Who remembers that notorious music video parody by ZDoggMD rapping about how difficult EHR's are to use? If you haven't seen it, I recommend watching it here. It's very catchy and sums up the difficulties of health IT software in a way that all health professionals will be able to relate to.
Your doctors received years of training to heal patients, but statistics have shown that physicians are now spending as little as 10% of their working hours on direct patient care - a figure that has been shrinking each year.
Health IT has large scale potential to benefit both patients and providers, but much of the 90% of the time physicians are not engaging with patients is spent navigating ineffective, cumbersome health IT software. Physicians, who are largely responsible for the entry of patients' electronic health records, frequently cite EHR implementation as one of the key drivers of job dissatisfaction.
Rather than waiting for the health IT industry to catch up with the realities of patient care, it may be time for you to take matters into your own hands to alleviate this burden from your physicians, for the sake of your staff, patients, and revenue.
Who Are Medical Scribes?
As connoted by the title, a medical scribe is an individual who manages all paperwork and documentation for physicians. In many cases, they will shadow a physician, acting as an assistant to handle all information entry into the EHR with physician oversight. Today there are over than 15,000 medical scribes represented by the American College of Medical Scribe Specialists, most of whom work in emergency care departments.
Medical scribes are typically "pre-professionals" - meaning they are looking to enter the medical field and will likely be the next generation of physicians, nurses, and PAs. For future medical students, it is easy to imagine the obvious educational benefits of becoming immersed in the frontlines of healthcare early on. These individuals who will go on to become tomorrow's medical providers are eager to fill the role of medical scribe, as it allows them countless opportunities to interact with physicians and gives them firsthand experience within the medical industry.
The benefits of employing medical scribes among hospital staff are numerous and far-reaching. Though the use of medical scribes has been most successful in emergency rooms, many believe that with the proper implementation scribes could be extremely useful for inpatient settings as well.
Let Your Doctors Be Doctors
“Our docs are very smart people. If they would have wanted to do a clerical-type job, they would have done a clerical-type job,” says Jeffry Kreamer, MD, chief executive officer of Best Practices Inpatient Care. Doctors spend far too much of their valuable time typing patient details, scrolling through options, and clicking on the screen that they could be spending seeing more patients, or giving better care to existing patients.
Simply put, much of today's healthcare technology is a pain to use. Sure, health IT is the future of medicine, no one is arguing that. But there is plenty of room for improvement, especially in regard to ease of user operability. Studies show that many physicians report that EMR documentation has added several hours to their workday - meaning physicians are spending extra hours after work entering patient information into the electronic records, or they are spending less time throughout their day actually seeing patients, or a combination of the two.
By managing the time-consuming record-taking that hospitalists are currently responsible for, medical scribes take a large administrative load off of physicians, who can then use their valuable time and expertise in more productive ways. It simply does not make sense to take your most valuable human capital, the physician, and have them spending hours a day completing menial paperwork that could be done at a much lower cost. As a matter of fact, Kreamer noted that hiring scribes saved his hospitalists about 3 hours of productivity per day - a little over 10 minutes per chart on a typical 18-patient rotation.
Putting physicians back to the frontlines of medical care, where they belong, is likely to boost morale as physicians are able to once again engage with patients and and focus on the actual treatment and care. Says Michael Murphy, MD, cofounder of ScribeAmerica, "[medical scribes] have the potential to extend the current provider workforce and improve quality of life for our doctors.”
Improving Patient Care
By allowing increased face-to-face time with patients, medical scribes have the potential to make physicians significantly better healthcare providers. When your physicians don't have to constantly shift their focus between the patients' words and frantically typing into a computer, their relationships with the patients are greatly improved. The physician is able to spend far more one-on-one time with each patient, asking more questions, learning more about the patients' symptoms, and ultimately providing better treatment and care, without being interrupted by nagging administrative requirements.
Patient engagement and patient satisfaction rates are improved by the use of medical scribes, and the note-taking itself is also much more detailed and accurate. It is difficult for physicians to practice critical thinking while also typing on a keyboard, but having a medical scribe present to record the physicians' notes in real-time during a medical exam can foster better medical record-keeping, resulting in improved health outcomes.
Now, the use of medical scribes is not a one-size-fits-all solution for all hospital departments. There will be some medical fields and healthcare markets where the uptick in physician productivity cannot justified by the cost of employing medical scribes. But in the face of severe physician shortages, many hospitals may find that a medical scribe program can help them extend their workforce and maximize efficiency.
Though the idea of medical scribes may be relatively new to modern healthcare, the concept has been around since ancient Egypt. Historically, scribes were used to copy medical texts and hieroglyphs, and their prominence in medicine began to fade with the advent of the modern printing press - however, the current healthcare system could probably stand to benefit to experiment further with the practical use of medical scribes.
Sources: http://www.the-hospitalist.org/article/use-of-medical-scribes-spurs-debate-about-costs-difficulties-of-electronic-health-records; http://www.kevinmd.com/blog/2012/11/biggest-issues-emr-today.html