- A new study by researchers at Kaiser Permanente Northern California adds weight to the argument for using medical scribes to reduce reporting burden and physician burnout.
- Researchers analyzed use of scribes by 18 primary care doctors at two medical centers over a 12-month period in 2016 and 2017. The doctors were randomly assigned to use or not use scribes for the first three months and then alternated back and forth at three-month intervals for the duration of the study.
- During periods when scribes were used, doctors reported less after-hours EHR documentation (under an hour during the week and on weekends). They also reported a significant uptick in time spent interacting with patients — 85% spent more than 75% of visits focused on patients, versus 13% when scribes were not used. Also, doctors were more likely to finish documenting the encounter by the end of the day.
The report comes as CMS has promised to work with providers to reduce reporting burden, which is seen as an increasing liability with the looming doctor shortage. Nearly two-thirds of U.S. physicians in a Medscape survey reported feeling burned out, depressed or both, and 33% said those feelings affected interactions with patients. Those with the highest rates of burnout were family physicians and internists.
Scribes, essentially human note-takers for doctors, are one possible answer to this problem.
At the same time, a number of companies are also leveraging voice recognition technologies to streamline dictation work. A recent Epic and Nuance Communications partnership aims to help doctors retrieve schedules and look up patient information via voice-activated EHRs. And Google is teaming with Stanford Medical to assess AI and voice recognition in generating EHRs, with a focus on physician note taking.
The latest study showed that patients came out ahead as well when scribes were used, with more than six in 10 saying scribes had a positive impact on their visit.
In a follow-up survey, 88% of PCPs said they liked their scribe experience and 65% said they would be willing to take on additional patients in exchange for a full-time scribe. Of the six who were not willing to expand their panels, four already exceeded the practice limit, according to the study. It was published online in JAMA Internal Medicine.
"Our results suggest that the use of scribes may be one strategy to mitigate the increasing EHR documentation burden among PCPs, who are at the highest risk of burnout among physicians," the authors wrote. "Although scribes do not obviate the need for improving suboptimal EHR designs, they may help alleviate some of the deficiencies of currently implemented EHRs."