Use of medical scribes improves physician satisfaction, charting

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The first randomized controlled trial of medical scribes finds that they produce significant improvements in overall physician satisfaction, chart quality and accuracy and charting efficiency, but had no effect on patient satisfaction.

In the study conducted in a family medicine clinic associated with a large academic medical center in Northern California, physicians were randomly assigned to one week practicing with a scribe, then one week without a scribe over the course of a year.

“We found that scribes significantly improved physician satisfaction across all measured aspects of patient care and documentation,” states the study’s authors in an article published in the Annals of Family Medicine. “Scribes improved physician-perceived chart quality and chart accuracy, as well as charting efficiency as measured by the likelihood of closing a chart within 48 hours.”

Four doctors and two scribes participated in the study, which leveraged an outpatient version of the Epic electronic health record system.

While critics contend that scribes are no substitute for better functioning EHRs and that they may in fact remove some of the pressure on health IT vendors to improve their systems, the study’s researchers consider scribes to be “an immediate solution that can be implemented while the more onerous and time-consuming problem of EHR redesign is also tackled.”

Also See: Are medical scribes standing in way of EHR innovation?

The authors noted that physicians working with a scribe in the study were “much more satisfied with how their clinic went, the length of time they spent face-to-face with patients, and the time they spent charting.” As a result, they contend that their findings “suggest that scribes may have a protective effect on physicians’ well-being.”

In addition, the study found that not only were physicians satisfied with the quality and accuracy of charting done by scribes, they were more satisfied with scribed charts than with their own.

When it came to charting efficiency, the study revealed that scribed charts were more likely to be closed within 48 hours, compared with charts completed by physicians alone.

Nonetheless, at the same time, the authors found no difference in patient satisfaction between visits with or without a scribe, and that the presence of a scribe did not decrease patient satisfaction.

Scribes serve an important function by reducing the time that physicians spend on clerical tasks, according to the researchers, who note that scribes are currently used in more than 1,000 hospitals and clinics across 44 states and that there will be an estimated 100,000 scribes nationwide by 2020, or 1 scribe for every nine physicians. Still, they say there is a lack of high-quality evidence regarding their effects.

“Our findings are positive with respect to physician satisfaction and efficiency, but future randomized studies should be conducted with large sample sizes and across multiple institutions to improve the generalizability of these findings,” conclude the authors.

“This study validates what we have known for 14 years since we pioneered the medical scribe industry—providers are being crushed under the weight of increasing ancillary duties. They are spending less time with patients and more time behind a computer,” says Michael Murphy, MD, CEO of ScribeAmerica.

“As this study points out, medical scribes extend new life to providers, decreasing burnout and increasing satisfaction with chart quality and accuracy," Murphy adds. "Ultimately, scribes allow providers to work at the top-of-their license, delivering better quality of care to their patients.”

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