Use of Scribes for Documentation Assistance in Rheumatology and Endocrinology Clinics: Impact on Clinic Workflow and Patient and Physician Satisfaction.

Abstract

The aim of this study was to examine the impact of utilizing medical scribes on clinic workflow, physician professional satisfaction, and patient satisfaction in rheumatology and endocrinology clinics. We conducted a within-practice pilot study of medical scribes that included a 6-week intervention phase (documentation assistance by medical scribes) followed by a control phase (usual documentation with no assistance) in outpatient rheumatology and endocrinology clinics at an academic medical center. We evaluated the following outcomes: physician professional satisfaction (range, 5-25, with higher values denoting higher satisfaction), autonomy (range, 4-16, with higher values denoting higher autonomy), perception of clinic workflow (range, 1 = calm, 5 = chaotic), and patient satisfaction (5-point Likert item, anchors: strongly agree, strongly disagree). Six physicians, including 3 rheumatologists and 3 endocrinologists, and 496 patients nested within their practices participated. The use of a medical scribe was not associated with physician professional satisfaction (18.17 [SD, 2.9] vs. 17.83 [SD, 1.94], not statistically significant), perception of clinic workflow (2.50 [SD, 0.84] vs. 3.17 [SD, 0.75], not statistically significant), or autonomy (8.67 [SD, 3.44] vs. 8.83 [SD, 3.06], not statistically significant). Physicians had an overall favorable view of the medical scribes program and perceived that documentation support provided by scribes was useful and easy to use and had a positive impact on their clinic workflow. Patient satisfaction was high during the intervention phase (99.4% strongly agree/agree) but not significantly different than in the control phase. Rheumatologists, endocrinologists, and their patients had consistently positive views regarding the use of a medical scribe without an observed negative effect on clinic workflow in outpatient clinics.