Do You Know What Your Scribe Did Last Spring? The Impact of COVID-19 on Medical Scribe Workflow

Abstract

Objective To understand the impact of the shift to virtual medicine induced by coronavirus disease 2019 (COVID-19) has had on the workflow of medical scribes. Design This is a prospective observational survey-based study. Setting This study was conducted at academic medical center in the United States. Participants Seventy-four scribes working in ambulatory practices within an academic medical center. Interventions All medical scribes received a survey assessing their workflow since beginning of COVID-19 restrictions. Primary and Secondary Outcomes To assess the current workflow of medical scribes since transition to virtual care. Secondary outcomes are to assess the equipment used and location of their new workflow. Results Fifty-seven scribes completed the survey. Overall 42% of scribes have transitioned to remote scribing with 97% serving as remote scribes for remote visits. This workflow is conducted at home and with personal equipment. Of those not working as scribes, 46% serve in preclinic support, with a wide range of EHR-related activities being reported. The remaining scribes have been either redeployed or furloughed. Conclusion The rapid transition to virtual care brought about by COVID-19 has resulted in a dramatic shift in scribe workflow with the adoption of a previously unreported workflow of remote scribing for virtual care. Additional work is now needed to ensure these new workflows are safe and effective and that scribes are trained to work in this new paradigm.

The Use of Medical Scribes in Primary Care Settings

“…Some practices have shifted to a virtual scribing model, where scribes document in-person or telemedicine visits from a remote location. 44 , 45 Many primary care practices, including CHCs, are furloughing staff. Reduced revenue due to drops in visit volume may also make it more difficult for practices to afford scribes in the foreseeable future.…”

The future of medical scribes documenting in the electronic health record: results of an expert consensus conference

“…In a quantitative study at a large academic hospital, the researchers reported that scribes have taken on some new roles due to COVID-19. Some scribes are doing pre-charting only, remote scribing for virtual visits, and remote scribing for traditional in person visits [ 35 ]. Due to redeployment, scribes are aiding in non-visit-related tasks like “working in the virtual help desk… check point staffing, and chart abstraction” [ 35 p 809 ].…”

“…Some scribes are doing pre-charting only, remote scribing for virtual visits, and remote scribing for traditional in person visits [ 35 ]. Due to redeployment, scribes are aiding in non-visit-related tasks like “working in the virtual help desk… check point staffing, and chart abstraction” [ 35 p 809 ]. This shows that the scribes’ role could expand to include activities not typically involved in scribing duties.…”

“…During the conference, it was noted that tele-scribing allowed providers who are doing in person or virtual patient encounters in remote or rural locations to still have access to scribes. With the pandemic, the push for tele-scribing has increased dramatically in not only rural areas, but also at larger academic hospitals [ 35 ]. There was an increase in scribes who were doing tele-scribing, regardless of whether the provider and/or patient were remote as well [ 35 ].…”

“…With the pandemic, the push for tele-scribing has increased dramatically in not only rural areas, but also at larger academic hospitals [ 35 ]. There was an increase in scribes who were doing tele-scribing, regardless of whether the provider and/or patient were remote as well [ 35 ]. Another study showed that because of the COVID-19 pandemic, an otolaryngology clinic went to tele-medicine and therefore their scribes went to tele-scribing [ 36 ].…”