specialties enrolled in the study; 76 matched control group providers were included for analysis. Median utilization of DAX was 47% among active participants. We found positive trends in provider engagement, while non-participants saw worsening engagement and no practical change in productivity. There was a statistically significant worsening of after-hours EHR. There was no quantifiable effect on patient safety.
CONCLUSIONS: Nuance DAX use showed positive trends in provider engagement at no risk to patient safety, experience, or clinical documentation. There were no significant benefits to patient experience, documentation, or measures of provider productivity.
CONCLUSIONS: Our results highlight the potential of ambient dictation as a tool for improving the provider experience. Head-to-head comparisons of EHR documentation efficiency training are needed.
METHODS: We performed a peer-matched controlled cohort study from March to September 2022 to evaluate the impact of DAX in outpatient clinics in an integrated healthcare system. Primary outcome measurements included provider engagement survey results, reported patient safety events related to DAX use, patients\' Likelihood to Recommend score, number of patients opting out of ambient listening, change in work relative values units, attributed value-based primary care panel size, documentation completion and CPT code submission deficiency rates, and note turnaround time.
RESULTS: A total of 99 providers representing 12 specialties enrolled in the study; 76 matched control group providers were included for analysis. Median utilization of DAX was 47% among active participants. We found positive trends in provider engagement, while non-participants saw worsening engagement and no practical change in productivity. There was a statistically significant worsening of after-hours EHR. There was no quantifiable effect on patient safety.
CONCLUSIONS: Nuance DAX use showed positive trends in provider engagement at no risk to patient safety, experience, or clinical documentation. There were no significant benefits to patient experience, documentation, or measures of provider productivity.
CONCLUSIONS: Our results highlight the potential of ambient dictation as a tool for improving the provider experience. Head-to-head comparisons of EHR documentation efficiency training are needed.
摘要：
目的：评估使用环境聆听/数字划线解决方案（NuanceDragon环境体验（DAX））对护理人员参与的影响，在电子健康记录（EHR）上花费的时间，包括下班后的时间，生产力,基于价值的护理提供者的属性面板大小，文档的及时性，和当前程序术语(CPT)提交。
方法：我们于2022年3月至9月进行了同行匹配的对照队列研究，以评估DAX在综合医疗保健系统中门诊诊所的影响。主要结果测量包括提供者参与度调查结果，报告与使用DAX相关的患者安全事件，患者推荐评分的可能性，选择退出环境听力的患者数量，工作相对值单位的变化，基于属性价值的初级保健小组规模，文档完成和CPT代码提交不足率，并记下周转时间。
结果：共有代表12个专业的99个提供者参加了研究；76个匹配的对照组提供者被纳入分析。活跃参与者中DAX的平均利用率为47%。我们发现提供商参与的积极趋势，而非参与者则看到参与度恶化，生产力没有实际变化。小时后EHR有统计学上显著的恶化。对患者安全没有可量化的影响。
结论：NuanceDAX的使用在提供者参与方面显示出积极的趋势，对患者安全没有风险，经验,或临床文件。对患者体验没有显著益处，文档,或衡量提供者的生产力。
结论：我们的结果强调了环境听写作为改善提供者体验的工具的潜力。需要进行EHR文档效率培训的头对头比较。
方法：我们于2022年3月至9月进行了同行匹配的对照队列研究，以评估DAX在综合医疗保健系统中门诊诊所的影响。主要结果测量包括提供者参与度调查结果，报告与使用DAX相关的患者安全事件，患者推荐评分的可能性，选择退出环境听力的患者数量，工作相对值单位的变化，基于属性价值的初级保健小组规模，文档完成和CPT代码提交不足率，并记下周转时间。
结果：共有代表12个专业的99个提供者参加了研究；76个匹配的对照组提供者被纳入分析。活跃参与者中DAX的平均利用率为47%。我们发现提供商参与的积极趋势，而非参与者则看到参与度恶化，生产力没有实际变化。小时后EHR有统计学上显著的恶化。对患者安全没有可量化的影响。
结论：NuanceDAX的使用在提供者参与方面显示出积极的趋势，对患者安全没有风险，经验,或临床文件。对患者体验没有显著益处，文档,或衡量提供者的生产力。
结论：我们的结果强调了环境听写作为改善提供者体验的工具的潜力。需要进行EHR文档效率培训的头对头比较。
