Having a medical scribe is a ever growing, popular way to help clinicians work harder and smarter without getting burnt out.
A recent AmericanEHR study showed that 40% of physicians would not recommend their EHR to a colleague, and that dissatisfaction is growing over time. This study also showed that on average providers lost 78 minutes per day or a total of 6.5 hours per week. That’s almost a full day every week needed to deal with electronic charting.
In a separate study Medscape published that two of the top three reasons for physician burn out were ‘Increasing computerization of practice’, and ‘Spending too many hours at work’.
Come to find out, having a medical scribe tag along can significantly help providers and the practice they work in.
Let's take the time to learn a bit about medical scribes. Below you'll learn what they are, what they do, as well as advantages and drawbacks. Should you hire a scribe to work at your practice with your provider(s)? Are alternatives available that provide all the advantages and minimize the minuses?
What's a medical scribe?
So, just in case you're reading this and not too familiar with what a medical scribe is and the role they fill in a practice, see below. If you are familiar, go head and skip down to the next section.
A medical scribe is a licensed or unlicensed individual that is used to enter information into the electronic health record (EHR) or chart at the direction of a physician or licensed independent practitioner. A good scribe is accurate, detailed and efficient. They should not be making independent decisions or translating what they are experiencing within encounters they are present for.
Typically a practice either hires a scribe as a new employee, converts a current employee to a scribe or hires a company to place a scribe onsite.
Popular Scribe Duties
Chart preparation (locating information for review via previous notes/reports/labs)
Researching information requested by the provider
Helping their provider navigate the EHR
Recording encounters into the EHR
Ultimately the role of a scribe is determined by the practice type and setting. Since practices differ so widely in specialty and workflow, a scribes role is rarely the same from one practice to another. Often onsite scribes are given "other duties as assigned" around the office to help with the burden of employment, but this often result in a decrease in the quality of the information captured in the EHR.
What makes someone qualified to be a scribe?
Scribes have been around since ancient times, but the increased use of medical scribes is a newer phenomenon caused by the boom of EHR usage in the last decade. There aren't any official regulations forcing specific qualifications be met before someone can be a scribe. But there are some pretty good guidelines one can follow when hiring a medical scribe or company that provides medical scribes as a service. Here is a good competency list provided by The Joint Commission:
Competency: At a minimum, all persons performing documentation assistance have the education or training on the following:
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Principles of billing, coding, and reimbursement
Electronic medical record (EMR) navigation and functionality, as appropriate based on job description
Computerized order entry, clinical decision support and reminders, and proper methods for pending orders for authentication and submission
Benefits and Drawbacks
The biggest benefits found to be gained from using medical scribes is improved productivity. KarenZupko & Associates, a practice consulting firm states that practices using high quality scribes or scribe services are finding that scribes enable them to get back to the same level of productivity they experienced pre-EHR. In a report from 2013 ClinicoEconomics and Outcomes Research reported that four cardiologists in an outpatient clinic over 65 clinical hours, found that they were able to see 81 additional patients when using scribes.
Additionally, scribes are known to a fantastic way to improve the quality of patient encounters. Dr. David Strumpf is quoted by the ModernMedicine Network as saying "It's a challenge to be both data entry person and clinician, and it's very distracting to the process [of patient care.]" A great scribe has the ability to allow the provider to get back to focus in their attention solely on the patient, because the know their scribe will capture all the needed information from the encounter just they way he/she [the provider] likes it.
Finally, with the proper training a scribe can be trained to handle certain aspects of billing and coding, depending on the specific practice. With time and familiarity, a scribe can help a practice drastically improve their reimbursement timeline and percentage.
Typically, drawbacks are directly correlate with drawbacks of hiring a new employee. Time and resources are needed to bring a new person from the "outside" into your organization, especially if this is a totally new role for the practice. In this case not only does the scribe require training, but the existing staff will too. Workflows will need adjusting and it is of course important to make sure the clinician and scribe mesh well. In most cases it typically takes 2-3 months for a scribe to become fully familiar with a practice. The more complex and varied a patient population, the longer this may take.
In addition, of course there is the cost to hire a scribe. The market generally demands anywhere from $13-18 per hour, depending on location and the individual's prior experience. Not included in this number are other costs of employment that typically fall into the "benefits" category. After all is said and done a practice should expect an expense of somewhere between $20 and $25 per hour for a full time medical scribe. That can be a big pill to swallow.
There are alternatives to hiring a new employee as a scribe, turning a current employee into a scribe, or hiring a company that places a scribe at your practice. One such alternative is to have your clinician(s) work with a remote scribe. A quality remote scribe service provider should give providers a highly experienced professional scribe at a cost that is significantly lower that employing a medical scribe or hiring a service that places medical scribes onsite.
The major difference in delivering what a medical scribe provides is that a remote medical scribe meets with their provider via a secure web meeting platform and listens in through the day's encounters, while in real time entering in all of the notes into the EHR.
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