The financial advantages of medical scribes extend beyond increased visits
Employing medical scribes can boost revenue for a practice, the authors show, well beyond being an opportunity to expand patient volume.
During the study period, the EMR decision-support tool for HCC coding underwent several changes designed to improve HCC coding. In addition, systematic changes to primary care visits took place, leading to an increase in the number of patients seen and screenings required.
Outcomes
We examined 2 categories of outcomes that confer financial benefit to many institutions: billing measures and pay-for-performance measures.
Billing measures included the percentage of visits (1) coded as LOS 4 or 5 and (2) with at least 1 HCC code billed (among those for which the decision-support tool identified at least 1 potential HCC code).
Pay-for-performance measures. We examined whether any of 3 pay-for-performance quality measures were addressed during the visit, selecting 3 that are commonly addressed by primary care providers (PCPs) and that require PCPs to sign an order for screening during a primary care visit: breast cancer (mammography order), cervical cancer (Papanicolaou smear order), and colon cancer (an order for fecal occult blood testing or colonoscopy).
Intervention
Scribes were employees of Cambridge Health Alliance who had recently graduated from college and were interested in a career as a health care professional. Scribes received 3 days of training on how to function effectively in their role; 1 day of training in EMR functionality; and 2 hours of training on decision-support tools for pay-for-performance quality measures and risk coding. Scribes continued learning on the job through feedback from supervising PCPs. Scribes documented patient encounters, recording histories and findings on the physical exam and transcribing discussion of treatment plans and the PCP’s instructions to patients.
Continue to: The 14 scribes worked with 17 physician...
