UAB Medical Center tests ‘virtual scribes’ to trim docs’ workday

UAB Medical Center is testing “virtual scribing” services to help primary care physicians complete treatment documentation more quickly.

The organization, based in Birmingham, Ala., wants to see whether the technology can help free up physician time to see more patients while completing their work earlier.

Some 60 doctors have struggled to keep up with documentation in the organization’s electronic health record system, working late and often spending as much as four hours a night documenting and doing more on the weekends, says Stephen Stair, MD, medical compliance officer and an assistant professor at UAB.

Mountains of paperwork are wearing out physicians across the nation and Stair says he’s seen published burnout rates of as much as 40 percent. Recently, UAB learned that Massachusetts General Hospital was using the virtual scribing service of IKS Health, which allows more time for physician/patient interaction during clinic visits and reduces the time spent on electronic documentation. UAB now is piloting the scribing service, which is outsourced transcribing of encounters by trained physicians in India.



UAB implemented tablet computers and uploaded schedules on them, and the tablets record every word of a treatment encounter. Patient informed consent forms also are scanned into the chart to confirm a patient knows the encounter is being recorded.

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Still, all that documentation on a tablet has to be transcribed, and that’s being done by uploading the recordings to a secure server and having them transcribed by trained physicians in India, who are working on the UAB electronic health record.

“We will be able to attract and retain the best talent in India to make sure the product is at the highest standard,” says Shane Peng, MD, chief clinical services and innovations officer at IKS Health, which supplies the transcribing physicians in India.

Most patients like the visit being recorded because the doctor is verbally explaining everything during the visit instead of spending half of the time pecking on a computer, and the patients better understand what’s going on, Stair says.

“We have data that shows improvement in patient satisfaction because we are talking through the exam with them,” he adds. “Several patients have said they are glad I am their doctor because they like that the focus is on them.”

Physicians at UAB edit notes from India, but it only takes one or two minutes per encounter. In this early stage, 43 providers are using the service, which for now covers urology, ear, nose and throat, OB/GYN, hematology and oncology encounters.

The bottom line, Stair says, is that now doing notes during a visit is gone, all discussions are captured, and he has time to consider other issues, such as how to improve care coordination. “The visits are richer, claims and coding is so much better, doctors are not coders anymore, and we talk through the diagnosis with the patient. The first time I read a transcribed visit, I choked up. That was a new experience for me.”