January 23, 2018 Owen Carey

Scribes Reduce EHR Use, Restore Joy of Practice for Physicians

A recent study by Sattler et al. found integrating scribes into primary care clinics can reduce administrative burden associated with EHR use, improve levels of physician satisfaction, and allow for higher quality care.

Beginning in 2015, researchers collected data from four physicians working with two scribes at a single academic family medicine practice using an Epic EHR system. Over a one-year period, researchers administered surveys measuring the effects of medical scribes on physicians’ daily workload, attitudes, behaviors, and relationships with patients. Participating physicians submitted a total of 361 open-ended reflections about their experiences after four-hour clinic sessions with patients. 

Ultimately, physicians reported scribes had a positive effect on quality of care, patient experience, and clinical operations. Additionally, utilizing medical scribes in primary care clinics benefitted patient experience and restored some of the joy of practice for physicians.

Presently, widespread EHR use and time-consuming clinical documentation are contributing to rising rates of physician burnout.

“A major contributor to burnout among physicians is growing workload outside of the examination room,” wrote researchers. “For every hour physicians spent in direct contact with patients, 2 more hours are spent on electronic health record (EHR) and desk work.”

Integrating scribes into primary care clinics could help to lessen the negative impact of universal EHR use and data entry, researchers suggested.

“The popularity of scribes in the United States has risen sharply recently, and at least 22 companies are recruiting, training, and providing scribes to physicians,” stated researchers. “The number of scribes has been doubling annually; it is estimated that by 2020, there will be 100,000 scribes in the United States, or one scribe for every nine physicians.”

Physicians reported scribes had a largely positive effect on charting efficiency, clinical operations, EHR use, and non-patient-facing-work. However, some physicians did submit negative feedback about operational inefficiencies or dissatisfaction with EHR systems that were unrelated to scribes.

Specifically, scribes helped to improve charting quality and accuracy, as well as the interpersonal connection between providers and patients.  Additionally, physicians described the partnership with their scribe as having a great psychological benefit that helped reduce feelings of isolation.

“Providers rediscovered a joy in practice as a result of working with scribes,” wrote researchers. “They frequently had a healthier perspective going into work and a more relaxed attitude when clinic hours were over because they were less mentally burdened by the thought of charting.”

Some providers also preferred having scribes in the room during sensitive conversations so they could give patients their undivided attention. Utilizing scribes also allowed physicians to pick up on patients’ nonverbal cues.

“Providers reported that they could spend more time on interpersonal subtleties when a scribe was present in the examination room,” researchers stated.

“In particular certain communication challenges – for example, patient encounters performed in another language by a bilingual provider and conversations that involved complex family dynamics – were easier to navigate when the scribe was present, allowing the physician to focus on the conversation,” the research team continued.

Researchers stated past studies have positioned utilizing scribes primarily as a way to increase the volume of patients physicians can see per day by reducing EHR clinical documentation. However, the research team suggested scribes could improve clinical operations and restore the joy of practice for physicians.

This study follows previous research tying the use of medical scribes for EHR documentation to improvements in physician satisfaction. One study published in the Annals of Family Medicine also linked scribes to reducing the likelihood of physician burnout.

While several studies have shown the value of utilizing scribes as a way to improve physician satisfaction, scribes appear to have no affect on improving patient satisfaction.

This article originally appeared here.

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