Impact of a medical scribe on clinical efficiency and quality in an academic general internal medicine practice
| Autor: | Neda Laiteerapong, Felipe Fernandez del Castillo, Anastasia Pozdnyakova Piersa, Wei Wei Lee, Sachin D. Shah, Deborah L. Burnet, Sandra A. Ham |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Population Documentation Efficiency 01 natural sciences Health informatics Health administration 03 medical and health sciences Scribe 0302 clinical medicine Internal medicine Clinical efficiency Physicians medicine Internal Medicine Electronic Health Records Humans Medical scribe 030212 general & internal medicine 0101 mathematics education education.field_of_study business.industry Health Policy Public health Nursing research Research 010102 general mathematics Quality of care Workload Primary care Public aspects of medicine RA1-1270 business Medication list |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 21, Iss 1, Pp 1-9 (2021) |
| ISSN: | 1472-6963 |
| Popis: | Background Scribes have been proposed as an intervention to decrease physician electronic health record (EHR) workload and improve clinical quality. We aimed to assess the impact of a scribe on clinical efficiency and quality in an academic internal medicine practice. Methods Six faculty physicians worked with one scribe at an urban academic general internal medicine clinic April through June 2017. Patient visits during the 3 months prior to intervention (baseline, n = 789), unscribed visits during the intervention (concurrent control, n = 605), and scribed visits (n = 579) were included in the study. Clinical efficiency outcomes included time to close encounter, patient time in clinic, and number of visits per clinic session. Quality outcomes included EHR note quality, rates of medication and immunization review, population of patient instructions, reconciliation of outside information, and completion of preventative health recommendations. Results Median time to close encounter (IQR) was lower for scribed visits [0.4 (4.8) days] compared to baseline and unscribed visits [1.2 (5.9) and 2.9 (5.4) days, both p p = 0.001] and sufficient HPI information [OR = 2.21 (1.13–4.35), p = 0.02] compared to unscribed notes. Physicians were more likely to review the medication list during scribed vs. baseline visits [OR = 1.70 (1.22–2.35), p = 0.002]. No differences were found in the number of visits per clinic session, patient time in clinic, completion of preventative health recommendations, or other outcomes. Conclusions Working with a scribe in an academic internal medicine practice was associated with more timely documentation. |
| Databáze: | OpenAIRE |
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