Grand Rounds

Do Medical Scribes Reduce Physician Time Requirements for ‘Out-Of-Visit’ Tasks?

BACKGROUND AND PURPOSE:

Medical scribes assist primary care providers (PCPs) with documentation during patient visits and are associated with decreased charting times
PCPs spend 1 to 2 hours of personal time at night doing mostly EMR work, such as responding to prescription requests and patient messages
Zallman et al. (Journal of the American Board of Family Medicine, 2021) assessed the hypothesis that if providers spend less time on charting, more time will be available for out-of-visit tasks

Observational study
Participants
- PCPs in an academic health setting
Exposure
- Medical scribes: Recent college grads who received training and continual supervision from their supervising PCP
Study design
- Studied difference in outcomes before implementation of a scribe program (July 2017 to June 2018) with the year after implementation (July 2018 to June 2019)
- Data adjusted for provider and patient demographics and complexity | Could not account for NPs as there were too few vs physicians
Primary outcomes
- Changes in “time to completion” for the following
  - Patient portal messages | Prescription requests | Test results

472,411 tasks were examined
- Scribed PCPs: 27,645 tasks | 5 PCPs
- Nonscribed PCPS: 444,766 tasks | 74 PCPs
Unadjusted analyses: No change in time to completion for any of the out-of-visit tasks examined (scribed vs nonscribed PCPs)
- Prescription refill requests: 1.02 times (P = 0.585)
- Patient portal messages: 1.06 times (P=0.516)
- Patient test results: 1.02 times (P=0.787)
Adjustment for provider and patient characteristics did not alter the findings

The assistance of a medical scribe for charting was not associated with a decrease in PCP time spent on out-of-visit tasks
The authors conclude that while other studies support benefits of medical scribes, reducing the burden of out-of-visit tasks on PCPs will require different interventions

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