Documentation burden & workload

Lee Taylor-Vaughan, Morrison W Helena +4

Can an EHR interface mirroring the physical ICU room layout speed documentation and lower cognitive load? In a randomized two-period crossover simulation, 36 ICU nurses completed two standardized documentation scenarios using a Spatial Awareness Integrated EHR prototype versus a traditional linear flowsheet interface, analyzed with linear mixed-effects models. The spatial prototype cut documentation time by 177 seconds per task (27% faster; d = 0.88), reduced NASA-TLX workload 51.3% (18.44 vs. 37.82), and improved accuracy 6.3% (98.70% vs. 92.86%). Behavioral intention to adopt rose 25.5%, but System Usability Scale (77.99 vs. 71.60) and perceived usefulness differences were not significant.

Andrew J Henreid, Kimon L H Ioannides +5

How do emergency physicians actually allocate shift time, and how much of it goes to the computer? This cross-sectional observational time-motion study in a high-volume urban ED used the validated TimeCaT application to track 20 physicians across one 8- to 9-hour shift each, totaling more than 150 hours of real-time observation, supplemented by EHR event logs for after-shift work. Physicians spent a median 34.1% of shift minutes on the computer (156.5 min) versus 26.9% with patients (115.2 min), plus 15.9% on verbal communication with staff. EHR logs showed an additional median 1.3 hours of post-shift computer use, or 29.8 combined computer minutes per scheduled hour. Visualizations showed frequent task switching and variable fragmentation.

Sin Hung Timothy Yu, Julie Li +4

What shapes adoption of digital scribes, and what do they change for patients, clinicians, and organisations? This PRISMA-ScR scoping review searched MEDLINE, CINAHL, Web of Science, SCOPUS, and EMBASE for original studies or case reports evaluating digital scribe implementation in real-world care, mapping themes to the updated Consolidated Framework for Implementation Research and its Outcomes Addendum. Of 4772 studies screened, 29 were included. Scribes were generally acceptable (n=11) and usable (n=8), though nine reported accuracy concerns; reported impacts included reduced documentation burden (n=18), improved clinician wellbeing (n=12), and better patient-clinician interaction (n=10). Only three examined cost or productivity. The abstract reports no pooled effect sizes.

Jose María Alcázar-Peral, Juan Antonio Álvaro-de la Parra +7

Can an ambient AI scribe scale across emergency departments without degrading documentation or patient experience? This 12-month multicenter retrospective observational study covered five emergency specialties at 48 Spanish hospitals (February 2025–January 2026), including all level 4 and 5 consultations among roughly 2.27 million ED visits. The scribe was used in 1,032,558 consultations (45.3%), with monthly adoption rising from 7.7% to 57.8% and 2,097 physicians using it at least once. Scribe-assisted consultations were shorter (mean relative time savings 21.8%, p<0.001), transcription accuracy averaged 93.9%, and audited report quality and patient Net Promoter Scores were higher; the abstract reports no effect sizes for the quality and experience comparisons.