Use of Medical Scribes Spurs Debate About Costs, Difficulties of Electronic Health Records

The Hospitalist. 2015 October;2015(10):

October 6, 2015 | The Hospitalist

Dr. Murphy says those concerns are unfounded. In a response letter not yet published, he wrote, “Can you honestly believe that the small minority of providers who find EHR acceptable due to scribes are what is preventing EHR companies from making improvements? No, it is as a result of system and technology limitations.”

On scribes being used beyond their scope, Dr. Murphy says there will always be “‘bad actors’ willing to act outside of accepted industry norms; however, that does not mean that TJC [The Joint Commission] does not have control over the industry.”

SHM has not taken a position on the value or potential value of scribes in the inpatient setting.

Tom Collins is a freelance writer in South Florida.

With a Nod of the Head, a More Seamless Office Visit

In addition to boosting bottom lines, scribes make for more engaged—and happier—doctors, says Jeffry Kreamer, MD, who heads a company that runs six Illinois hospitals. Here’s how it works:

When the doctor meets with a patient during an office visit, a scribe is present.

With a slight nod of the head or other signal to the scribe that what he is about to say should be entered into the chart, the physician begins speaking to the patient: “My understanding is you’re feeling better today, but you’re still coughing,” the hospitalist might say. The scribe can then record that in the chart. An added benefit is that, at the same time, the patient gets confirmation that the doctor has heard what he has reported.

Then, as the exam goes on, the hospitalist might make comments such as, “Lungs clear,” and so on. The scribe can record these in real time as the exam is performed.

“It’s very hard to do critical thought and keyboard at the same time,” Dr. Kreamer says. “While the scribe is working on the chart, you can be talking to the patient.”

Dr. Kreamer says he’s been pleased with the way scribes have helped boost volume and at the same time allowed doctors to focus more on actual care, so much so that now he “couldn’t imagine practicing without it.

“It’s the greatest thing.”

References

Bansal A, Bejerano RL, Cashimere CK, Polashenski WA, Jr. Reducing length of stay by using standardized admission process: retrospective analysis of 11,249 patients [abstract]. Society of Hospital Medicine Annual Meeting 2015. Accessed September 10, 2015.
Gellert GA, Ramirez R, Webster SL. The rise of the medical scribe industry: implications for the advancement of electronic health records JAMA. 2015;313(13):1315-1316.