{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:39:09Z","timestamp":1792719549783,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["5TL1DK139565-02"],"award-info":[{"award-number":["5TL1DK139565-02"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This retrospective cohort study evaluated the effect of an artificial intelligence (AI) scribe on patient instructions documentation in ambulatory internal medicine settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We analyzed 391\u00a0061 adult encounters at a single medical center from December 2023 to July 2025. A difference-in-differences analysis estimated the relationship of AI scribe availability with patient instructions documentation frequency. Mixed-effects logistic regression estimated the association between encounter-level AI scribe utilization and documentation, adjusted for patient, clinician, and encounter characteristics. Length and readability were compared across instructions created by AI alone, clinicians assisted by AI, and clinicians alone. Character-level edit distances between AI drafts and final documentation were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AI scribe availability was associated with a 10.5 percentage-point increase in patient instructions documentation frequency (P\u2009=\u2009.018), and encounter-level AI use was associated with higher odds of documentation (aOR 4.32; 95% CI, 4.14-4.50). AI instructions were longer than clinician-authored content (median 1994 vs 482 characters) and scored higher on 3 text-complexity indices (all P\u2009&amp;lt;\u2009.001). Clinician editing of AI content increased length without meaningfully reducing complexity. AI drafts and final documentation differed substantially, with a median character-level edit distance of 39.7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>AI scribe availability was associated with increased patient instructions documentation. However, AI-generated instructions were longer and scored as more linguistically complex than clinician-authored instructions, and clinician editing did not close this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ambient AI scribes can improve availability but may increase complexity of patient instructions. Research into downstream effects including patient comprehension and satisfaction is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jamia\/ocag177","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:40:26Z","timestamp":1792712426000},"source":"Crossref","is-referenced-by-count":0,"title":["Association of ambient artificial intelligence scribe availability with patient instruction documentation and readability in ambulatory care"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7318-6857","authenticated-orcid":false,"given":"Kevin","family":"Shi","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Creasman","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Schmajuk","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aris","family":"Oates","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E","family":"Byron","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Garcia-Agundez","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-4094","authenticated-orcid":false,"given":"Jinoos","family":"Yazdany","sequence":"additional","affiliation":[{"name":"Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California , San Francisco, CA, 94143,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"2026102221214519300_ocag177-B1","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.23.0404","article-title":"Ambient artificial intelligence scribes to alleviate the burden of clinical documentation","volume":"5","author":"Tierney","year":"2024","journal-title":"NEJM Catal"},{"key":"2026102221214519300_ocag177-B2","doi-asserted-by":"publisher","first-page":"100157","DOI":"10.1016\/j.fhj.2024.100157","article-title":"Use of an ambient artificial intelligence tool to improve quality of clinical documentation","volume":"11","author":"Balloch","year":"2024","journal-title":"Future Healthc J"},{"key":"2026102221214519300_ocag177-B3","doi-asserted-by":"publisher","DOI":"10.1056\/AIoa2400659","article-title":"Does AI-powered clinical documentation enhance clinician efficiency? 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