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    Scribes slash EMR burden

    Provider satisfaction ‘off the charts,’ says one urologist

    Urologists who view electronic medical record documentation as a burden are turning to scribes. Scribes, many say, relieve them of that burden, freeing urologists and other providers to focus on patient care.

    Also see: Redefining the culture of NP-physician collaboration

    But scribes cost money—money that’s on top of what urology practices have already spent on EMRs.

    Urologists tend to view working with scribes in a mostly positive light, while noting a few negative aspects. Some have developed best practices on working with scribes and shared them with Urology Times.

    First, a look at the data on scribes

    Studies examining the use of scribes in medical practice have been, for the most part, positive.

    A PubMed search yielded one study of scribe use in urology. EMR scribes increase urologist satisfaction and don’t lessen urology practice patient satisfaction, according to the study, published in the Journal of Urology (2010; 184:258-62).

    The study’s authors assigned EMR scribes to five academic urologists, then surveyed patients and physicians to determine acceptance and satisfaction. They found that patients had slightly higher satisfaction rates when scribes were present, at 93% versus 87%. But it was the physicians who were most dramatically impacted. Nearly 70% of urologists surveyed were satisfied with office hours when they had a scribe, versus almost 20% of those who were without a scribe.

    A more recent urology-focused article, published in Urology Practice (2015; 2:101–5), found that medical scribes in an academic setting could increase patient flow and reduce the burden on providers by reducing computer charting. The model described in the study “is only financially prudent if the increased expenses are offset by additional revenue from increased patient visits,” the authors wrote.

    Another study, published in ClinicoEconomics and Outcomes Research (2015; 7:489-95), looked at scribes’ yearly impact on physician productivity and revenue in a cardiology clinic. It found physician productivity was about 10% higher among those who used scribes. The use of scribes generated an additional annual revenue of $1,372,694 at a cost of $98,588, according to the authors.

    The Journal of the American Board of Family Medicine published a review in 2015 on medical scribe use, identifying five studies, including the 2010 urology study. The authors found that although the number of studies was small, the research collectively suggests medical scribes improve “clinician satisfaction, productivity, time-related efficiencies, revenue, and patient-clinician interactions.” But more studies are needed, they concluded.

    Next: On the frontlines of care

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...

    3 Comments

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    • brian@------.com
      Dear Anonymous, Great questions! When I first started using a scribe, our front desk handed all of my patients a written explaination detailing the scribe's role on our healthcare team. Patients were always given the option of seeing me without a scribe in the room. I almost always have my scribe step out of the room for the patient exam, unless I need a chaperone and no one else is available. I can count on one hand the number of patients in the past year who have asked to see me without a scribe in the room. We also try hard to be very sensitive to the nature of the patient's visit. Not uncommonly, my scribe will volunteer to step out of the room in an effort to make the patient feel more comfortable - particularly during discussions about sexuality and sexual dysfunction. Patients seem to really like the eye contact and focused attention that having a scribe affords me. I believe that since I started using a scribe my documentation is better and my orders and coding are more accurate. Plus, she is just super nice and really fun to work with! Again, thank you for your question. I'd be happy to try to answer any additional questions you might have about how we use a medical scribe in our office. - Brian Stork
    • Anonymous
      Scribes are all well & good for the practice. My question is did the doctor ask the patient if it was okay with them that someone else is in the room? Many don't ask the patient. Does the scribe leave the room before any exam is performed? I know in some practices they don't. I look forward to hearing from you. Regards, Raffie
    • Anonymous
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