Scribes May Enhance Quality of Outpatient Notes

By Steve Barrett
Monday, January 30, 2017

The growth of EHRs has boosted use of medical assistant scribes. A study in The Journal of Family Practice suggests that may be a worthwhile investment.

Researchers compared the quality of 217 outpatient progress notes written at eight practice sites within a single health system before and after the practices shifted from physicians writing the notes to medical assistant scribes handling that task. The notes were related to diabetes care and same-day appointments.

With regard to diabetes, notes written by medical assistant scribes were of higher quality overall than those written by the primary care physicians. The scribes’ notes were deemed more thorough, understandable, useful and up to date, according to the study.

Quality was similar, however, for physicians’ and scribes’ notes that related to same-day appointments. The average lengths of the notes were also similar: 618 words for notes written by medical assistant scribes, compared with 558 words for those written by physicians.

Discussing the results, researchers cited previous studies suggesting EHRs can hinder communication between patients and physicians, and that use of scribes could improve those interactions.

They recommended further study on issues such as how scribes affect primary care work flow and the cost of care.

Barriers (and Bridges) to Patient Engagement

Robust patient engagement takes effort, but it’s worth it, says the Go Practice Blog of Kareo, an integrated EHR, practice management and revenue cycle management software vendor.

That engagement takes forms ranging from scheduling appointments online to providing digital access to health records, the blog notes. Kareo gathered data from sources as diverse as AARP and the Healthcare Information and Management Systems Society about patient and physician views on how engagement should look.

From the patient perspective, more than three in five want to communicate with physicians via email and consider digital capabilities a significant factor in selecting a physician. Almost two-thirds want to schedule appointments online, and a similar number are willing to change physicians to have online access to medical records.

More than eight in 10 physicians agree on the value of patient engagement. However, three-fourths cite lack of reimbursement as a disincentive to embracing secure messaging, and 42 percent say payment for patient engagement efforts overall is inadequate.

Costs of greater digital engagement can be offset, however, by the benefits it offers, according to the blog.

For example, a stronger online presence and online scheduling can yield a 20 percent increase in patients. Fewer no-shows, meanwhile, can mean an extra $25,000 annually for a physician. And 73 percent of healthcare leaders say use of technologies such as text messaging has resulted in a positive return on investment.