Medical scribes have positive impact on workflow

Some clinicians are turning to medical scribes to reduce the time they spend managing electronic health records. In fact, incorporating medical scribes into surgical practice increases the number of patients seen, according to research presented this week at Clinical Congress.

“We wanted to quantify how scribes could benefit patient care in surgical practice. While often employed by physicians in nonsurgical specialties, scribes are rarely seen in surgical outpatient clinics,” said lead author Sirivan S. Seng, MD, resident physician, Crozer-Chester Medical Center, Upland, PA. “Scribes allow surgeons to focus on patient interactions while maintaining accurate documentation of their conversations with patients.”

The aim of the pilot study was to evaluate the effect of scribes on the workflow of two attending surgeons at an outpatient surgical oncology practice at Loma Linda University Medical Center, CA. Dr. Seng and colleagues reviewed outpatient clinic records and compared various metrics before and after medical scribes were introduced into a surgical practice. They looked at the number of operations scheduled, medications prescribed, patient wait time, time spent charting, and the number of patients seen per day.

Over four months, a total of 335 clinical encounters occurred, 183 without scribes and 202 with medical scribes. The average number of patients seen per day increased from 10 to 16 when assisted by a scribe. Study results also showed better resident interactions. Resident involvement in patient visits increased from 34 percent to 45 percent when assisted by a scribe.

“Our main finding was that medical scribes increased the number of patients seen per day and resident contact with patients in the clinic,” Dr. Seng said.

At the same time, the level of complexity of the patients seen remained the same, the researchers found, as the study showed no significant differences in medications prescribed, orders placed, cases scheduled, or length of office visits.

Furthermore, average patient wait times were similar, approximately 30 minutes with or without the use of a scribe. Times to completion and closure of charts were shorter, but not significantly so. Dr. Seng said the reason the scribes did not lead to significant improvements in productivity may be attributable to the relatively small sample size at the time of the analysis.

“I think it’s really important, from a resident perspective, that medical scribes become incorporated into the surgical practice. Not only does it benefit the attending physician, but it also benefits the resident and the patient. We are all here for our patients, and we want to be able to give our full time, focus, and energy to them,” Dr. Seng said.

“The use of scribes could be one of the great tools that enhances physician-patient encounters and improves surgeon workflow,” she concluded.

Study coauthors are Jenny H. 
Chang; Kirollos Malek, MD; Maheswari Senthil, MD, FACS; 
and Sharon S. Lum, MD, FACS.