Scribes

The Use of Scribes to Document in an EHR

If you are one of the 34% of physicians who responded to the EHR satisfaction survey (see graph below) in 2012, and stated that you were very dissatisfied with your EHR’s ability to decrease practice workload, you may have considered employing a scribe to assist with documentation in your EHR system. For some, this may not be an unreasonable solution.

EHR-Satisfaction-Workload

Source: AmericanEHR Partners EHR Satisfaction Survey

The following comments were submitted by physicians who completed the survey regarding their use or intended use of scribes:

  • I am 10% less productive. Everyone (physicians) who I’ve spoken to says the same thing. I’m thinking about hiring a scribe to bring me back to my previous productivity levels.
  • Our EHR has slowed me down as I have to enter and type up everything: my thoughts are distracted from thinking about the patient and what I must do to care for them and diverted towards getting the data entered into the EHR. I feel I need a scribe next to me just to free up my mind.
  • I answered as regards my primary office. We are part of a much greater group, 13 Practices, 18 office sites. Our vendor provides no daily support. We have our own incredible IT department inhouse. Their services are superb. I would not be able to function without them. The second issue is productivity. I do not believe I would ever have reached pre-EHR productivity without using a scribe. After a year of getting home at 11 pm when my spouse threatened to leave me, I began using a scribe real time in the room. She completes 98% of the note, does all orders, enters the visit code, updates the med list and problem list, sends the prescriptions, prints patient handouts, sends inter-office flags to call for outside reports during the visit, prints the patient summary, and even completes forms such as school physicals in the room while I attend to the patient. In short she is the major reason that the EHR will deliver Meaningful Use. A majority of our Medical Assistants are trained as scribes and all of the docs in our office are now using them. They more than earn their extra expense because visits are more efficient and visit levels are better documented, thus yielding higher reimbursement. If I didn’t have a scribe, I would probably take the day off. It does take a number of days to train a scribe to modest proficiency and months to full productivity.
  • There is great non-recognized costs with implementation and lost productivity. A LOT of info has to be typed in. All tend to take focus away from the patient. Many have to hire scribes so that they can focus on the patient.

What is your experience? Do you use a scribe or have you considered using a scribe to improve productivity? Share your thoughts or comments.

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