Medical scribes improve documentation consistency and efficiency in an otolaryngology clinic

Andrew C Elton; Dalton Schutte; Gerard Ondrey; Frank G Ondrey

doi:10.1016/j.amjoto.2022.103510

Medical scribes improve documentation consistency and efficiency in an otolaryngology clinic

Am J Otolaryngol. 2022 Jul-Aug;43(4):103510. doi: 10.1016/j.amjoto.2022.103510. Epub 2022 May 20.

Authors

Andrew C Elton¹, Dalton Schutte², Gerard Ondrey³, Frank G Ondrey⁴

Affiliations

¹ University of Minnesota Medical School, 420 Delaware Street, MMC 396, Minneapolis, MN 55455, USA. Electronic address: elton024@umn.edu.
² Institute for Health Informatics, 8-100 Phillips-Wangensteen Building, University of Minnesota - Twin Cities, 516 Delaware Street SE, Minneapolis, MN 55455, USA.
³ University of Minnesota Medical School, 420 Delaware Street, MMC 396, Minneapolis, MN 55455, USA. Electronic address: ondre014@umn.edu.
⁴ University of Minnesota Medical School, 420 Delaware Street, MMC 396, Minneapolis, MN 55455, USA; Department of Otolaryngology - Head and Neck Surgery, University of Minnesota - Twin Cities, 420 Delaware Street, MMC 396, Minneapolis, MN 55455, USA. Electronic address: ondre002@umn.edu.

PMID: 35636088
DOI: 10.1016/j.amjoto.2022.103510

Abstract

Objective: Scribes in medical practice enable more efficient documentation requirements but insufficient analyses have occurred to fully evaluate their efficacy in otolaryngology. We analyzed pre/post metrics of scribe implementation that may aid practitioners in determining feasibility for use in their practices.

Methods: 1808 patient charts were analyzed in The Epic Electronic Medical Record system (EMR) (903 pre and 905 post scribe implementation). We measured: clinic volumes, time saved in documentation, chart billing level, and lag days of chart closure.

Results: Patient volumes increased by 3.02% with an 11-17% decrease in time spent in clinic/day and lag days for billing. The distribution of visits for new patients was 17.75% level 2, 51.45% level 3, 29.71% level 4 before the scribe and was 6.83% level 2, 89.21% level 3, 3.96% level 4 after the scribe. For established patients it was 3.97% level 2, 84.92% level 3, 8.93% level 4 before and 0.34% level 2, 91.76% level 3, 7.73% level 4 after. The change in level of documentation for established and new patients pre and post scribe implementation was not statistically significant (p = 0.821, 0.063, respectively). Charts were closed within 0 to 7 days with the implementation of a scribe instead of 7-21 days when awaiting dictations for transcription.

Conclusions: The implementation of a scribe in an academic otolaryngology clinic facilitated more rapid completion of documentation while decreasing provider hours/day in clinic. We feel the analysis can be generalized to otolaryngology practitioners in general and the data structures we implemented are usable for others.

Keywords: Billing; Medical scribe; Otolaryngology.

MeSH terms

Ambulatory Care Facilities
Documentation
Efficiency
Humans
Otolaryngology*
Patient Satisfaction*