Being a physician has always been busy with hectic work schedules. This holds true especially in the case of primary care physicians who aim at providing comprehensive care for patients. And, it’s no surprise that it’s the primary care physicians who suffer from excessive workloads and a high volume of clerical and administrative tasks, like EHR documentation. As a result, they work after clinic hours or on weekends to meet the documentation demands. High levels of EHR usability have been associated with physicians facing burnout at alarming levels. Fortunately, use of medical scribes in a primary care setting appears to be a viable solution to reduce documentation burden, relieve burnout, improve productivity and enhance job satisfaction.

Primary care providers spend more time documenting encounters than seeing patients

The EHR and the slew of administrative tasks have made primary care physicians spend more time working with papers than with patients. Charles R. D’Agostino, MD, an Internist in Howard, OH decided to analyze and investigate his life as a primary care provider. For this purpose he chose a simple and straight forward method. He documented the daily tasks that he performed in a typical workday, including time spent providing patient care and doing administrative paperwork. He started to collect data at 10 a.m. after completing his morning rounds and ended at 6 p.m. During the 8 hours of work he saw 18 patients, of which he spent 75 minutes doing paperwork during patient hours, 170 minutes doing paperwork during non-patient hours, and 225 minutes interacting with patients during patient hours. He concluded that he spent more time interacting with the computer than with his patients. No wonder, primary care providers are frustrated with the endless piles of paperwork they have to deal with on a daily basis and feel burnout the most.

Are medical scribes a solution?

JAMA Internal Medicine published a crossover study that was conducted from July 1, 2016 to June 30, 2017 in two medical facilities and included 18 primary care physicians. For the first three months the primary care physicians were asked to start with or without medical scribes and then switch status every three months of the year. At the end of each study period they were asked to complete a 6 questionnaire survey. Compared to non-scribed periods scribed periods were associated with less after-hours documentation, more than 75% of the visits interacting with patients, and less than 25% on computer. The study concluded that use of medical scribes in primary care practices resulted in reduced EHR burden, improved work efficiency and better interactions with patients. The study also strongly supports the use of medical scribes as a potential solution for improving clinic workflow and quality of patient visits in a primary care facility.

Study to evaluate physician productivity, face-to face time and patient comfort levels with scribes

A prospective observational study was conducted at an urban primary care clinic. Medical scribes accompanied physicians during patient visits and documented patient encounters. They added an extra 20-minute patient slot for every 200 minutes of the session after a preliminary phase-in period. Utilizing information from the EHR on the number of patients seen and work RVUs per hour, they analyzed productivity. It was observed that work RVUs per hour increased by 10.5% and patients seen per hour increased by 8.8% post scribe implementation. Time spent facing the patients increased by 57% and the time spent entering data into the EHRs decreased by 27%. Time spent interacting and gathering information from patients increased by 39% and 69% of the patients felt comfortable with the scribe’s presence in the exam room. This study concluded that using medical scribes in a primary care practice appeared to be a promising strategy.

Impact of remote scribes on primary care physicians’ wellness, EHR satisfaction, and EHR use

ScienceDirect journal published an article about a non-randomized controlled study that was performed to evaluate a scribe program among PCPs at the University of Wisconsin Health. Remote scribes joined visits via an audio-only cellphone connection to listen to and document patient encounters in real-time. It was observed that providing remote scribes to help primary care physicians in documenting visits in real-time showed significant improvements in physician wellness and reduced EHR time. The use of remote scribes was also found to be useful in reducing physician burnout. However, scribe intervention did not have a noticeable impact on PCP’s satisfaction with EHRs.

Incorporating scribes into your primary care practice can help document patient encounters in real-time directly into your EHRs. By significantly reducing EHR documentation burden, physician productivity is increased, patient interactions are improved and physician job satisfaction is enhanced. Well, if you are a primary care provider and looking to ease your EHR documentation burden get in touch with Scribe4Me, today. We have a solution for your documentation woes!

How Scribes Can Help Primary Care physicians? Authored by Kevin Miller

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