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Scribes ease physician administrative burden and boost patient experience, JAMA study says

New research shows the use of scribes meant less after-hours EHR work for doctors and a better experience for patients.

Beth Jones Sanborn, Managing Editor

It's becoming more and more common to see the words physician burnout and electronic health record in the same sentence. The pervasiveness of burnout is increasingly being studied, while physicians and researchers are tying it to administrative burden and the prevalence of EHRs in their work routines. A new study in The Journal of the American Medical Association found that the use of scribes can directly and positively impact the amount of time physicians spend on EHR documentation and bring significant improvements in productivity and job satisfaction.

The 12-month study was conducted from July 1, 2016 to June 30, 2017 in 2 medical center facilities within an integrated health care system and included 18 participating primary care physicians.

Of the 18 participating PCPs, 12 were internal medicine physicians and 6 were family practice physicians. Results showed that compared to periods where scribes were not used, periods where they were showed less self-reported after-hours EHR documentation, also sometimes referred to as 'pajama time."

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Scribed periods were also linked to doctors spending more time with patients. For periods of the study where scribes were used, there was a higher likelihood of the PCPs reporting that they spent more than 75 percent of the visit interacting with the patient and less than 25 percent on a computer. Also, encounter documentation was more likely to be completed by the end of the next business day during scribed periods.

Notably, 450 of 735 patients reported that scribes had a positive impact on their visits; only 2.4 percent reported a negative influence.

"Medical scribes were associated with decreased physician EHR documentation burden, improved work efficiency, and improved visit interactions. Our results support the use of medical scribes as one strategy for improving physician workflow and visit quality in primary care," researchers said.

As physicians continue with the slow transition from volume to value-based care it is not likely that EHRs will become less endemic to the practice of medicine or less heavily relied upon for all manner of practice and provider operations. Providers and health systems can not ignore the mounting evidence that EHR work is a major and frequent complaint of physicians, who have said EHRs add work to their already large load, complicate workflows and take time away from seeing patients and rendering the type of quality, interactive care they strive for.

If the industry is to address the growing relationship between EHRs and physician burnout, then a solution like using scribes to shoulder some of that burden seems a logical one, one that could keep physicians happy, healthy and practicing longer. 

That's a boon for hospitals and practices that don't want to suffer the costs of staff turnover nor the fallout that might come with patient dissatisfaction over the quality of care given by doctors who are either burning out or too consumed by administrative work to deliver quality care.

Twitter: @BethJSanborn
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