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.
We reviewed patient EHRs of 5 family physicians over 2 time periods: the 3 months prior to having a medical scribe and the 3 months after beginning to work with a medical scribe. Chart data extraction occurred from 4/11/13 to 8/28/14. We reviewed 1000 patient EHRs—100 EHRs each for the 5 participating physicians before and after scribe use. Selected EHRs ran chronologically from the start of each 3-month period. Reviewing EHRs at 3 months after the onset of the medical scribe program allowed time for the scribes to be fully integrated into the practice and confident in their job responsibilities. Chart review was performed by an office administrator who was blinded as to whether documentation had been done with or without a scribe present during the visit.
Eight quality measures were evaluated in chart review. These measures were drawn from the Healthcare Effectiveness Data and Information Set (HEDIS), a tool used to measure performance in medical care and service.
We surveyed 30 patients of each of the 5 providers, yielding a total of 150 survey responses. A medical assistant gave surveys to patients in the exam room following each office visit, to be completed anonymously and privately. Patients were told that surveys would take less than 2 minutes to complete. Office visits included episodic visits, physical exams, and chronic disease management.
After the trial period, we surveyed participating physicians regarding medical scribe assistance with documentation. We also asked the physicians 3 open-ended questions regarding their experiences with their medical scribe.
This study was reviewed and approved (IRB Approval #11424) by the Tufts Health Science Campus Institutional Review Board.
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