Can medical scribes improve quality measure documentation?
Yes, according to this study that found significant improvements in the documentation of 4 pay-for-performance quality measures and higher patient/physician satisfaction.
In a 2015 systematic review, Shultz and Holmstrom found that medical scribes in specialty settings may improve clinician satisfaction, productivity, time-related efficiency, revenue, and patient-clinician interactions.8 The use of scribes in one study increased the number of patients seen and time saved by emergency physicians, thereby increasing physician productivity.9 Studies have also shown that physicians were more satisfied during scribe engagement, related to increased time spent with patients, decreased work-related stress, and increased overall workplace satisfaction.10-12
Studies on the use of medical scribes have mainly focused on physician satisfaction and productivity; however, the data on patient satisfaction are limited. Data about the use of the medical scribe in the primary care setting are also limited. The aim of our research was threefold. We wanted to evaluate the effects of using a medical scribe on: (1) patient satisfaction, (2) documentation of primary care pay-for-performance quality measures, and (3) physicians’ perceptions of the use of scribes in the primary care setting.
METHODS
Data collection
This study was conducted at Family Practice Group in Arlington, Massachusetts, where 5 part-time physicians and 3 full-time physician assistants see approximately 400 patients each week. The representative patient population is approximately 80% privately insured, 10% Medicaid, and 10% Medicare. The EHR system is eClinicalWorks.
The scribes were undergraduate college students who were interested in careers as health care professionals. They had no scribe training or experience working in a medical office. These scribes underwent 4 hours of training in EHR functionality, pay-for-performance quality measures, and risk coding (using appropriate medical codes that capture the patient’s level of medical complexity). The Independent Physician Association affiliated with Family Practice Group provided this training at no cost to the practice. The 3 scribes worked full-time with the 5 part-time physicians in the study. Scribes were not required to have had a medical background prior to entering the program.
After the aforementioned training, scribes began working full-time with physicians during patient visits and continued learning on the job through feedback from supervising physicians. Scribes documented the patient encounters, recording medical and social histories and physical exam findings, and transcribing discussions of treatment plans and physicians’ instructions to patients.
Continue to: We reviewed patient EHRs...
