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Scribes Improve Physician Workflow, Patient Interaction

Scribes lower EHR documentation burden for doctors and increase time spent interacting with patients

TUESDAY, Sept. 18, 2018 (HealthDay News) — Use of medical scribes is associated with decreased physician documentation burden, improved work efficiency, and improved patient interactions, according to a study published online Sept. 17 in JAMA Internal Medicine.

Pranita Mishra, from Kaiser Permanente Northern California in Oakland, and colleagues evaluated the effect of medical scribe use on 18 primary care physicians’ (PCPs’) workflow and patient experience. The PCPs (12 internal medicine and six family practice physicians) were randomly assigned to start the first three-month period of the one-year study with or without scribes and then alternated status every three months. A six-question survey was administered at the end of each period.

The researchers found that, compared with non-scribed periods, scribed periods were associated with less self-reported after-hours electronic health record documentation (less than one hour daily during week: adjusted odds ratio [aOR], 18.0; less than one hour daily during weekend: aOR, 8.7). There was also a higher likelihood of PCPs reporting spending more than 75 percent of the visit interacting with the patient during scribed periods (aOR, 295.0) and less than 25 percent of the visit on a computer (aOR, 31.5). In addition, during scribed periods encounter documentation was more likely to be completed by the end of the next business day (aOR, 2.8). A total of 61.2 percent of surveyed patients (450 of 735) reported that scribes had a positive bearing on their visits, with only 2.4 percent reporting a negative impact.

“Our results support the use of medical scribes as one strategy for improving physician workflow and visit quality in primary care,” the authors write.

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