What Can a Scribe Do for You?
Evidence suggests that documentation support provided by scribes can help relieve physician burnout and increase practice productivity.
Fam Pract Manag. 2020 Nov-Dec;27(6):17-22.
Author disclosures: no relevant financial affiliations disclosed.
Although electronic health records (EHRs) were originally hailed as a means to improve clinical productivity, quality of care, and patient outcomes, the widespread use of EHRs has had the unintended effect of dramatically increasing the administrative burden on physicians. In fact, primary care physicians spend about half of their workdays on the computer during and after clinics.1 According to some estimates, every hour of direct patient care requires two hours of EHR work, and many physicians spend one to two hours a night on charting.1,2 Additionally, physician burnout rates in family medicine are well above 50%, and many physicians indicate that complicated EHR systems are a strong contributor to burnout.1,3
For physicians who are frustrated by cumbersome EHR systems and increasing documentation requirements, documentation support is one possible solution. Models of documentation support include the following:
Speech recognition software, which converts spoken notes to digital text saved in the EHR system. Emerging technology includes software that “listens” to the physician-patient interaction in the exam room and adds notes to the EHR automatically.
Scribes, which the Joint Commission defines as an unlicensed, certified, or licensed individual who enters information into the EHR or chart at the direction of a physician or licensed independent practitioner.4 Scribe services may be virtual — the documenter is not physically present for the physician-patient interaction and documentation is completed either in real time or after the visit — or in person. In-person scribe services typically are provided by care team members such as medical assistants (MA), advanced practice providers (APP), technicians, or medical scribes provided by an outsourced vendor.
This article reviews some of the available evidence on the effectiveness of in-person scribes and presents the outcomes of two different scribing models. While our focus in this discussion is primarily on in-person scribing services, we also provide a brief review of virtual services, given the impact of the COVID-19 pandemic on the clinic environment.
Complicated EHR systems and time spent in front of the computer contribute to physician burnout. Scribes can help relieve the administrative burden.
The two primary implementation models for integrating scribes into a practice are in-house development and utilization of an outsourced vendor.
Both models of implementation for in-person scribes result in increased patient volume and physician and provider satisfaction.
SUMMARY OF EVIDENCE ON THE BENEFITS OF SCRIBES
The literature on scribes shows improvement in some metrics and no change in
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10. Odenheimer S, Goyal D, Jones VG, Rosenblum R, Ho L, Chan AS. Patient acceptance of remote scribing powered by Google Glass in outpatient dermatology: cross-sectional study. J Med Internet Res. 2018;20(6):e10762.
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