Effect of Medical Scribes on Outpatient Oncology Visits at a Multidisciplinary Cancer Center

Abstract

PURPOSE: The use of medical scribes has emerged as a strategy to increase clinic workflow efficiency and reduce physician burnout. While oncology clinics may be ideally suited to scribe integration because of the high burden of documentation, oncology-specific scribe research has been limited. The objective of this study was to determine the effect of scribe integration on clinic workflow efficiency and physician satisfaction and quality of life in outpatient oncology clinics. METHODS: We conducted a retrospective, concurrent qualitative and quantitative analysis of patient visit durations and survey data for 129 attending physicians affiliated with an academic hospital’s cancer center between January 2017 and January 2019. Thirty-three physicians were paired with scribes in each physician’s individual clinic or clinics. RESULTS: In terms of clinic efficiency, physicians with scribes had a 12.1% decrease in their overall average patient visit duration compared with their own time before receiving a scribe ( P < .0001) and spent significantly less time completing charts at the end of the day ( P = .04). Compared with their peers, oncologists with scribes showed a 10%-20% decrease in the duration of all patient visits. Scribes also contributed to patient care, as shown by 90% of physicians surveyed who strongly agreed that they spent less time at the computer and more time with patients; 100% of physicians surveyed strongly agreed that scribes improved their quality of life. CONCLUSION: The integration of medical scribes into oncology clinics across several oncologic disciplines has the potential to reduce burnout through increasing physician satisfaction and quality of life, improving patient care, and streamlining clinic workflow.

Effect of Medical Scribes on Throughput, Revenue, and Patient and Provider Satisfaction: A Systematic Review and Meta-analysis

“…15,16,28,30,[32][33][34]39,50 Of these 9 studies, 7 of them 15,16,28,[32][33][34]50 reported higher provider satisfaction with a scribe, whereas 2 of 9 studies 30,39 reported no difference. Seven studies 18,20,23,36,45,49,51 reported provider satisfaction specifically with scribes without a comparator, and all results were supportive of scribes.…”

“…Thirty-nine studies were included, comprising greater than 562,682 patient encounters (Table E1, available online at http://www.annemergmed.com). Five studies were randomized controlled trials, [15][16][17][18][19] 23 studies were prospective nonrandomized studies, 10 studies were retrospective, [43][44][45][46][47][48][49][50][51][52] and 1 study had both prospective and retrospective components. 53 All studies were published between 2010 and 2020.…”

“…Most studies were conducted in the United States, [15][16][17][18]21,23,24,[26][27][28][29][30][32][33][34][35][36][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][53] with 4 conducted in Australia 19,22,25,42 and 2 performed in Canada. 20,31 Nineteen studies were conducted in EDs, 17,19,20,[22][23][24][25][26][27]31,36,38,[42]<...>…”

“…The sensitivity analysis with only prospective studies found similar results (mean difference 3.93 minutes; 95% CI -2.48 to 10.33 minutes). In 7 studies taking place in a clinic setting, 18,29,37,41,48,51,53 length of stay was shortened from 32.06 to 26.32 minutes with a scribe (mean difference 5.74 minutes; 95% CI 0.42 to 11.05 minutes) (Figure E2, available online at http://www.annemergmed. com).…”

Health Resource and Cost Savings Achieved in a Multidisciplinary Lung Cancer Clinic

“…Productivity loss was calculated based on an income loss of CAD 29.55/hour [28] over the time calculated for an average clinic visit [29], return travel time, and estimate of time for parking and finding the clinic (2.53 h). Productivity loss was only evaluated for patients <65 years old, comprising 23% of MDC patients (79/350) [30,31].…”