Ambient scribes and inbox drafts: what the evidence shows

Ambient scribes listen to the visit and draft the note. Columbia Nursing, summarizing its researchers' commentary, said scribes are often classified as administrative tools rather than medical devices, allowing them to bypass FDA regulation. A Swedish health technology assessment found four randomized trials, all in the U.S., with 23 to 238 physicians each, and no data on total documentation time including editing, or on accuracy. Kaiser Permanente researchers estimated that scribes saved nearly 16,000 hours of documentation time over more than 2.5 million uses. In a MedStar Health simulation, 31 of 44 draft notes contained errors.

Inbox tools draft replies to messages from patients, which rose to 157% of the prepandemic average for U.S. ambulatory clinicians during the pandemic. Of 23 studies in a 2025 systematic review of AI-drafted replies, 16 were simulations; all seven in live use tested GPT-4 tools built into Epic. In a Mass General Brigham simulation, 7.1% of GPT-4 drafts could pose a risk to the patient if sent unedited, and 0.6% a risk of death.