AI Scribes Cut Notes, Not ER Wait Times

A Tuesday evening in the Brigham ED

The Brigham and Women's Hospital emergency department has 61 acute care rooms. On one evening in early September, there were 59 patients in beds and 152 people total, once you counted the waiting room. "You can't see 152 patients in 61 rooms," emergency physician Christopher Baugh told the Boston Globe. He was using an ambient AI scribe that evening, the same category of tool now standard in hundreds of US health systems: it listens to the visit and drafts the note so the doctor doesn't have to type it.

The scribe did its job. The math still didn't work.

What the study actually found

A study out of Mass General Brigham, published in Annals of Emergency Medicine and covered by STAT News and the Boston Globe on September 9, tested what ambient AI scribes change in a real ER. The result: AI scribes saved physicians about 1.6 minutes per note. Human scribes, working the old-fashioned way, saved roughly double that, about 3.2 minutes per note.

Neither moved the numbers that matter to a department drowning in patients. Neither increased how many patients a clinician could see in a shift. Neither increased how much the hospital collected per patient. The minutes were real. They just didn't go anywhere useful.

One of the researchers put it plainly: those few minutes "are unfortunately being erased by all of the other roadblocks and bottlenecks of the system."

That is the whole story in one sentence, and it is worth sitting with.

The note was never the bottleneck

Ambient scribes got popular for a good reason: typing is miserable, and doctors have said so for years. But typing a note faster doesn't create a bed. It doesn't get radiology to read a scan sooner. It doesn't summon a specialist, free up a nurse, or make a discharge paperwork process move quicker. A shift in the ER is a chain of handoffs, waits, and decisions, and the note is one link near the end of it, not the link holding the chain together.

So a tool that only touches the note can save real minutes and still leave the shift exactly as brutal as it was before. That's not a knock on ambient scribes specifically. It's a structural fact about point tools in general: they optimize the piece they can see, and the piece they can see is rarely the piece that's actually slowing the ward down.

This is the same gap we built Medows around. A doctor's shift isn't a documentation problem wearing a workflow costume. It's orders, results, handover, escalation, and the note, all pulling on the same twelve hours, and they don't get faster just because one of them got faster. A workspace has to touch the whole chain, or it's just moving the bottleneck two feet to the left.

What hospitals should actually measure

The uncomfortable part for scribe vendors: "minutes saved per note" has become the default sales metric, and this study is a pretty direct argument that it's the wrong one. If a hospital wants to know whether an AI tool is worth the contract, the question isn't how much documentation time it shaves off. It's whether patients move through the department faster, whether the hospital collects more per encounter, whether clinicians can actually see more people in the same shift.

By that bar, this round of ambient scribes, on their own, didn't clear it. That doesn't mean the technology is useless. It means the technology was pointed at the wrong layer of the problem, and the industry has been grading it on the wrong exam.

The doctors in that Brigham ED still have 152 people to see in 61 rooms tomorrow night. A faster note doesn't change that number. Something that touches the whole shift might.

Sources

• Can AI fix health care? In the chaos of emergency rooms, the technology comes up short (STAT News, September 9, 2026)
• Can AI fix health care? In the chaos of emergency rooms, the technology comes up short (The Boston Globe, September 9, 2026)
• Medical Scribe and Ambient Artificial Intelligence Impact on Emergency Physician Documentation Burden and Clinical Productivity (Annals of Emergency Medicine)