The Productivity Requirements of Implementing a Medical Scribe Program

Miksanek, Tyler J; Skandari, M. Reza; Ham, Sandra A.; Lee, Wei Wei; Press, Valerie G.; Brown, Marie T.; Laiteerapong, Neda

doi:10.7326/m20-0428

Cited by 15 publications

(15 citation statements)

References 30 publications

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“…In addition, persistent shedding virus is helpful in obtaining sample for further examination, like detecting variant of concern / interest or whole genome sequencing for phylogenetic analysis. Recent systematic reviews indicate comparable sensitivity and specificity of saliva specimen compared to nasopharyngeal specimens [ 13 , 14 ], supporting economic advantage and expansion of testing access. In our study, SARS-CoV-2 was detectable in 38.2% of saliva specimens and in 19.5% of the nasopharyngeal swabs.…”

Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 using qRT-PCR in saliva obtained from asymptomatic or mild COVID-19 patients, comparative analysis with matched nasopharyngeal samples

et al. 2021

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Objectives The accurate detection of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) is essential for the diagnosis of coronavirus disease 2019 (COVID-19). We compared the quantitative RT-PCR results between nasopharyngeal swabs and saliva specimens. Methods A COVID-19 outbreak occurred on a cruise ship at Nagasaki port, Japan. We obtained 123 nasopharyngeal swabs and saliva each from asymptomatic or mild patients in the late phase of infection. Results The intervals from the diagnosis to the sampling were 25.5 days for nasopharyngeal swabs and 28.9 days for saliva. The positive rate was 19.5% (24/123) for nasopharyngeal swabs and 38.2% (47/123) for saliva (P = 0.48). The quantified viral copies (mean ± SEM copies/5 μl) were 9.3±2.6 in nasopharyngeal swabs and 920±850 in saliva (P = 0.0006). Conclusions The advantages of saliva specimens include positive rate improvement and accurate viral load detection. Saliva may be used as a reliable sample for SARS-CoV-2 detection.

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Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 using qRT-PCR in saliva obtained from asymptomatic or mild COVID-19 patients, comparative analysis with matched nasopharyngeal samples

et al. 2021

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“…Reducing clinician salaries or increasing revenue are options to pay for scribes. 14,20 In some emergency departments, scribes have increased the number of patients seen per hour 21,22 and reduced charting time. 23 However, there is insufficient evidence to determine whether scribes are cost-effective.…”

Section: Discussionmentioning

confidence: 99%

Reduced Cognitive Burden and Increased Focus

Pfoh

Hong²,

Baranek

et al. 2022

Medical Care

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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.

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“… 33 A study examining the productivity requirements of implementing a medical scribe program found that in orthopaedic surgery an average of 2.78 additional visits per day and 1.80 additional new patients per day are needed to cover the cost of scribes. 34 …”

Section: Discussionmentioning

confidence: 99%