A Custom-Built Ambient Scribe Reduces Cognitive Load and Documentation Burden for Telehealth Clinicians

Abstract

Clinician burnout has motivated the growing adoption of ambient medical scribes in the clinic. In this work, we introduce a custom-built ambient scribe application integrated into the EHR system at Included Health, a personalized all-in-one healthcare company offering telehealth services. The application uses Whisper for transcription and a modular in-context learning pipeline with GPT-4o to automatically generate SOAP notes and patient instructions. Testing on mock visit data shows that the notes generated by the application exceed the quality of expert-written notes as determined by an LLM-as-a-judge. The application has been widely adopted by the clinical practice, with over 540 clinicians at Included Health using the application at least once. 94% (n = 63) of surveyed clinicians report reduced cognitive load during visits and 97% (n = 66) report less documentation burden when using the application. Additionally, we show that post-processing notes with a fine-tuned BART model improves conciseness. These findings highlight the potential for AI systems to ease administrative burdens and support clinicians in delivering efficient, high-quality care.