Over the years, the medical industry has seen tremendous evolution geared towards helping increase the efficiency of healthcare provision. One of the significant developments in the medical industry is the adoption of medical scribes. Even though this practice first appeared in the 1970s, it was not until 2009 when the federal HITECH Act incentivized healthcare providers to adopt EHRs, that medical scribes started to gain prominence. 

EHR systems were supposed to simplify patient record keeping and ease the work of doctors. However, they did not meet the expectations. Doctors found entering data and notes into the EHR to be cumbersome and time-consuming. These shortcomings generated the need for medical scribes. 

What is a medical scribe?

Massive volumes of documentation must be created and maintained to help healthcare providers track patient progress and receive payment from insurance companies. Needless to say, physicians prefer to treat their patients instead of being bogged down with paperwork. This is where medical scribing comes in. 

A medical scribe inputs information from a patient’s visit into the EHR under the physician’s direction to assist in delivering the best possible healthcare. A medical scribe essentially acts as an extension of the physician’s arm. 

While bringing a medical scribe into your practice can both raise the level of patient care and lift the burden of EHRs, there are instances when having a medical scribe physically on-site isn’t feasible. In such a scenario, a virtual medical scribe may just be what you need. 

What is a virtual medical scribe? 

Unlike the physically on-site medical scribes, virtual scribes provide real-time medical assistance without being present in the healthcare facility. They specialize in charting patient-physician interactions as they happen. These professionals remotely accompany physicians during patient visits, take critical notes pertinent to the patient’s condition, and document these notes. 

Virtual medical scribes can work in various capacities, including in the emergency department or in the outpatient setting during regular patient’s office visits.

Why would physicians need a medical scribe? 

In this day and age, most healthcare facilities and physicians use EMR sometimes tailored to their practice to undertake most documentation tasks. Even so, regardless of how good an EMR is, you will still need a lot of time to key data into it. 

According to a Harvard Business Review article titled “The Strategy That Will Fix Healthcare,” a doctor’s cost of service per minute may be up to $4 per minute. That said, it would make no economic sense to pay a doctor up to $240 every hour to fill data into the EMR system. Having a medical scribe will ensure that the doctor’s time is spent solely on providing medical care rather than recording patient examination information. 

Also, remember that if the doctor fills the EMR in front of a patient, some patients may perceive them as inattentive. This is because the doctor is more focused on recording the data than paying attention to what they are saying. Nonetheless, if the doctor waits until the patient exits the examination room to complete their progress note, it would mean that other patients would have to wait longer to receive medical attention. Hiring a medical scribe can solve these bottlenecks.  

What are the benefits of virtual medical scribes over in-person medical scribes?

• Increased perception of privacy: studies have shown that patients may feel uncomfortable with an in-person and a doctor both present in a small examination room. Some patients may fear being judged by the extra person in the room. Using a virtual scribe who is not present in the room helps put the patient at ease when undergoing medical examination. This can help build a better relationship between the patient and the healthcare provider. 
• Reduction in functional creep: Functional creep refers to the process of increasing an employee’s responsibilities beyond the scope of their work—often unintentional.  In-person medical scribes tend to suffer from being given more responsibilities or asked to complete complex tasks beyond their scope. The degree of separation between a virtual medical scribe and a doctor minimizes cases of functional creep.
• Reduced training and expedited boarding time: One of the best elements of virtual scribes is that they are usually trained employees in reputable organizations and scribe networks. As such, they have a solid foundation on which they can build. That’s not usually the case with in-person scribes. Most on-site scribes have little training. There is a need to train them to get them up to speed on their tasks. 
• Virtual medical scribes are flexible: Given that they can work from any remote location, they are suitable options for medical practices in rural or secluded areas where it can be challenging to access on-site medical scribes. 
• Cost friendliness: Unlike on-site scribes who may require office spaces from where to operate, working with a virtual scribe relieves you of such obligations. . Also, virtual medical scribes are usually more affordable. They usually cost lower than in-person scribes.

What are the challenges of using medical scribes? 

Below are some of the demerits inherent from using medical scribes: 

• Lack of standardized training: Despite the scribing industry booming, standardized training is yet to be developed in this industry. While some third-party staffing companies have come up with internal training programs for medical scribes, these programs receive little to no regulation from the federal government. Moreover, there is a wide variation in the level of experience between scribes. A recent study showed that while 22% of medical scribes have received some form of certification, 44% have no previous experience. 
• There are cases of inaccurate documentation: It’s not always every day that you get efficient medical documentation from scribes. There are instances that you might get erroneous data, especially if you are working with a novice scribe. As such, clinicians still have to review the notes that the scribe took down for any inconsistencies or erroneous medical assessment. Remember, false medical documentation can lead to medical practitioners incurring legal liabilities. 
• Cost: Despite a virtual scribe being less costly than an in-person scribe, you will still have to fork out at least $1200 per doctor every month. 
• High turnover rates: Given that the scribing industry is mainly occupied by students entering medical school to get experience, this industry is plagued by a high turnover rate. As such, medical institutions incur additional costs on replacement and onboarding. 

While medical scribes play a massive part in improving the efficiency of delivering medical services and reducing the documentation baggage, voice recognition and smart documentation solutions have made even further strides in improving service delivery and documentation in this industry.  Here are some of the ways it has solved the challenges of medical scribes: 

• It is faster: Since most people speak faster than they write, AI-powered speech recognition software provides doctors with a simple way to get words into documents without any delays in the process. As a result, it helps improve their productivity. 
• It is relatively accurate: It reduces that gap between care recording and care delivery. In doing so, it helps ensure that clinical and health documentation match more accurately. The clinical handoff means fewer errors on the medical documents.  
• It’s flexible: You can access the voice recognition software from pretty much anywhere. As such, whether your health institution is in a metropolis or a rural area, you can depend on this software to help you undertake your tasks efficiently. Also, this software is suitable for users who may have any physical disabilities that hinder them from typing. 

Are there any alternatives to using medical scribes? 

Scribes, whether physically present or not, can be expensive and not every clinician or their administrator will be willing to pay the average $25 per hour rate that they usually cost. A viable alternative solution is the use of dictation and dot phrases. This approach is relatively inexpensive and simpler to implement.

The use of speech-to-text technologies and standardized note templates can enhance electronic medical record documentation by improving the accuracy and quality of the clinical note. It can also reduce errors and cut back on editing time. Clinicians often have to spend at least a few minutes reviewing and editing the scribe’s documentation. Moreover, a good note should also capture the clinical judgment that justifies the clinician’s decision making. Something that it’s hard to communicate to a scribe that is passively listening to the doctor-patient interaction.

Chartnote is revolutionizing medical documentation by making voice recognition and thousands of templates available to medical practitioners. We know that treating patients while taking notes can be a daunting task. That’s why we’ve developed medical speech recognition software that helps doctors automate documentation and deliver better quality services. Visit our website today for more information.

Do you use a scribe? Share your experience by commenting below.

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About Chartnote

Chartnote is revolutionizing medical documentation one note at a time by making voice-recognition and thousands of templates available to any clinician. We know first-hand that completing notes while treating patients is time-consuming and an epic challenge. Chartnote was developed as a complementary EHR solution to write your SOAP notes faster. Focus on what matters most. Sign up for a free account: chartnote.com

Posted on: June 4, 2021, by : Gerardo Guerra Bonilla