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Grand Rounds

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

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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

METHODS:

  • 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

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

CONCLUSION:

  • 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

Learn More – Primary Sources:

Do Medical Scribes Help Primary Care Providers Respond More Quickly to Out-of-Visit Tasks?

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