Medical scribes are cropping up in hospitals and physicians’ offices around the country. Their primary draw lies in the potential to save physicians time; that is, by relieving physicians of the duty to dictate patient notes into the electronic health record (EHR).
But can this method completely alleviate physicians of their EHR dictation duties? And are there any downsides?
Why Employ Medical Scribes?
Founded in 2010, the American College of Medical Scribe Specialists (ACMSS) says that employing scribes will “maximize the efficiency and productivity of clinical care.” It’s also been estimated that there will be 100,000 scribes nationwide by 2020.
And to the ACMSS’ credit, there has been research that shows the effectiveness of scribes. Epic, a popular EHR provider, released findings that indicate medical scribes may make the transition to an EHR platform easier.
However, the study only followed two hospitals – hospital A went live on Epic’s EHR platform, CareConnect, with the help of scribes, and hospital B went live without them.
Downside of Medical Scribes
Improved efficiency and productivity sounds great. And if using scribes lessens the burden on physicians, shouldn't we be all for it?
Maybe. There are downsides to this method that are worth considering.
There’s another “body” in the room. While this might not seem like a big deal, adding another person to the physician-patient mix is complicated.
It can be difficult enough to develop a level of trust with a patient, and when another person is included in those conversations, patients may be less reluctant to speak openly.
Fraud and liability concerns. Last year, KevinMD published a behind-the-scenes look at the life of a medical scribe. Not only did this individual note the benefits scribes can bring to healthcare, he also discussed the increased fraud and liability concerns too.
For instance, consider this scribe-physician exchange:
“In Epic’s CareConnect, there is a small button that, when pushed, indicates the physician has counseled the patient to stop smoking. It adds a small amount ($20-30) to the billing, and the physician makes a little more. I’ve been told by physicians, 'If the patient is an active smoker, just click that button about the counseling.' Most of the time, the patient is counseled. Sometimes though, they aren’t. But if that button isn’t pressed, eventually, it comes back onto me. 'I told you to press it, so just press it,' [says the physician]. At which point, I protest, 'But you didn’t counsel them.' The physician responds, 'You probably just weren’t paying attention.' Or 'It’s okay, just click it anyways.' As a “good” scribe, I don’t say anything and I click the button."
That's a worrisome exchange, isn't it? There are bound to be disagreements regarding the interpretation of occurrences during a patient visit or exam.
So which person's recollection - that of the physician or the medical scribe - should win out? These are the types of problems that can muddy the EHR dictation waters.
Future of Medical Scribes
In the next few years, it’s likely that additional studies evaluating the effectiveness of medical scribes will be conducted.
However, it's much less likely that medical scribes will completely eliminate the need for physician EHR dictation.
For now, front-end speech recognition has proven itself a viable time-saving alternative for physician dictation woes. Similar to scribes, evolving voice recognition software offers data entry at point of patient care with immediate availability in the healthcare record.
Would you use medical scribes in your practice? Why or why not? Please join the conversation below.