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Hiring of Scribes Rises as Practices Seek to Maintain Productivity Levels

Posted in The Top Line | Dec 2013 | Comments (0)

Tags: Editor's Choiceelectronic medical recordsorthopaedic practice managementhiringstaffing

Since the 1990s, medical scribes have mostly been found alongside physicians in the Emergency Room (ER). Nowadays the number of scribes working in healthcare is on the rise, and so is the variation in the settings in which you will find them. What exactly is a medical scribe? Why are they utilized? And why is their employment on the rise?

The Joint Commission describes a medical scribe as an unlicensed individual hired to enter information into the electronic health record (EHR) or chart at the direction of a physician or licensed independent practitioner. Further described by the American College of Emergency Physicians (ACEP), a scribe works side by side with the practitioner as a documentation assistant. The scribe accompanies the practitioner into the exam room and documents the practitioner/patient encounter as it is verbalized by the practitioner and patient. A scribe cannot act independently, but simply documents the practitioner's dictation and activities during the visit.

A recent ACEP study reported a 100 percent return on investment for employing scribes in the ER. Physicians in the ER setting spend approximately half of their time on indirect patient care activities such as charting and recordkeeping. The use of a scribe frees the physician from spending too much time on indirect activities, which allows a physician to see more patients. Scribes make sense in the fast paced and critical ER setting. So why are they now being employed in new specialties and clinical settings?

This movement has been fueled by Federal payments and incentives under the American Recovery and Reinvestment Act, which accounted for the implementation of Electronic Medical Record systems (EMRs) for more than 4,000 hospitals and 300,000 physician practices. The push and monetary reward for hospitals and practices to switch to EMRs has created an unexpected and growing need to employ medical scribes in such facilities.

Physicians find the implementation of these new EMRs to be time consuming, taking away from their ability to see and care for patients. Due to EMR system implementation, many hospital departments and physicians practices have reported drastic decreases in their typical productivity rates. EMR programs can run slowly, have system glitches and require multiple steps in the documentation process. These and other issues underscore the rising need for scribes in all healthcare settings. Studies suggest that physician productivity can decrease as much as 30 percent as they take the time to learn a new and complex EMR system. In response to the decrease in productivity, physicians are hiring scribes to document and enter their patient data. Having a scribe in the exam room has helped physicians to return to their "pre-EMR patient load."

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