Electronic health record (EHR) adoption has brought new triumphs and new challenges. Coping with these challenges has caused many changes, few more interesting than the rise of the EHR scribe. While there are a seemingly unlimited number of EHR vendors in the marketplace, it’s no secret that not all of these programs have the clinical efficiency providers require. Because of this, many physicians end up looking for a new solution. For some, switching EHRs still isn’t enough because of their unique workflow needs. As a result, EHR scribes have popped up as a strategy to allow providers to structure their workflow the way they want while maximizing the benefits of the EHR.
According to Dr. Kathleen Myers, CMO and founder of Essia Health, a scribe training/staffing firm, scribes are typically aspiring nurses, nurse practitioners, or physicians. In a patient encounter, a scribe will input all of the physician’s comments and orders into the EHR, as the doctor dictates. Sometimes called “at-the-elbow” support, a scribe follows the doctor from encounter to encounter, to the point of occasionally needing to be told by physicians like Myers, “I’m going to the bathroom, you don’t have to follow me here.”
According to Dr. Myers, Essia’s scribes are vetted for academics, typing skill, and medical passion before being admitted into the training program. Independent study of medical jargon, how to create encounter notes, and how to create differential diagnoses is followed with 20 hours of classroom training, where they practice charting in the EHR. Following independent study and classroom time, the new scribes progress to an actual encounter. They’re paired with existing scribes and trainers for an additional 80 hours of observation and instruction before becoming a full-fledged scribe themselves.
Scribe Impact on Clinical Efficiency
While scribing might not seem efficient at first glance, according to Dr. Myers and several studies, scribing can actually help some practices. According to a study published in the Journal of ClinicoEconomics and Outcomes Research, physicians who used scribes saw an increase of 1.3 patients per hour, and 2 work relative value units (wRVU) per day. There was even a rise in levels of patient and provider satisfaction of 6 and 50 percent, respectively. Perhaps the most (or least) surprising benefit is the rise in patient satisfaction. Having an additional person involved in every patient encounter might seem awkward, but if the physician is spending more time interacting with the patient instead of a screen, it’s not surprising that patients felt better engaged.
Future of Scribing
As data from the Centers for Medicare and Medicaid Services (CMS) shows, nearly half a million providers have begun to use EHR programs since the Meaningful Use incentive program began, and the number continues to rise. A brief Google search turns up hundreds of companies moving into the medical scribe training and placement business to meet an increasing demand. For providers who can’t seem to find the right workflow efficiency with an EHR, this can be a good solution, but there is a cost. According to Myers, most Scribes make $10-$15 per hour. So, consider carefully if hiring a scribe is the best option. Then, look for someone with experience using your EHR to minimize training and onboarding time.
So you may want to balance the option of a scribe against the time and cost of additional personalized training for providers who are struggling to adapt to an EHR.
About the Author
Charles Settles is a content writer at TechnologyAdvice. He frequently covers topics related to Health IT, business intelligence, and other emerging trends.