Medical scribes lessen the burden of record keeping and order entry aspects of the chart for providers. Prior research has shown that medical scribes can decrease the documentation time for providers and allow providers to spend more quality time with patients. A medical scribe is typically an unlicensed paraprofessional, often a pre-professional student (typically a pre-medical student), a medical assistant (MA), a registered nurse (RN) or a licensed practical nurse (LPN), whose purpose is to document patient encounters in real time in the EHR and be a part of the clinical team. The current estimate is that there are nearly 100,000 scribes employed in the U.S. With the push towards EHRs, the scribing industry has grown exponentially in health care. Medical scribes were first introduced into medicine in 1975 as nurse-scribes who helped the provider with recordkeeping on patients. Scribes have been used for centuries to aid in documentation. Another widely adopted solution to EHR inefficiencies and provider burnout has been the incorporation of medical scribes into provider workflow. To combat these issues with the EHR, organizations have tried a variety of approaches from voice dictation to improved provider EHR training. Documentation burden is substantial: provider notes in the United States (U.S.) are nearly four times longer than in other countries. One of the most prominent unintended consequences of the EHR is the significant and negative impact on provider workflow due to documentation burden, which is driven by a combination of EHR design and regulatory requirements. This increased expansion in EHR use has been associated with several negative, unintended consequences. With the implementation of the HITECH Act, there has been a rapid development and use of electronic health records (EHRs). With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. Threats and opportunities for medical scribing were identified. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Threats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. ![]() An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes. ![]() In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. ![]() The first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry. With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated.
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