The introduction of electronic medical records (EMR) into medical practices has occasionally—in some cases, frequently—resulted in frustration and complaints from physicians. Many of these frustrations center around EMR interference with patient interaction and the extra time needed to complete charting.
Explore this issue:October 2014
Enter the scribes. These individuals, who usually have at least some medical background, work under the direction of the physician to perform the data entry and management associated with charting.
“Scribing is not listening to what the doctor says and writing it down; that could be done with voice recognition software,” said Sidney Lipman, MD, a private practice physician with ENT
Specialists in Erie, Penn. “We like to call our scribes “data management specialists” because only a human can effectively manage data at the level we need. They are managing the entire realm of data in the patient’s EMR.”
Current EMRs are heavily templated, making pure narrative charting no longer viable. In addition, test results and old notes are spread out over the computer instead of located in specific sections of the paper chart. Scribes can typically find this information faster, and for less money, than physicians can. “Would you pay a doctor’s wage of $240 an hour to have someone type and click information into an EMR?” asked Asfer Shariff, MD, with ENT Physicians, Inc., in Toledo, Ohio. “You don’t see radiologists operating their own CT scanners; they have technicians so their mental energies are devoted to interpreting data and managing the patient. By asking doctors to become data entry clerks, we are expending their energies incorrectly.”
Adding a scribe to a practice can make an impressive difference. Dr. Shariff, who also owns Physician’s Angels, a company that links offsite “virtual” scribes with physician practices, said he is seeing approximately $50,000 a year in increased profits per physician per year across multiple specialties with the addition of a scribe. Dr. Lipman’s group found revenue was up 32% within a few months.
Revenue enhancements may not be the most important outcome to the physician. Quality of life issues are often cited. “Doctors go home sooner because there’s no documentation to do after clinical hours,” said Cheryl Toth, practice leadership and implementation coach with KarenZupko and Associates in Chicago. “They don’t have to log in from home or stay at the office until 7 o’clock each night to complete their charting. Basically, when the clinic is done, the charts are pretty much finished and ready to be signed off.”