An Analysis of Physician Productivity and Self-Sustaining Revenue Generation in a Free-Standing Emergency Department Medical Scribe Model

Brody Dawkins,Brandon R Allen,Michael Falgiani,J Adrian Tyndall,Komal N Bhagudas,Thomas F Payton,Marcelo E Guerra,Joshua Hurwitz

doi:10.1155/2015/518179

Abstract

Objectives. A free-standing emergency department (FSED) is a facility that provides comprehensive emergency medical care similar to a traditional emergency department but is not attached to a hospital campus. Medical scribes are increasingly likely to work in free-standing emergency departments. The purpose of this study was to retrospectively investigate the benefits of a scribe program in an FSED. Methods. A retrospective, Institutional Review Board-approved analysis from December 1, 2013, to February 1, 2015, of free-standing emergency department medical data was extracted to determine if scribed charts resulted in increased revenue and improved throughput. Results. When scribes are present in the FSED there is a small, but statistically significant, decrease in time from patient arrival to provider by 2.74 minutes. Scribed charts collected $4.69 more per chart and resulted in an increase in productivity. Incremental cost effectiveness ratios resulted in proven cost-utility with a net-positive effect. Conclusion. While there are some gains in terms of operational metrics and provider productivity with the addition of scribes to a free-standing emergency department, there is a net-positive financial impact of scribes. Implementing a scribe program at a FSED is cost-effective and justified from both an operational and a financial analysis.

Highlights

Emergency departments (EDs) throughout the United States have been early adopters of electronic health records in efforts to increase the accuracy, availability, storage, and retrieval of health information in order to provide timely, effective, and efficient patient care
The aim of this study is to retrospectively investigate and quantify the value of a scribe program in a highly efficient free-standing emergency department (FSED)
During the study period, which comprised a total of 512 days, a scribe was present during the 11:00 a.m. to 9:00 p.m. time on 338 days (66% of the time)

Summary

Introduction

Emergency departments (EDs) throughout the United States have been early adopters of electronic health records in efforts to increase the accuracy, availability, storage, and retrieval of health information in order to provide timely, effective, and efficient patient care. In 2009, one of the key provisions of the American Recovery and Reinvestment Act was a mandate that all public and private health care providers and eligible professionals demonstrate meaningful use of electronic medical records (EMRs). This provision alone has spawned the rapid and widespread adoption of EMRs. there has been significant evidence demonstrating the benefits of a systematic approach to collecting and sharing health data on patient care quality outcomes, the EMR has so far proven to be less successful when considering the impact on a provider’s time, to the detriment of the patientprovider interaction [1]. A separate study sponsored by the American College of Emergency Physicians showed that about half of an emergency medicine physicians’ time is spent on indirect patient care activities [3]

Objectives

Methods

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Conclusion