The use of automated note-taking tools during patient visits holds promise in reducing physicans’ administrative load–but the tradeoffs are complicated.
In 2024, Mass General Brigham, the largest health system in Massachusetts, piloted an AI-powered ambient note-taking program among a subset of clinicians to address increasing rates of staff burnout and turnover–largely driven by the administrative burden of clinical documentation in the electronic health records (EHR). The pilot program aimed to test AI tools which used natural language processing to record, transcribe, and summarize physician-patient encounters, reducing time spent on documentation and allowing physicians to focus more on patient care. Early results showed promising reductions in clinician burnout, intention to leave, and increased physician efficiency. But concerns about the technology, including the generation of inaccurate notes with errors or hallucinations, made physicians resistant to learn and adopt it into their workflows.
Harvard Business School Associate Professor Susanna Gallani and host Brian Kenny discuss the challenges leadership at the health care organization anticipated as they considered scaling the AI technology responsibly in the case: The AI Scribe: Enhancing Physician Presence and Curbing Burnout at Mass General Brigham.
BRIAN KENNY: Welcome to Cold Call, the podcast where we dive deep into the groundbreaking ideas in Harvard Business School case studies with the faculty who wrote them. In healthcare, some of the most important innovations aren’t new drugs or breakthrough devices. They’re new ways of giving clinicians back the one resource they can never make more of, time. As artificial intelligence rapidly finds its way into hospitals and medical practices, leaders face a difficult balancing act. Can technology reduce administrative burdens without creating new risks? Will it strengthen the relationship between physicians and patients or subtly change it? And how should organizations measure success when the benefits extend beyond efficiency to include trust, wellbeing and the quality of care?
Today’s case explores a real-world effort to answer those questions inside one of the nation’s leading academic health systems. We’ll examine the organizational challenges that accompany technological change and the difficult trade-offs involved in evaluating investments whose returns are both financial and deeply human. My guest today is Professor Susanna Gallani, and we’ll discuss her case, “The AI Scribe: Enhancing Physician Presence and Curbing Burnout at Mass General Brigham.”
I’m your host, Brian Kenny, and you’re listening to Cold Call on the HBR Podcast Network.
Susanna Gallani studies performance management systems and explores the interplay between monetary and non-monetary incentives, and you probably study much more than that too, Susanna. Welcome back to Cold Call.
SUSANNA GALLANI: Thank you. Thank you for having me. It’s good to be back.
BRIAN KENNY: Yeah, it’s been a little while, so we’re happy to have you back on the show, and we were just chatting before we rolled tape here, and every conversation these days seems to turn to AI. It’s just top of mind for everybody, to the point maybe of AI fatigue, but there are some real-world implications for the case that you wrote and for how Mass General is trying to use AI to help physicians. So, thanks for writing it. Thanks for being here to talk about it.
BRIAN KENNY: Maybe we just get started by asking you, how did you hear about this? Why did you think this would be an interesting case to write?
SUSANNA GALLANI: So there’s a combination of things that are happening in this space. First of all, the case is written with Rob Huckman and Suraj Srinivasan and also an external co-author, Asaf Bitton, who is at Ariadne Labs, and of course the conversation about AI in healthcare is everywhere. Everybody talks about AI in healthcare and what we can do or cannot do with that, and we were looking for our course, “Transforming Healthcare Delivery,” which is a second-year course here in the MBA program. We were looking to introduce more of this AI content in our course, because as you can imagine, the evolution of AI in healthcare is a big transformational drive, and we still don’t know exactly what it’s going to do, but we want to be up with it as it evolves, and so Rob had heard about this implementation, and I had known about that system. MGB, which is the organization that we study in the case, is not the only one that is implementing this technique and this technology. It’s pretty much everywhere right now, but MGB was doing it at a large scale, and of course, it’s a leading academic medical center. So it was interesting for us from a number of perspectives, because it layers up, in addition to the delivery of healthcare, there’s also the training and the research part, and so all of these aspects kind of converge into the problems that we address in the case.
BRIAN KENNY: MGB being Mass General Brigham, just for our listeners who aren’t from the Boston area, it’s an enormous enterprise. I don’t know how many physicians they have on there.
BRIAN KENNY: Okay. So just enormous. So this is an effort to scale something up in a very significant way, and I think oftentimes, when we think about AI in healthcare, we’re thinking about how it could accelerate cures or treatments of some kind. This, I found to be very interesting, because it was really about how they’re doing their work and how they can do their work more efficiently. Can you talk maybe a little bit about some of the challenges that clinicians face?
SUSANNA GALLANI: Yes. So in a way, I have heard this described as the first innovation in healthcare that is improving care without asking the physicians to do more, and I want to extend this. This is not just physicians, it’s clinicians in general, because there’s nurses and there’s advanced practice providers as well. So this is not just a solution for physicians, narrowly defined, but this is the first time that we’re trying to do more and better in healthcare while taking work off the physician’s plate, the clinician’s plate, which is important, because we know we have a burnout problem. We have a wellbeing problem in healthcare. We have a turnover problem.
If you listen to the first Friday of the month job report, healthcare jobs are always at the top of the list in terms of job creation, because there’s so much churn, and in addition, the needs for healthcare are increasing. Populations are aging. During COVID, we’re still experiencing the tail end of the COVID effect where people didn’t take as good care of themselves as they should have or they would have in other times. So there’s a lot of demand of physician’s time.