Some reports suggested that scribes did not change patient satisfaction, while others found increases in patient satisfaction when providers used scribes. Of the 18 studies that looked at the patient view of scribe use, reports had varying findings. 29 Seven of the nine studies that investigated provider perceptions when working with scribes reported increases in satisfaction. They observed that providers could see more patients per hour and that the use of a scribe resulted in increased relative value units (RVUs), a measure of the relative economic value of the medical services provided. Their analysis consisted of 562,682 patient encounters from 39 different studies. found that changes in satisfaction, patient throughput, and revenue observed with the use of scribes was nearly consistent across the literature. 21- 28Ī systematic review and meta-analysis by Gottlieb et al. 20 It has been demonstrated that medical scribes may decrease provider EHR-time, increase patient and provider satisfaction, improve workflow efficiencies and boost billing and reimbursement through the optimization of coding. Besides documentation, research has suggested that medical scribes can also aid in information gathering and data entry. In today’s terms, a medical scribe is usually an unlicensed member of the clinical care delivery team who documents the patient encounter for providers in real-time, so that providers can spend more time with the patient and less time in the EHR. 19 With the massive increase in EHR use in the early 2000s, the scribing industry has risen in popularity. 4 Scribes have been aiding in documentation for centuries, but were not part of the medical field until 1975 when they were deployed as nursing scribes. Medical scribes are one proposed way to alleviate physician documentation burden. There are multiple ways to tackle the inefficiencies of the EHR and reduce the volume of time providers spend with the EHR. With the excessive time spent in the EHR, both during and outside of work hours, providers have issues creating a work-life balance – many wish they could spend more time with patients. 16 The majority of this time spent in the EHR is distributed, relatively equally, around three domains: orders, documentation, and chart review. 3, 6, 7, 15- 18 One study noted that for a patient encounter, providers spend an average of 16 minutes and 14 seconds using the EHR the average patient visit is 15 minutes, so providers are often spending more time documenting in the EHR than they are spending with the actual patient. 13, 14 Providers are spending an exorbitant amount of time doing computerized provider order entry and after-hours charting this phenomena is known as “pajama time”, where providers are spending time working, at the EHR, after business hours. 7- 12 Because of the EHR and documentation requirements, many providers experience EHR fatigue and note bloating.
3- 6 Health care professionals have some of the highest levels of burnout compared to other professions and the use of EHRs has been implicated as one of the possible factors contributing to burnout.
1, 2 However, EHRs have also led to some unintended consequences like provider burnout, over-documentation, and stress.
The implementation of electronic health records (EHRs) has led to many positive outcomes, including improved efficiency in healthcare delivery and enhancements to care because of provider access to complete and up-to-date information.
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