For Randa Perkins, MD, MBA, patient visits have improved in many ways since Dartmouth Health began offering ambient technology that acts as an AI-enabled scribe, recording patient consultations with their permission and creating AI-generated summaries for provider review and editing.
“I truly love focusing on the patient and their family in front of me. I feel like tools like this one allow me to center on the patient and what’s most important,” she says.
In addition to being Dartmouth Health’s Chief Health Information Officer (CHIO), Perkins is among a growing number of doctors at Dartmouth Hitchcock Medical Center (DHMC) and Dartmouth Hitchcock Clinics using ambient technology as an AI-enabled scribe to help capture key medical information from conversations during patient visits.
After the visit, providers at DH, including physicians and advanced practice providers (APP), use the technology to generate a summary that they review, edit, and then approve for documentation in the chart. This summary then becomes available for other providers and clinicians to see, and for you, the patient, to read on your electronic health record (EHR) via your patient portal.
“When I'm sitting with the patient, I’m spending less time feeling as if I have to write everything. It frees up my brain,” says Shoshana J. Hort, MD, who works in Internal Medicine at DHMC.
DHMC rheumatologist John N. Mecchella, DO, MPH, agrees. "I find it tremendously beneficial. My notes are more inclusive of this entire conversation, and instead of me trying to split my attention between the patient and capturing the conversation in some notes as we speak, I'm able to fully be there for my patient and ask important questions," he says.
Below are some of the benefits of ambient technology for you, the patient, according to Perkins, Hort, Mecchella, and others.
You get a comprehensive visit summary based on recorded, medically reviewed notes
Before the visit begins, your doctor asks for your permission to record your conversation. If you consent, ambient listening captures key medical information shared during the visit, such as symptoms, diagnoses, treatment plans, and follow-up instructions. The AI-enabled tool then generates a summary, which your provider reviews and edits for inclusion in the EHR that you and your doctor can access.
This process is a marked improvement on manual note-taking, according to doctors.
“The documentation process becomes secondary to patient communication and interaction, “ Perkins says, adding that knowing the visit is being recorded has changed how she practices, too.
“I have noticed that I share more of my thought process. I explain aloud what I’m doing, even narrating my physical exam. I might say, ‘I'm listening to your heart. I'm not hearing any murmurs or rubs.’ The patient then hears what I'm thinking, and by speaking aloud, I get it all in the notes. And these tools are also able to better capture not just my findings but also patient questions,” she says.
According to Mecchella, the ability to review and reflect on the notes after the visit brings added insight.
“I feel like looking back, I can even better understand what happened in the room and so, too, can the patient,” he says.
You get more focused attention and engagement from your provider
Patients notice the difference in how their providers engage.
“During our pilot program of implementing this technology, we surveyed over 300 patients, and everyone except for one person said they felt the quality of the visit was either the same or better. There was only one person who said that quality declined,“ says Mecchella. “Providers also felt like they were more present for the conversations with the patient.”
Studies back up the pilot findings. As reported in this independent study, patients whose provider used an ambient scribe had higher odds of reporting satisfaction with the perceived duration of time spent with the provider. Use of an ambient, AI-enabled scribe was also associated with improved patient-perceived attention from the provider.
Your provider won’t record without your full consent, and you can ask to stop it anytime
Your provider will always ask for your consent.
“As soon as I walk in the room, I say ‘Hi, I’m Dr. Perkins, I'm here as your provider today' and I confirm who I'm talking to, and then I say, ‘We're using a new technology that can listen to the visit and help us with documentation. We don't have to use it, but do you mind if I use it today?'” Perkins reports.
“Most patients say yes, but if a patient says no, there is no bias whatsoever against that patient, and we proceed with clinical care without recording. It does not inhibit clinical care to any degree. Once, when one of my patients asked if I could stop it, I said, yes of course and I stopped it immediately when she asked, so that she could tell me something very private. Afterward, she asked to restart. It felt very fluid to me,” says Perkins.
Mecchella comments, “Some people don't trust AI, and that is fine. This is not a required tool. You can always decline.”
Your information is kept private and secure
The technology is HIPAA-compliant and integrates with your EHR.
“It's a very secure process, “ says Perkins. “We have a very high security standard, which we require when processing any protected health information.”
Hort details how that secure process works for her and her patients. “We record on the mobile electronic health record app. If they consent, I put my phone right between us and explain they're not getting recorded on my phone but through the app. I also tell them that I review every note and make sure it's correct before I sign off," she shares.
For added assurance, shortly after the AI-scribed summary is uploaded to the patient portal, the recording itself is deleted, which ensures added privacy, says Mecchella.
Your doctor isn’t bogged down by administrative work and so has more time to think
“The biggest thing that we've seen and that has been reported widely in the literature is this concept of decreased cognitive burden,” says Mecchella.
“Anecdotally and also in the literature, this technology doesn't necessarily decrease the amount of time a provider spends in the record, but there's this tremendous burden that's lifted from the provider. Before, I might have seen 10 patients, gone back to my office, and had to try to remember everything that everybody said. Now I can pull up the summary and have that draft of my note," he says. "We've heard many times over, providers say I've never finished my notes before I've left for the day, and now they're all set.”
“A lot of what physicians do is cognitive work,” adds Perkins. “It really just frees up my brain space and my time to think about what’s most important for the patient,” she says.
Your care is more efficient
“We get the notes done faster, it doesn't take as long to get the records complete, and the patient can see their documentation of their encounter on the portal faster," says Perkins. "There's not a prolonged delay, and you get better continuity of care because the providers who see the patient after me also see those notes in a timely way. It’s faster to get to billing and coding, too.”
While current providers using the ambient technology are mostly in primary care, pediatrics, and dermatology, adoption is growing quickly.
“We have one thousand recording providers. Since the end of August of 2025, we've generated over 500,000 notes using this tool, mainly in the ambulatory space,” says Mecchella.
And you can expect use of the tool to start to extend to other areas, say Mecchella and Perkins.
Human factors are even more important in your care and are driving the use of supporting technology
Dartmouth Health is by no means unique in its use of A.I. technologies that audio-record clinical encounters and create notes for patient charts. More than a quarter of U.S. medical practices now use AI scribes, according to a recent STAT article.
“The benefits are making themselves apparent,” concludes Perkins. “And as A.I. applications grow, we will continue to make sure that provider decisions are never replaced by AI tools. And when we do use AI tools, including ambient listening, we will use those tools to facilitate workflows so that we can better focus on the patient in front of us. To that end, ambient listening supports a new way to practice medicine, keeping the human relationship at its core.”
