Incorporation of Scribes Into the Inflammatory Bowel Disease Clinic Improves Quality of Care and Physician Productivity

Abstract

The use of scribes improved the physician-patient relationship, clinical efficiency, physician productivity, bone density screening, and vaccinations for flu and pneumonia. If adopted by health systems, it may lead to significant cost savings and improved clinical outcomes.

Effect of Medical Scribes on Throughput, Revenue, and Patient and Provider Satisfaction: A Systematic Review and Meta-analysis

“…Thirty-nine studies were included, comprising greater than 562,682 patient encounters (Table E1, available online at http://www.annemergmed.com). Five studies were randomized controlled trials, [15][16][17][18][19] 23 studies were prospective nonrandomized studies, 10 studies were retrospective, [43][44][45][46][47][48][49][50][51][52] and 1 study had both prospective and retrospective components. 53 All studies were published between 2010 and 2020.…”

“…Most studies were conducted in the United States, [15][16][17][18]21,23,24,[26][27][28][29][30][32][33][34][35][36][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][53] with 4 conducted in Australia 19,22,25,42 and 2 performed in Canada. 20,31 Nineteen studies were conducted in EDs, 17,19,20,[22][23][24][25][26][27]31,36,38,[42]<...>…”

The Impact of Medical Scribes on Patient Satisfaction in an Academic Otolaryngology Clinic

“…[8][9][10][11][12][13][14] However, one study in the ED reported a quantitative increase in patient reported satisfaction after implementation of a scribe program, 15 as has a small study in an inflammatory bowel disease clinic. 16 Only one study by Martel et al found a small but significant decrease in patient satisfaction after scribes were introduced in multiple clinics in a safety net hospital. 17 Unfortunately, the heterogeneity between different studies' survey methods limits the conclusions that can be drawn and has prevented meta-analysis of this question 18,19 (Table 1).…”

“…It is interesting that studies have generally found no improvement in patient reported satisfaction despite physicians reporting increased face-to-face time and better quality of interactions with scribes. 16,17,20,21 Two additional studies placed independent raters in the visit, who also reported improvements in provider-patient interactions with a scribe. 22,23 The patient-provider discrepancy could possibly be due to the benefit of improved face-to-face communication being offset by patient discomfort with room crowding.…”

“…There is consistent evidence that scribes increase a physicians' work relative value units (wRVUs), an important measure of productivity that determines reimbursement. 11,12,14,16,[22][23][24] Additionally, scribes decrease the time physicians spend documenting, both in and after the visit. 10,12,17,24,25 While the primary satisfaction focus of this study was the effect of scribes on patient satisfaction, the Press Ganey does also ask two questions relating to patient wait times, which can be thought of as a patient-centered measure of efficiency: was the patient seen in under 15 minutes; and how satisfied were patients with their wait time.…”