Abstract
BackgroundWith the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry.MethodsThe first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes.ResultsThreats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing.ConclusionThreats and opportunities for medical scribing were identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified.
Highlights
With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated
Changes in documentation that allow visits to be recorded with audio and/or video, and enable visits to be archived, would allow providers to review patient visits and revamp notes without the need for medical scribes
“there will be some interesting things like voice-to-text and that artificial intelligence could help us go through things and for example come up with a skeleton of the note which people could populate and that would probably be better than what we are doing today.”
Summary
With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. With the implementation of the HITECH Act, there has been a rapid development and use of electronic health records (EHRs) [1] This increased expansion in EHR use has been associated with several negative, unintended consequences. Documentation burden is substantial: provider notes in the United States (U.S.) are nearly four times longer than in other countries [3]. To combat these issues with the EHR, organizations have tried a variety of approaches from voice dictation to improved provider EHR training. Another widely adopted solution to EHR inefficiencies and provider burnout has been the incorporation of medical scribes into provider workflow [4]
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