Do you ever feel like you spend more time on documentation than with actual patients? Or, that if you have to click, click, click through one more chart, you just might lose it? You aren’t alone. It is quite possible that one day I will personally throw my work computer off of the ER parking deck or bash it with a baseball bat Office Space style.
It seems every medical provider is under pressure to perfect documentation techniques. This is, after all, how most providers are paid. Medical charts are coded based on what you, as a nurse practitioner, have documented in the patient’s chart. This code is then used by the insurance company to determine your level of service and subsequent payment. A shoddy medical chart means you aren’t earning to your full potential, not to mention carries considerable legal risks.
More and more healthcare providers are becoming fed up with the time spent at the computer completing electronic health records (EHRs). Personally, for easy to treat illnesses and injuries in the ER, my time spent charting on the computer, printing prescriptions, and getting together discharge instructions may take longer than the patient exam itself. And, with increasing government regulations the problem is only getting worse. Many EHR systems are cumbersome and inefficient. And, a provider’s time is best spent at the bedside. So, some lucky MD’s, NPs and PAs are calling on medical scribes to help.
What exactly is a medical scribe?
The trend toward using medical scribes has been a breath of fresh air for many providers. Scribes take over all things documentation so MDs, NPs, and PAs can focus on patient care. The Joint Commission defines a medical scribe as an unlicensed individual hired to enter information into the electronic health record or chart under the direction of a physician or a licensed independent practitioner. Scribes may be employed directly by a medical organization or subcontracted from a scribe services. These services usually train prospective scribes for anywhere from three weeks to three months before sending them out in the field.
Scribes may also perform other clerical duties such as locating information from past medical charts, or responding to messages. Most often, scribes accompany the provider into the patient room to complete documentation in real time for maximum efficiency. Once the scribe’s documentation is complete, the chart must be reviewed, tweaked, and signed by the medical provider. The provider remains ultimately responsible for the quality and content of documentation.
Making the financial case for hiring a scribe (it’s worth it!)
Providers and patients feel the love when it comes to using medical scribes. Studies show that because using a scribe leads to more thorough medical charting, documentation codes at a higher level increasing clinic and hospital revenues. Providers also avoid nearly all of the hassle of documentation and prescription writing. Can you imagine what impact this would have on your average workday?
Not only can a medical scribe decrease the stress associated with documentation, it also frees providers up to fulfill their intended role- caring for patients. According to verbal report, physicians who use scribes see about one extra patient an hour on average, further boosting profits. Revenue increases are sustained even after paying the additional costs of employing a scribe.
With providers more at ease and fewer administrative tasks falling through the cracks in settings that use scribes, studies show that scribe use increases patient satisfaction scores, often dramatically.
Legal considerations for NPs and PAs with using a scribe
Hiring a scribe does come with a few legal caveats. Since the scribe phenomenon is relatively new, regulatory agencies have few guidelines regarding the use of scribes. You can expect more to come.
Currently, the main legal consideration for nurse practitioners and physician assistants in using a scribe relates to scope of practice laws. Since the Joint Commission defines scribes as working under the direction of a licensed independent provider, NPs and PAs in some states may not be able to work with scribes if state laws do not define them as independent providers. Look carefully at the laws in your state if you are considering using a scribe to help with your practice’s documentation needs.
If your clinic or hospital is open to jumping on the medical scribe bandwagon, you’re in luck. Spending your time at work with patients rather than checking boxes on a computer can drastically improve not only your personal job satisfaction, but also the experience of your patients as well.
Does your practice use medical scribes?
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