The push to develop and deploy EMRs, combined with the need for more detailed documentation, has forced emergency medicine (EM) and hospital medicine (HM) providers to spend extra time during patient visits capturing and entering data, which could impact the time they have to give care to the patient.
A solution to increase provider efficiency is the use of medical scribes or a speech-to-text EMR dictation resource.
“It is important for hospitals to support methods that improve provider efficiency, productivity, and documentation. That includes both scribes and dictation resources,” said David Schillinger, M.D., Chief Medical Officer, SCP.
Scribes work as on-premise or virtual assistants to EM and HM physicians and are responsible for entering information into the medical record with the doctor's oversight.
"A benefit of scribes is that they can look up details, such as: what's in old records, nurse’s notes, medications the patient is taking, and things the doctor can't readily recall,” explains Dr. Schillinger.
The scribe takes notes in real-time as the doctor interacts with the patient and alerts the doctor to questions he or she may need to ask, such as social or family history. Also, notes entered during the actual episode of care means fewer required entries at the end of the day.
As the industry evolves, speech-to-text EMR dictation tools are quickly becoming the resource of choice for provider documentation. This allows the provider to speak directly into the computer when documenting patient encounters.
“When a hospital commits to utilizing either medical scribes or speech-to-text EMR resources, they are committing to improving the physician experience by getting them away from the EMR. In turn, the result is improved documentation, expedited patient throughput, and an enhanced patient experience," says Dr. Schillinger.
While the benefits Dr. Schillinger described are sufficient to warrant the use of medical scribes, or speech-to-text dictation, the advantages are far more numerous. In this post, we profile the top nine benefits of scribes experienced by most EM and HM doctors. Look for a future post on the advantages of speech-to-text resources.
1. Increased Efficiency and Productivity
The use of scribes increases provider efficiency and decreases documentation burdens. Being relieved of the duty to take notes and document the chart in real-time lets providers be more productive, and see more patients during their shift than they could otherwise.
2. Better Bedside Manner
Doctors forced to interact with the EMR during a patient visit tend to be less communicative, splitting their time between the patient and computer. Scribes alleviate that responsibility so the doctor can interact with the patient face-to-face without the intrusion of a computer screen. Both the doctor and patient benefit from focusing on the visit, not the EMR.
3. Improved Surge Volume Management
Managing ED patient surge volume is another area where scribes give value. Increased volume in the ED means providers spend less time with each patient, but because surge times typically only last a few hours, calling in additional clinical staff is often too slow to affect the immediate situation. Having scribes on hand – either in-person or virtually – recording each encounter lets the medical staff attend to patient needs in quick-step without sacrificing quality.
4. Adequate Shift Coverage Ensured
Scribes can also be an asset in situations where the ED’s provider-patient ratio is insufficient to allow physicians to spend the time they need with patients. Their use helps ensure shifts are covered adequately, in two ways: by offsetting the need to hire additional providers, and increasing the productivity of the personnel on-hand.
5. Reduced Wait Times/LWOTs
Emergency departments across the U.S. are doing everything in their power to reduce wait times and LWOTs. Door-to-doctor time has become a standard measure of ED performance. The increased efficiency and productivity that results from the use of medical scribes who follow the physician during rounds, gathering and documenting information into the EMR, help drive those numbers down.
6. Rural Hospital Assistance
Rural hospitals lack the multitude of medical staff enjoyed by their urban counterparts, which is where virtual scribes — those who work offsite and communicate with physicians via a headset — can be invaluable.
The scribe has firewall access to the EMR and can record the doctor's encounter with the patient in real-time. Because the scribe is not physically following the provider, they can also look up and report lab results as the doctor enters a patient’s room, and capture the relevant findings required for appropriate documentation and coding.
7. Enhanced Patient Satisfaction
Improving patient satisfaction scores is a concern for all medical professionals, given the fact that patient experience has a bearing on a hospital’s reimbursement (HCAPS).
While the primary reason to hire scribes is to improve efficiency and productivity, they can also play a role in enhancing patient experience and satisfaction. Their service enables improved interaction between physicians and patients (and the patients’ families), and can translate into a significantly improved patient encounter.
That's not merely conjecture, either; research backs it up.
An article published by The Studer Group, a management consulting firm, cited a study in the American Journal of Emergency Nursing, found the introduction of scribes into the ED resulted in decreased patient length of stay and increased patent satisfaction.
8. Greater Provider Satisfaction
Of equal importance to improving patient satisfaction is making sure providers are satisfied, which is another area where scribes perform a vital function.
One Arizona hospital implemented the use of virtual scribes (PDF) due to provider satisfaction being low based on their need to spend up to two additional hours after their shift to complete documentation. Scribes were able to document and review in real-time saving the providers an average of 24 minutes per shift, which meant they spent less time at the hospital and more time at home with family.
9. Higher Revenue
Becker's Hospital Review, reporting on a 2015 study by the National Center for Biotechnology Information, said that physicians with scribes generated additional revenue of $24,257 by producing clinical notes that were coded at an optimal level. The total additional revenue generated was $1.4 million at the cost of roughly $100,000 for the employed scribes.
Other revenue drivers include the scribe’s ability to improve the quality of documentation, thereby reducing medical errors leading to fewer denials, and their potential to affect provider productivity resulting in increased patient volume.
The benefits of medical scribes outlined here are compelling in demonstrating that hospitals would benefit from their use. For that reason, Schumacher Clinical Partners supports the use of scribes and dictation resources in several of its partner facilities.
In an era when governmental regulations tie reimbursement to the quality of patient care, any service that improves efficiency, increases patient and provider satisfaction, cuts costs, and generates optimal revenue is a program every hospital should seriously consider implementing.