Medical scribes are physician extenders employed frequently in hospital Emergency Departments and other units (see: Shift of Hospital EMR Data Entry Tasks from MDs to Scribes; The Emergence of EMR Scribes as a New Category of Hospital Employees; Greater Adoption of the Scribe Model for EMR Data Input). these personnel transcribe dictated notes the busy physicians into the EHR. A recent article in the New York Times discussed this new category of hospital employees (see: A Busy Doctor’s Right Hand, Ever Ready to Type). Below is an excerpt from the article:
For decades, physicians pinned their hopes on computers to help them manage the overwhelming demands of office visits. Instead, electronic health records have become a disease in need of a cure, as physicians do their best to diagnose and treat patients while continuously feeding the data-hungry computer. Five years ago, only 10 percent of hospitals and doctors’ offices used electronic health records. But now the adoption rate is nearly 70 percent, thanks to tens of billions of dollars of federal incentive payments. And on the heels of electronic records has come the growing popularity of scribes. A study published jointly in October by the American Medical Association and RAND Corporation found that electronic health records were a major contributor to physician dissatisfaction, as doctors negotiate a cranky truce between talking to and examining the patient, and the ceaseless demands of the computer. And a recent article in the journal Health Affairs concluded that two-thirds of a primary care physician’s day was spent on clerical work that could be done by someone else; among the recommended solutions was the hiring of scribes.“Making physicians into secretaries is not a winning proposition,” said Dr. Christine Sinsky, a primary care physician at Medical Associates Clinic and Health Plans, in Dubuque, Iowa, who also researches physician dissatisfaction. Dr. Sinsky, who was an author of the article in Health Affairs, has visited more than 50 primary care practices over the past five years, in the course of studying ways to stem high rates of physician burnout. She has found that physicians who use scribes are more satisfied with their work and choice of careers. The inconsistency isn’t lost on health care experts. In most industries, automation leads to increased efficiency, even employee layoffs. In health care, it seems, the computer has created the need for an extra human in the exam room.
Here's a snap one-question quiz for you:
Healthcare is the the only business sector in the U.S. in which the wider deployment of computer technology (EHRs) is causing an increase the the number of personnel required to document patient care. One of the most common rationales for investing in IT is to reduce human work inputs and costs. Which of the following answers explains this unexpected outcome in healthcare:
(1) The delivery of healthcare is much more complex than comparable professional fields such as engineering, architecture, and finance;
(2) Inadequate training on EHRs is being provided by hospitals and EHR vendors;
(3) EHRs are poorly designed regarding clinical work flow, causing the most highly skilled and compensated hospital employees to be burdened with inefficient data input tasks.
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