The future of medical scribes documenting in the electronic health record: results of an expert consensus conference

Abstract

Background With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry. Methods The first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes. Results Threats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing. Conclusion Threats and opportunities for medical scribing were identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified.

Task shifting of medical office works: A preliminary questionnaire survey for generalists

“…First of all, overloading medical assistants beyond their capacity should be considered. 6,7 According to the present study, physicians are not willing to allow task shifting in all medical clerical tasks. Because the questionnaire did not ask about the factors that led them to each answer, it is still unclear why general physicians consider that ordering prescriptions and examinations, writing medical records and reply letters to referral physicians are chores that they should continue to perform on their own.…”

“…Thus, the reasons for the difficulties in shifting medical administrative jobs from physicians to medical assistants need to be discussed. First of all, overloading medical assistants beyond their capacity should be considered 6,7 . According to the present study, physicians are not willing to allow task shifting in all medical clerical tasks.…”

Assessment of the Relationship Between an Adverse Impact of Work on Physicians’ Personal Relationships and Unsolicited Patient Complaints

“…These may include improving efficiency in the practice environment to shorten the work day (eg, optimized patient rooming/checkout workflows, decreasing operating room turnaround times, and better team-based care), efforts to reduce after-hours electronic health records task burden through the use of documentation assistance (eg, team-based documentation, medical scribes, or artificial intelligence approaches) and optimized inbox management (eg, team-based inbox management or artificial intelligence approaches). [53][54][55][56] Careful attention to ensure equitable scheduling (ie, call schedule or weekend duty), providing coverage for time away, offering less than full-time work options, more optimal family leave policies, and increasing scheduling flexibility can also be helpful. [57][58][59][60][61] More creative approaches to provide assistance with home tasks to enable physicians to attend to high work demands and preserve time for personal relationships have also been reported.…”

Getting by With Less: How to do More With Less Staff After COVID-19?

“…Some of these cross-training solutions may be more feasible in private practices than in academic institutions but are worth considering. Another significant challenge for support staff and physicians is data entry into the electronic health record; numerous studies have demonstrated the benefits of incorporation of medical scribes into both private and academic practices (7)(8)(9). Finally, it will be imperative that institutions address parity for nurses and technicians so that their compensation is akin to operating room personnel (Table 1).…”