Background: Understanding how medical scribes impact care delivery can inform decision-makers who must balance the cost of hiring scribes with their contribution to alleviating clinician burden.Objective: The objective of this study was to understand how scribes impacted provider efficiency and satisfaction.Design: This was mixed-methods study.Participants: Internal and family medicine clinicians were included.Measures: We administered structured surveys and conducted unstructured interviews with clinicians who adopted scribes. We collected average days to close charts and quantity of after-hours clinical work in the 6 months before and after implementation using electronic health record data. We conducted a difference in difference (DID) analysis using a multilevel Poisson regression.Results: Three themes emerged from the interviews: (1) charting time is less after training; (2) clinicians wanted to continue working with scribes; and (3) scribes did not reduce the overall inbox burden. In the 6-month survey, 76% of clinicians endorsed that working with a scribe improved work satisfaction versus 50% at 1 month. After implementation, days to chart closure decreased [DID = 0.38 fewer days; 95% confidence interval (CI): −0.61, −0.15] the average minutes worked after hours on clinic days decreased (DID = −11.5 min/ d; 95% CI: −13.1, −9.9) as did minutes worked on nonclinical days (DID = −24.9 min/d; 95% CI: −28.1, −21.7).Conclusions: Working with scribes was associated with reduced time to close charts and reduced time using the electronic health record, markers of efficiency. Increased satisfaction accrued once scribes had experience.

Background: With an aging population, cognitive impairment has become increasingly prevalent. Early symptoms are often missed in primary care and may progress to clinical dementia before being noticed. Screening for dementia has been a challenge.No clear guideline describes how to assess for cognition in primary care despite the robust data suggesting that early identification of dementia allows for mobilization of resources to support patients and caregivers, and there is no harm in proactive assessing cognition in older patients. In addition, most of the cognitive assessment methods requires in-person cognitive testing in primary care practices, this may be affected by situations where the in-person visitations to the physician offices are limited such as in the COVID 19 pandemic. Our study aims to access performance of in-person cognitive assessment in primary care during COVID 19 pandemic.Methods: Cleveland Clinic implanted MiniCog as a cognitive screening tool in primary care at Cleveland Clinic Community Care (4C). Inclusion criteria are-Age 65+, Annual Wellness visit, no preexisting diagnosis of dementia, normal MiniCog in previous year.