Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a prospective study.
| Autor: | Bank AJ; United heart and Vascular Clinic, St Paul, MN, USA., Obetz C, Konrardy A, Khan A, Pillai KM, McKinley BJ, Gage RM, Turnbull MA, Kenney WO |
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| Jazyk: | angličtina |
| Zdroj: | ClinicoEconomics and outcomes research : CEOR [Clinicoecon Outcomes Res] 2013 Aug 09; Vol. 5, pp. 399-406. Date of Electronic Publication: 2013 Aug 09 (Print Publication: 2013). |
| DOI: | 10.2147/CEOR.S49010 |
| Abstrakt: | Objective: Scribes have been used in the emergency department to improve physician productivity and patient interaction. There are no controlled, prospective studies of scribe use in the clinic setting. Methods: A prospective controlled study compared standard visits (20 minute follow-up and 40 minute new patient) to a scribe system (15 minute follow-up and 30 minute new patient) in a cardiology clinic. Physician productivity, patient satisfaction, physician-patient interaction, and revenue were measured. Results: Four physicians saw 129 patients using standard care and 210 patients with scribes during 65 clinic hours each. Patients seen per hour increased (P < 0.001) from 2.2 ± 0.3 to 3.5 ± 0.4 (59% increase) and work relative value units (wRVU) per hour increased (P < 0.001) from 3.5 ± 1.3 to 5.5 ± 1.3 (57% increase). Patient satisfaction was high at baseline and unchanged with scribes. In a substudy, direct patient contact time was lower (9.1 ± 2.0 versus 12.9 ± 3.4 minutes; P < 0.01) for scribe visits, but time of patient interaction (without computer) was greater (6.7 ± 2.1 versus 1.5 ± 1.9 minutes; P < 0.01). Subjective assessment of physician-patient interaction (1-10) was higher (P < 0.01) on scribe visits (9.1 ± 0.9 versus 7.9 ± 1.1). Direct and indirect (downstream) revenue per patient seen was $142 and $2,398, with $205,740 additional revenue generated from the 81 additional patients seen with scribes. Conclusion: Using scribes in a cardiology clinic is feasible, produces improvements in physician-patient interaction, and results in large increases in physician productivity and system cardiovascular revenue. |
| Databáze: | MEDLINE |
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