How medical scribes reduce healthcare workflow burnout


It used to look so easy on television. Dr. Welby would hand over some cryptic notes to his trusted nurse/office assistant Consuelo Lopez to put into a color-coded manila folder among the record room’s many file stacks.

Fast forward to 2018, when laws require the physician to enter notes into an electronic health record (EHR) or electronic medical record (EMR) system. Gone are the days of appending a record by passing along a Post-it Note to the nursing staff.

The requirement to populate EHR systems with current patient data seems perfectly logical, and from the patient’s view seems absolutely critical. However, the implications of such a seemingly simple task have seismic proportions within most healthcare systems.

Simply stated, it comes down to the eternal battle of quality time with patients versus clerical time with technology. The requirement to enter vast amounts of data into patient records has put incredible pressure on physicians, many of whom have an already strained relationship with record-keeping technology. Not only are doctors frustrated, but the incidence of burnout is at a record high in an industry where there is no surplus of physicians to begin with. Further compounding the pressure is the movement from an “all-you-can-eat” healthcare delivery model to a “pay-for-performance” model where value-based care is king.

So from the physician’s point of view, the data he or she enters is not only documenting the care delivered, but also acting as a “big brother” to scrutinize the reimbursable costs of that care to the patient, and more importantly, to the contribution to the healthcare enterprise’s bottom line.

Technology can cause and solve many problems, but sometimes going totally retro may be the only way to get things done. In this case, the solution — the re-emergence of the scribe in clinical settings — goes back centuries.

Medical scribes, also known as documentation assistants, are the real-time bridge between the physician and the EHR. There’s really no way to glamorize what scribes do, yet their positive contribution to both the clinical workflow and the emotional well-being of the physician is significant.

The use of scribes does not come without critics. Many administrators question the ability of scribes to accurately translate complex medical and pharmaceutical terms on the fly for real-time entry into the EHR platform. This adds additional pressure on the physician, given they now need to worry about the accuracy of data and the management of the scribe who enters it.

The good news is that convergence of voice-enabled technology as the 21st century documentation assistant appears to have arrived. Dozens of new startups are developing voice-enabled applications that not only record the clinical engagement, but also add an artificial intelligence element to the documentation. Some of these scribe technologies are able to analyze the unstructured data and offer suggestions for other questions or procedures that may be warranted in the patient engagement.

Most agree that voice tech will be a game changer in the world of scribing. However, anyone who has used foreign language translation software knows that there will always be the requirement for human intervention before you would totally trust the output. Many would argue that healthcare terminology may be even more complex than a foreign language, so there will be some anxiety in the short term, especially if the information is going to another clinician.

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