Implementation Strategies for AI-Scribes

When implementing AI documentation tools, healthcare organizations must decide how deeply to integrate them into existing workflows. The answer isn't one-size-fits-all, and the approach you choose can affect both adoption success and long-term efficiency gains. In this article, we'll explore how to select the best option for your organization.

Introduction

AI documentation tools can be flexible when it comes to integrating with your current charting workflows. Some organizations want to lean in and completely overhaul their charting setup to get the most from AI capabilities, while others prefer to maintain consistency by using AI as an additional tool within their current note structure. The spectrum of implementation approaches ranges from minimal disruption to complete transformation, each with its own advantages and trade-offs.

Understanding these options upfront is important because the path you choose will influence everything from provider satisfaction to the efficiency improvements your organization experiences. It will also determine how well-positioned you are for future improvements as your team becomes more comfortable with AI-assisted documentation.

Why Implementation Strategy Matters

The structure of notes in your Electronic Health Record (EHR) varies across organizations, including different combinations of text fields, drop-down menus, toggles, and structured data entry points. Most healthcare organizations initially configured these systems without considering how they might later integrate AI companion tools. You need to consider this setup when trying to get the most from modern documentation assistance.

Consider this common scenario: your current note template might include five separate text fields for different aspects of a patient encounter—chief complaint, history of present illness, review of systems, physical examination, and assessment and plan. This segmented approach made sense when providers were manually typing each section, as it helped organize thoughts and ensure complete documentation. However, when working with an AI companion capable of intelligent formatting and organization, this same structure can slow down the documentation process by requiring 5 separate summaries to be generated and copied over.

By combining these separate fields into a single, thorough text area, AI can handle the formatting, organization, and structuring automatically. The provider can speak or type in a more natural, conversational flow, while the AI helps the final note meet all documentation requirements and follow proper medical formatting standards.

To choose the right approach, you need to understand each option's strengths, implementation effort, and your organization's willingness to change.

Implementation Options

Option 1: Maintain Current Note Structure

Implementation Effort: Low

Training Effort: Low

With this approach, you implement AI within your existing note templates and field structures without making any modifications to your current setup. The AI simply helps fill text-heavy fields that already exist within your documentation workflow, allowing you to engage with patients rather than typing notes.

Advantages:

• Minimal disruption to established workflows. Providers continue using the same note templates, field structures, and documentation patterns they've already mastered. This familiarity reduces the learning curve and potential resistance to adoption.

• Reduced administrative burden. No EHR template modifications, staff retraining, or updated policies and procedures are required.

• Fastest path to implementation. Without the need for template redesign, testing, and provider training on new structures, organizations can begin seeing benefits within days rather than weeks.

Challenges:

• Smallest efficiency gains. Existing note structures may force providers to work against AI's natural strengths, such as its ability to intelligently organize and format documentation streams.

• Interrupted workflow. The segmented field approach can interrupt the natural flow of AI-assisted documentation, requiring providers to copy and paste multiple separate summaries into their notes.

• Future optimization needs. As providers become comfortable with AI and begin requesting improvements, you may need to invest in a second round of change management to restructure notes.

Option 2: Strategic Note Optimization

Implementation Effort: Moderate

Training Effort: Moderate

This middle-ground approach involves making targeted modifications to existing note structures to better accommodate AI capabilities while avoiding a complete overhaul of documentation workflows. Changes might include consolidating related fields, moving toggles or drop-downs into text fields, or modifying the sequence of documentation elements. Some AI platforms offer white-glove onboarding services that help identify which specific optimizations make the most sense for your practice.

Advantages:

• Moderate but real efficiency improvements. By making strategic adjustments—such as combining the history of present illness and review of systems into a single field, or creating larger free-text areas for complex assessments—providers can take better advantage of AI organizational capabilities while maintaining familiar overall note structures.

• Balance between improvement and manageable change. Providers experience some workflow modifications but within a framework that remains recognizable. The learning curve is moderate, and most organizations find that provider adaptation occurs smoothly with appropriate training and support.

• Flexibility for different provider preferences. This approach allows some customization while maintaining core consistency.

Challenges:

• May not reach full efficiency potential. You might achieve good results but remain below the efficiency potential available through more thorough optimization.

• Requires careful planning. Determining which specific optimizations to pursue requires analysis of current workflows and a clear understanding of AI capabilities. This planning phase can be complex and may require input from providers, administrators, and technical staff.

• Possible need for future changes. Success with moderate changes might create appetite for further optimization, potentially leading to additional change management cycles.

Option 3: Complete Note Transformation

Implementation Effort: Moderate

Training Effort: High

If you choose this path, you'll redesign note structures to maximize AI capabilities. Rather than working within existing constraints, organizations design new templates specifically built for AI-assisted documentation. This involves creating large, flexible text fields that allow for natural conversation flow or establishing new documentation patterns that use AI's advanced organizational capabilities.

Advantages:

• Highest efficiency gains. Providers can work with AI in its most natural mode, speaking or typing in conversational flows while the AI handles complex formatting, organization, and standardization tasks automatically.

• Increased standardization across the organization. When note structures are designed specifically for AI assistance, they can enforce consistent documentation patterns while still allowing for provider personalization and clinical judgment. The result is improved note quality alongside efficiency gains.

• Best positioned for future AI capabilities. As AI tools continue evolving, organizations with optimized structures will be better positioned to take advantage of new features without requiring additional structural changes.

Challenges:

• Significant change management requirement. Providers must learn new documentation patterns and support staff must be prepared for an extended period of questions and troubleshooting.

• Highest organizational commitment needed. Leadership must be prepared to invest in training programs, extended support periods, and potentially temporary productivity decreases as providers adapt to new workflows.

• Longer implementation timeline. The transformation process takes more time upfront, though it pays off in long-term efficiency.

Choosing the Right Option for Your Organization

The best implementation approach depends on several key organizational factors. Here's what to consider:

Organizational Change Capacity

 Look at what your organization has been through recently. Teams that have recently undergone major EHR implementations, policy overhauls, or other significant changes may have limited appetite for additional disruption. On the other hand, organizations with strong change management capabilities and provider groups that want improvements may be well-positioned for more aggressive approaches.

Timeline Pressures

 If you're facing immediate needs to work faster or have specific deadline requirements, you may need to prioritize faster implementation over long-term gains. However, it's important to weigh short-term timeline benefits against the potential for needing to repeat implementation efforts later.

Provider Demographics and Preferences

 Consider the technology adoption patterns and change preferences of your provider group. Organizations with tech-savvy providers who actively request workflow improvements may be good candidates for complete transformation. Those with providers who prefer incremental changes may find better success with moderate optimization approaches.

Current Note Structure Assessment

 Check how well your current note structures align with AI-assisted documentation patterns. Organizations with already-flexible note templates may find that Option 2 provides significant benefits with moderate effort. Those with highly fragmented or rigid structures may need to choose between accepting limited gains (Option 1) or making major changes (Option 3).

Future Growth and Technology Plans

 Consider your organization's longer-term technology roadmap. Organizations planning additional AI implementations, EHR upgrades, or workflow improvement projects may want to coordinate AI documentation implementation with these broader initiatives.

Resource Availability

 Assess the availability of key resources, including change management support, training capabilities, technical development resources, and provider time for learning new workflows. More aggressive implementation approaches require more time and effort across multiple organizational functions.

Conclusion

Approach	Implementation Effort	Training Effort	Efficiency Gains	Key Considerations
Option 1: Maintain Current Structure	Low	Low	Low	Fastest implementation, minimal disruption, may need future optimization
Option 2: Strategic Optimization	Moderate	Moderate	Moderate	Balanced approach, good compromise between gains and change
Option 3: Complete Transformation	Moderate	High	High	Maximum benefits, requires strong organizational commitment

The decision doesn't have to be permanent. Many successful organizations begin with Option 1 or 2 and move toward bigger improvements as their experience grows and their willingness to change increases. However, this evolutionary approach should be planned carefully to avoid provider fatigue and repeated change management cycles.

The best implementation approach is one that matches your organization's specific circumstances while setting you up for long-term success with AI-assisted documentation. The key is making an informed decision based on a clear look at your organizational capabilities and commitment to supporting the chosen approach through successful adoption. With platforms like Kenzie that offer dedicated white-glove onboarding and ongoing partnership, you'll have expert guidance throughout your implementation journey, regardless of which approach you choose.