{"stable_id":"868ad97f92d5e208","slug":"ucla-ambient-scribe-rct","company":"UCLA Health","workflow_name":"Randomized deployment of DAX and Nabla ambient AI scribes","function_code":"healthcare_screening","pattern_codes":["creator_to_judge"],"changed_assumption":"Ambient tools can draft notes in practice, but vendor-specific efficiency and error results require comparison.","evidence_strength":"verified","publication_tier":"showcase","freshness":"current","reviewed_at":"2026-08-23","updated_at":"2026-08-22","source_quality_summary":"1 peer reviewed; publication outcomes are verified.","caveat_summary":"DAX did not significantly improve time versus control. Requires continuing physician vigilance; product performance was not uniform.","freshness_caveat":null,"workflow_summary":{"before":[{"actor":"Outpatient physician","action":"Conducts the visit and writes the note in the EHR.","actor_type":"human"},{"actor":"Physician","action":"Completes and reviews documentation.","actor_type":"human"}],"hinge":"Ambient tools can draft notes in practice, but vendor-specific efficiency and error results require comparison.","after":[{"actor":"Ambient AI scribe","action":"Records the conversation and generates a draft note.","actor_type":"ai"},{"actor":"Physician","action":"Reviews, corrects, and signs the draft.","actor_type":"human"}],"decision_mode":"shared","decision_marker":"Human moves from creator to judge"},"before":[{"order":1,"actor":"Outpatient physician","action":"Conducts the visit and writes the note in the EHR.","handoff_to":"Clinical record","control":"Physician signature."},{"order":2,"actor":"Physician","action":"Completes and reviews documentation.","handoff_to":"Care team","control":"Clinical accountability."}],"after":[{"order":1,"actor":"Ambient AI scribe","action":"Records the conversation and generates a draft note.","handoff_to":"Physician","control":"Two-month randomized clinical deployment."},{"order":2,"actor":"Physician","action":"Reviews, corrects, and signs the draft.","handoff_to":"Clinical record","control":"Physician vigilance for clinically significant inaccuracies."}],"decision_rights":"Physicians decide whether any generated content enters the record.","exception_path":"Inaccurate output is corrected or discarded and documented manually; adverse events follow clinical safety reporting.","removed_work":["Some initial note composition"],"outcomes":[{"metric":"Time writing each note","baseline":"Control arm fell from 4:22 to 4:04 per note.","result":"Nabla arm fell from 4:30 to 3:49; a 9.5% greater reduction than control.","period":"November 4, 2024-January 3, 2025.","scale":"238 physicians, 14 specialties, about 72,000 encounters.","attribution_caveat":"DAX did not significantly improve time versus control.","evidence_label":"verified"},{"metric":"Safety and accuracy","baseline":"Usual physician-authored documentation.","result":"One mild adverse event; clinically significant inaccuracies were reported occasionally for both products.","period":"Two-month randomized trial.","scale":"Two scribe products across 238 physicians.","attribution_caveat":"Requires continuing physician vigilance; product performance was not uniform.","evidence_label":"verified"}],"executive_lesson":"Treat ambient scribes as distinct products with measurable differences, not as one uniform category.","anti_pattern":"Scaling a category-wide claim when one tested product did not beat control.","questions_for_leaders":["Which product-specific metric matters?","How are inaccuracies sampled?","Do savings persist at scale?"],"collections":["human-still-decides","regulated-autonomy","negative-results"],"bundle_version":"1.0.0","bundle_fingerprint":"sha256:c23c6cc2b88153d008ea8fda928f632ce0011fc2d4c5036672a16e5d895bab93","canonical_url":"https://brianletort.ai/transformations/ucla-ambient-scribe-rct"}