Medical Scribes Have a Variable Impact on Documentation Workflows.

Area of Science:

• Medical Informatics
• Health Services Research
• Clinical Documentation

Background:

• Physician documentation burden is a significant concern, impacting efficiency and job satisfaction.
• Scribes are increasingly used to alleviate documentation time, but their precise role and impact on workflows are not well understood.

Purpose of the Study:

• To investigate how medical scribes affect physician documentation workflows and electronic health record (EHR) usage.
• To analyze the types of edits scribes make and how physician editing behaviors change when working with scribes.

Main Methods:

• Utilized EHR audit logs to track scribe and physician actions during outpatient ophthalmology visits.
• Analyzed data from seven physicians and their staff across 13,000 patient encounters.
• Compared documentation and editing patterns between scribes with and without clinical training.

Main Results:

• Scribes routinely edited progress notes, exam findings, and diagnoses.
• Clinically trained scribes edited additional items, such as vital signs, compared to non-clinically trained scribes.
• Physicians working with scribes often deferred their own editing to later in the day, with significant EHR time reductions observed in those who deferred most.

Conclusions:

• The impact of scribes on documentation workflows and physician time is highly variable.
• Scribe documentation content and physician collaboration strategies influence EHR time savings.
• Evidence-based best practices are needed to optimize scribe utilization and maximize efficiency gains.