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Using Scribes to Decrease Clerical Burden

Series One: Electronic Health Records

Scribes — individuals trained to enter data into the EHR in real time with physician review — can decrease physician burnout caused by EHR-associated clerical burden.

A recent study of the effects of scribes on physician burnout, published in the Journal of the American Board of Family Medicine, found that scribes:

  • Decreased administrative burden by decreasing charting time
  • Increased joy in practice by decreasing feelings of isolation and the stress associated with data entry
  • Generally increased the quality of documentation
  • Allowed physicians to focus more on the patients’ nonverbal cues during more natural conversation, without the intrusion of data entry.

Team Documentation

The AMA StepsForward module on team documentation is a multimedia tool kit organized around eight steps. Its goal is to help medical practices select a scribe model, train staff and continue to evolve the team documentation approach.

Virtual Scribes

Virtual scribes may also be an option. A virtual scribe may enter information into the EHR in real time from a remote location, or may enter data into the EHR from a patient encounter recorded at an earlier time.

Patient Acceptance of Remote Scribing Powered by Google Glass in Outpatient Dermatology: Cross-Sectional Study
This journal article describes one clinic’s experience with remote scribing via Google Glass. By connecting clinicians to remote medical scribes during patient visits, it enabled real-time documentation in the EHR in order to reduce burnout.

Digital Scribes

Taking virtual scribes one step further, systems that automatically transcribe physician-patient conversations are being developed. Speech recognition programs for EHR have been traditionally limited to transcribing one person’s voice. These systems transcribe conversations between the physician and patient, and then machine learning tools enter the information into the EHR.

Speech Recognition for Medical Conversations
This article discusses the development of an automatic speech recognition model for transcribing doctor patient conversations. 

Return on Investment for Scribes

Administrators may initially believe that hiring a scribe is too expensive. However, the return on investment for a medical scribe is generally positive due to increased productivity. The ROI calculation does not even take into account the value of increased accuracy in data entry, potential for increased patient satisfaction with the overall encounter, and decreased clerical burden on physicians.

Stop Physician Burnout — How to Get a Scribe — The Claw Back Method
This article describes step-by-step instructions for asking administrators to authorize a scribe.

Primary Care Scribes: Writing a New Story for Safety Net Clinics
This article describes a scribe program using trained volunteers.