Clinical trial NCT06329427: Dragon Ambient eXperience (DAX) Copilot Evaluation
Official title: Dragon Ambient eXperience (DAX) Express Pilot Evaluation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Automated Clinical Documentation
Keywords: speech-to-text
Dragon Ambient eXperience (DAX)
intervention evaluation
Lead sponsor: Wake Forest University Health Sciences
Sponsor class: OTHER
Collaborators: name: Hieu Nguyen, MS - Biostatician
name: McKenzie Isreal, MPH - project manager
name: Casey Stephens, MPH - Health services researcher
First posted: 2024-03-26
Enrollment: 238
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: AI solutions like, Dragon Ambient eXperience (DAX) Copilot (Nuance/Microsoft), hold the potential to significantly enhance provider and patient interactions and alleviate pain points that contribute to burn out. Atrium Health was the first healthcare system in the world to pilot Nuance's DAX Copilot intelligence (AI) enabled scribe software, which synthesizes a draft clinic note by "listening" to the conversation between a provider and patient. After 180 days of use by primary care clinicians and advanced practice providers (APPs), along with a control group, the investigators assess provider satisfaction, patient experience, and provider efficiency through qualitative and quantitative methods.

Detailed description: In this non-randomized stepped-wedge trial, clinicians (including physicians and advanced practice providers \[APP\]) specializing in family medicine, internal medicine, and general pediatrics were recruited from outpatient clinics located in North Carolina and Georgia. The intervention group was divided into 5 waves between June and August 2023 based on clinic locations. Prior to the activation of accounts, clinicians underwent a one-hour training session on DAX Copilot. Meanwhile, a comparison group comprising clinicians not utilizing DAX was recruited in five waves from locations and specialties similar to those of the intervention group. Two types of primary outcomes, electronic health record (EHR) metrics and financial metrics, were assessed after 180 days of intervention. EHR metrics include time in EHR (EHR8), work time outside of work (WOW8), time in documentation (Note8), completed appointment rate, same day closure rate, and note length. Financial metrics include gross revenue per visit and work relative value units (wRVU) per visit. Secondary outcome include provider satisfaction survey, provider interview, and patient satisfaction survey.

Eligibility criteria: Inclusion Criteria:

* clinicians specializing in family medicine, internal medicine, and general pediatrics (including physicians and advanced practice providers \[APPs\])
* (intervention group) showed interests in participating in Dragon Ambient eXperience (DAX) Copilot
* (control group) clinicians who opted out from Dragon Ambient eXperience (DAX) Copilot in vendor's baseline survey
* (control group) clinicians who worked in the same clinic/region as the intervention group

Exclusion Criteria:

* preceptors
* inactive DAX participants (i.e., had DAX license but never activate it)
* have the same first use and last use DAX date
* missing demographics

Primary outcomes:
measure: Total EHR time
timeFrame: Month 10
measure: Work outside of work
timeFrame: Month 10
measure: Time on encounter note documentation
timeFrame: Month 10
measure: Completed appointment rate
timeFrame: Month 10
measure: Same day closure rate
timeFrame: Month 10
measure: Note length
timeFrame: Month 10
measure: Gross revenue per visit
timeFrame: Month 10
measure: wRVU per visit
timeFrame: Month 10
Secondary outcomes:
measure: Provider satisfaction
timeFrame: Month 4
measure: Provider interview
timeFrame: Month 1
measure: Patient satisfaction
timeFrame: Month 6
Other outcomes:
Locations:
city: Macon
country: United States
facility: Atrium Health Navicent
state: Georgia
city: Rome
country: United States
facility: Atrium Health Floyd
state: Georgia
city: Charlotte
country: United States
facility: Atrium Health
state: North Carolina
city: Laurinburg
country: United States
facility: Scotland Health Care System
state: North Carolina
city: Winston-Salem
country: United States
facility: Atrium Health Wake Forest Baptist
state: North Carolina
Study officials:
affiliation: Wake Forest University Health Sciences
name: Tsai-Ling Liu, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Wake Forest University Health Sciences
name: Timothy C Hetherington, MS
role: PRINCIPAL_INVESTIGATOR
affiliation: Wake Forest University Health Sciences
name: Jeffrey A. Cleveland, MD, FAAP
role: STUDY_CHAIR
References: