Scribes slash EMR burden
Provider satisfaction ‘off the charts,’ says one urologist
On the frontlines of care
Brian Stork, MD, a urologist practicing at West Shore Urology in Muskegon, MI, said he found it was becoming increasingly stressful to listen to and maintain eye contact with his patients while simultaneously entering their information into the EMR.
“I thought there had to be a way I could practice better, and serve my patients and the community in a way that would be quite frankly more fun than sitting at a keyboard, talking to the patient and typing,” he said.
Dr. Stork told Urology Times that he solved that problem more than a year ago by hiring a scribe.
“Nursel, our certified medical scribe, and I walk into the exam room together. She sits at the computer monitor and basically transcribes to the best of her ability, while I’m talking to the patient. I don’t touch the computer at all when I’m in the room,” Dr. Stork said. “I feel like I can actually really listen to a patient without having to worry about what box I’m going to click to make the office visit billable.”
In addition to doing the documentation, Dr. Stork said his scribe, who has a background in accounting, is another set of eyes looking at billing, to make sure it’s correct.
“Because of her accounting background, when I am out of the office or in surgery, she helps us in the business office,” Dr. Stork said.
Barry A. Kogan, MD, chief of urology at Albany Medical Center in Albany, NY, is glad to have the help of a scribe.
Dr. Kogan, who was among the authors of the 2010 Journal of Urology study looking at scribes in urology, said he is not a great multitasker.
“I think my face would be in the computer screen much of the patient visit, and my typing would be a mess,” Dr. Kogan said.
The scribe facilitates a better physician and patient interaction and dramatically reduces the burden of EMR documentation.
“I merely review, make a few small edits (if more than that, I need to do additional training of the scribe), and sign the note,” he said. The only disadvantages, according to Dr. Kogan, are cost and the time and energy required to train a scribe.
At Dr. Kogan’s practice, the scribe’s primary role is to type into the EMR. The scribe prepares notes before the patient arrives. For example, for new patients, the scribe might add x-ray and culture reports to the results section of the note, he said. And for follow-up patients, the scribe summarizes data from the previous note and copies results of previous studies and procedures. The scribe accompanies Dr. Kogan into the room and records the patient’s history and physical findings that he points out. The scribe records the discussion of Dr. Kogan’s plan for the patient and the diagnosis.
“Of course, they cannot make any independent judgments,” Dr. Kogan said.