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.
Pay-for-performance quality measures
Breast cancer screening. Scribed providers increased the number of visits at which breast cancer screening was ordered by 2.7 percentage points (from 17.3% before implementation of scribes to 20.0%); during the same period, the number of visits at which breast cancer screening was ordered by nonscribed providers decreased by 1.9 percentage points (from 19.5% to 17.6%). Scribes were therefore associated with an increase of 4.6 percentage points in breast cancer screening orders, compared to nonscribed providers (P < .003) (TABLE 2). That difference remained significant after adjusting for patient demographics (P = .01).
Colon cancer screening. Similarly, scribed providers increased the number of visits at which colon cancer screening was ordered by 1.2 percentage points (from 19.2% before implementation of scribes to 20.3%); during the same period, the number of visits at which colon cancer screening was ordered by nonscribed providers decreased by 2.7 percentage points (from 18.5% to 15.9%) (P = .112). After adjusting for patient demographics, scribes were associated with an increase of 4.9 percentage points in colon cancer screening orders, compared to nonscribed providers (P = .044) (TABLE 2).
Cervical cancer screening. The rate at which cervical cancer screening was ordered did not change among scribed providers and decreased (by 2.5 percentage points) among nonscribed providers—a difference that was not statistically significant (P = .26).
Nonpreventive visits. Our findings overall did not change in analyses focused on nonpreventive visits, in which scribes were associated with an increase of 8.2 percentage points in LOS 4 or 5 billing (P < .001); an increase of 3.1 percentage points in HCC coding (P < .001); and an increase of 3.2 percentage points in breast cancer screening orders (P = .03) (TABLE 3). Although scribes were associated with an increase of 1.5 percentage points in cervical cancer screening orders and an increase of 3.1 percentage points in colon cancer screening orders, these increases did not reach statistical significance.
Discussion
We found that implementation of scribes is associated with (1) an increase in LOS coding and risk coding and (2) a higher frequency of addressing 2 of 3 pay-for-performance quality measures in primary care. In adjusted analyses in our study, and compared to nonscribed providers, scribes were associated with an additional 9.2 percentage points in LOS 4 or 5 billing; 3.6 percentage points in HCC coding; 4.0 percentage points in breast cancer screening orders; and 4.9 percentage points in colon cancer screening orders. Cervical cancer screening orders followed a similar pattern, with an increase of 2.3 percentage points in the adjusted screening order rate among scribed providers, compared to nonscribed providers, during implementation of scribes—although the increase was not significant. These findings did not change in analyses focused on nonpreventive visits.
Continue to: Our findings are consistent
