Medical Scribe Impact on Provider Efficiency in Outpatient Radiation Oncology Clinics Before and During the COVID-19 Pandemic

Abstract

Purpose/Objective(s)Medical documentation has become increasingly challenging for providers, particularly with time constraints and changes to office visit formats during the ongoing COVID-19 pandemic. Medical scribes may help mitigate this burden. Our objective was to determine how scribes affect provider workflow efficiency during the COVID-19 pandemic compared to pre-pandemic controls.Materials/MethodsProviders completed a survey in February 2020 (S1, pre-pandemic) and one year into the COVID-19 pandemic in February 2021 (S2, during-pandemic). Standardized surveys administered during S1 evaluated perceived impact of scribes on clerical work, medical documentation, and efficiency during office visits using the Likert Scale. Surveys administered during S2 also addressed scribe use during telemedicine visits, in addition to office visits. Provider perception of time spent on documentation with or without a scribe was evaluated using a 5-level ordinal scale. Provider response was assessed using descriptive frequency statistics. Fisher's exact test was used to compare categorical variables. Analysis was performed using SAS version 9.4 (SAS Institute Inc, Cary, NC). All tests were two-sided with an alpha level of 0.05.ResultsFifty-eight providers responded to the surveys: 36 (62%) for S1, 22 (38%) for S2. Scribe use decreased perceived clerical work, facilitated chart review, recording of physical exam findings, note documentation and improved efficiency, both before and during the pandemic (P = 0.5, P = 0.7, P = 0.8, P = 0.8, P = 0.9 respectively). Scribe use significantly decreased perceived time to complete documentation pre-pandemic (P = 0.002) and during the pandemic for both in person (P = < 0.0001) and telemedicine visits (P = 0.0004). More providers took over 60 minutes to complete medical documentation without the use of a scribe pre-pandemic (72% versus 30% with a scribe, P = 0.006) and during the pandemic, for both in person (40% versus 0% with a scribe, P = 0.002) and telemedicine visits (35% versus 0% with a scribe, P = 0.002). Even with increased telemedicine visits during the pandemic, 17 (77%) providers strongly agreed that scribe use decreased their daily clerical work and improved efficiency and 18 (82%) strongly agreed scribes were just as helpful during telemedicine visits as during in person visits.ConclusionScribe use decreases provider time spent on medical documentation and improves overall efficiency. This improvement in clinical efficiency was similar before and during the COVID-19 pandemic for both in person and telemedicine clinic visits. Integration of scribes into radiation oncology clinics may improve provider satisfaction by reducing burden of documentation and may improve provider well-being.