![]() One recent editorial by the American College of Medical Scribe Specialties estimated “industry ranks to swell to 100,000 by 2020.” 8Ī review of existing literature reflects this trend. 9 Scribes have been employed in emergency departments since the late twentieth century 7 and their use has grown steadily since. Duties include real-time transcribing of physician notes, organization of objective healthcare data, point-of-service collections, and patient tracking. 6, 7, 8Ī medical scribe is a non-clinical ancillary staff member who assists a licensed-independent provider. 2, 3, 4, 5 A number of solutions to this largely uncompensated effort have been proposed, ranging from improving the usability of the EHR to medical scribes. Outside of office hours, physicians spend another 1 to 2 h of personal time daily performing additional computer and clerical work. 1 For every hour that physicians provide direct clinical face time to patients, two additional hours are spent on EHR and desk work within the clinic day. This dynamic has a measurable negative effect on patient centeredness and physician work-life balance. With increasing use of the medical record as an instrument for billing, and particularly with advent of the electronic health record (EHR), the medical note may seem as important as the actual patient care. In this test of a modified practice model, scribes supported greater patient throughput and improved provider perceptions of documentation burden with no decrement in high patient satisfaction.ĭocumentation, once a small part of the patient encounter, has grown to become a major driver of physician time. 1.91 p interaction < 0.001) and generated more wRVUs per hour (3.42 vs. Compared with the control providers, providers with scribes completed more visits per hour (2.29 vs. Average patient experience scores did not differ between the experimental and control groups (4.73 vs. A total of 6202 visits occurred during the study period. Providers with scribes were more likely to agree that work for the encounter would be completed during the visit then controls (3.58 vs. 3.40 respectively p time-by-group interaction = 0.26). Average provider experience scores did not differ between providers working with scribes and control providers working without (4.01 vs. Participating providers worked a total of 664 clinic sessions and returned 547 (82%) surveys. Provider experience and patient experience using 5-point Likert scale surveys from the AMA Steps Forward Team Documentation Module, and visits and wRVUs per hour during 4 weeks before and 12 weeks after initiation of a practice model that included use of scribes and a shortened visit template. Participantsįour attending physicians who worked with scribes, 9 control physicians who did not, and their patients in a large, hospital-affiliated academic general internal medicine practice. Quasi-experimental difference-in-differences longitudinal design. ![]() To measure the effect of medical scribes on patient satisfaction, provider satisfaction, and provider productivity. However, their acceptability to patients and effects on provider experience have not been tested in a real-world model of effectiveness. ![]() Medical scribes have been proposed as a solution to the problems of excessive documentation, work-life balance, and burnout facing general internists. ![]()
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