One of the limiting factors when it comes to EMR systems is that it requires some amount of training to use an EMR system. Doctors are in the habit of writing down notes, or dictating them into dictaphones for transcribing later. So the idea of an EMR system that requires typed input can easily face some resistance, just based on the process change it requires. And hence the rise of a new class of health IT worker – the scribe.
Having a scribe taking notes at hand would’ve seriously helped me like my doctor better at my last appointment. This was someone whom I was meeting on account of a referral – I didn’t already have an established relationship with the doctor. The doctor and an assistant spent about a third of their time figuring out how to enter my scans into the EMR system. I don’t know what was at fault – the newly acquired iPad or an EMR they didn’t know how to use. They were effusive with their apologies but I couldn’t help feeling that I got the short end of the stick when the doc rushed through the rest of my visit and quickly ushered me out. A competent scribe, well versed in their EMR of choice, might have really helped.
There have been a slew of articles about the rise of scribes in health IT. They started sounding really promising to me, especially when I considered how one could tail a doctor on his/her rounds with patients, and gain some insight into the business of being a doctor from the ground up. I checked out a couple of companies (ScribeAmerica, EM Scribe Systems) that train medical scribes and source them out to ERs. EM Scribe Systems’ application form states that it requires a one or two year commitment, wants to know what your future med school plans are. The pay anywhere is between $8-$16/hour (scroll to the bottom of the page). The higher end of that range gets paid with scribe experience.
(Seriously? If medical transcription can be outsourced to India and Philippines, why set the bar so high for medical scribe jobs? Or alternatively, if the bar is so high, why not pay better?)
I guess the pre-med scribes are approaching it from a different aspect – the real payback for them comes from understanding the medical aspect. The EMR system is merely a tool to an end.