Physician Perspectives on Ambient Intelligence for Clinical Documentation

Austin Stroud, MA – Biomedical Ethics – Mayo Clinic; Michele Anzabi, MBE – Biomedical Ethics – Mayo Clinic; Hugo Botha, MB, ChB – Neurology – Mayo Clinic

Abstract: One application of ambient intelligence (AmI) rapidly being adopted by health systems is ambient listening tools to support clinicians with documentation. These tools "listen in" on clinical encounters and can automatically generate documentation. Despite current literature focused on efficiency, comparatively little is known about physicians' anticipated impacts of AmI-enabled documentation on their clinical practice and patient interactions.
We conducted case-based interviews with 40 physicians to characterize their perspectives on AmI-enabled clinical documentation. Interview data were analyzed using qualitative methods.
Physicians were generally enthusiastic about potential efficiency gains from AmI-supported documentation, citing opportunities for more direct patient interaction. However, some were skeptical, suggesting efficiency gains might justify additional workload or that reviewing automated notes might create additional burdens. Physicians noted concerns about data retention and how such technologies could introduce patient sensitivities and medicolegal issues due to audio recording of encounters. They suggested these tools might disrupt rapport building with technophobic patients and that ambient listening could create a discouraging environment for some patients to share their health experiences. Some physicians also highlighted how automated documentation could depersonalize healthcare experiences, potentially altering the physician-patient relationship.
As health organization leaders consider adopting AmI tools, our findings highlight several implementation and ethical considerations that influence physician acceptance, independent of conventional efficiency metrics. Beyond key data ethics considerations related to consent, privacy, and liability, we explore how AmI might disrupt conventional documentation practices—and by extension—influence the physician-patient relationship in ways some physicians perceive as harmful.

Keywords: Ambient intelligence, Physician perspectives, Patient communication