Many hospitals, and some larger medical practices, have been using scribes to capture medical documentation within EMRs — leaving the provider free to make old-fashioned eye contact with patients.
Using the scribe might sound like a crude workaround to techies, but it’s been a hit with emergency department doctors, who prefer to focus on their brief, critical encounters with patients rather than the hospital’s expensive toy.
While it was clear from the outset that doctors loved having a scribe to support them, there’s been scant evidence that the scribe was anything other than an added cost.
A recent study, however, has concluded that at least from a Case Mix Index standpoint, scribes can have a meaningful impact on a hospital’s revenue. The study, which evaluated the use of scribes between 2012 and 2014 across a group of hospitals, concluded that the scribes save money and boost patient-doctor communication.
The study, which was designed to capture the impact of medical scribes on a hospital’s CMI, linked Best Practices Inpatient Care Ltd. with Advocate Good Shepherd Hospital, Advocate Condell Medical Center and hospitalist-specific medical scribes from ScribeAmerica LLC.
Kicking things off to a good start, ScribeAmerica and Best Practices put scribes through a jointly-developed course that emphasized workflow, productivity and accurate inpatient documentation. The researchers then tallied the results of using trained scribes over a two-year period in the two hospitals.
From 2012 to 2014, researchers found that for both Advocate Condell Medical Center and Advocate Good Shepherd Hospital, CMI values climbed after medical scribes came on board. Advocate Good Shepherd’s CMI grew by .26 and Condell Medical’s CMI rose .28. These are pretty significant numbers given that a CMI growth of 0.1% typically translates to a gain of about $4,500 per patient. In this case, the hospitals gained roughly $12,000 per patient.
These findings make sense when you consider that using scribes seems to have served its purpose, which is to be extenders for providers who’d otherwise be hunched over an EMR screen.
Researchers found that inpatient physicians at the two hospitals studied were able to cut time spent on chart updates by about 10 minutes per patient on average. This profit-building effect is enhanced by the fact that scribes often get discharge summaries prepared immediately, rather than within 72 hours as is often the case in other hospitals.
That being said, it should be noted that the study we’ve summarized here was co-written by the CEO of Best Practices, which clearly invested a lot of time and effort training the scribes for the specific tasks important to the study.
Still, the study does suggest, at minimum, that scribes need not necessarily be written off as an expense, given their capacity for freeing providers for billable clinical activity. Ideally, IT vendors will develop an EMR that doctors actually want to use and don’t need an intermediary to work with effectively. But until that happy day arrives, scribes seem like they can make a difference.