A hospitalist’s rounds are documentation intensive, necessitate substantial preparation and involve significant repetition. Each of these factors limiting the potential efficiency of a hospitalist in the wards can be dramatically influenced by the use of a medical scribe. By the time the hospitalist arrives to begin their shift, their scribe will already be on-site having compiled a complete list of the patients to be seen, navigating the clinic’s EMR to amass relevant past medical histories, both completed and pending labs and tests, pertinent medications, and any hand-over notes. As the hospitalist and scribe begin their shift, the physician is able to complete their new admissions and rounds with far greater efficiency because the scribe is documenting the physician’s patient encounter concurrently. While the physician reviews the chart between patients, the scribe is available to complete the ancillary duties that would otherwise have fallen on the doctor, tracking down lab results, and guiding patients to the locations they’ve been sent such as to diagnostic imaging. With each patient discharge, the scribe assures that all quality measures have been addressed, and that discharge instructions are properly logged and conveyed. By day’s end, all of the hospitalists charts are complete and they can leave for home at the scheduled time.
The benefits of a scribe on the floors are experienced not only
by the physician but by the patient as well. Aside from being able to fill admission orders more quickly, avoid the hassles of EMR data entry, and more efficiently complete rounds, the use of scribes in an inpatient setting has been shown to allow the hospitalist additional time to develop and convey the patient’s plan of care to them and their family, improving patient experience. More concrete measures of improved patient outcomes according to rates of readmission, and a decrease in average hospital length of stay have also been demonstrated.
The dramatic improvement in job satisfaction that comes as a direct result of working with a scribe bolsters physician retention by limiting burnout. Better still, in pay-for-performance models of care, the improvements in productivity afforded to physicians by using a scribe can more than completely offset their cost. To further the financial incentive of
contracting scribe services, MSC is in the process of training our scribes to document billings according to ICD-10-CA standards. Not only will this further increase physician efficiency, but scribe managed billings have been demonstrated to result in increased revenue capture per document by decreasing downcodes.physician efficiency, but scribe managed billings have been demonstrated to result in increased revenue capture per document by decreasing downcodes.
To begin the implementation of an MSC Medical Scribe Program, an MSC representative will conduct a thorough needs assessment for the client in question’s practice and ward. This process will identify and evaluate the site-specific needs that will be addressed as new medical scribe cohort is rolled out. EMR access and training integration, organization specific compliance measures and human resource trainings, and physician and administration information sessions will be coordinated as scribe candidate recruitment begins. At this time, a Scribe Manager will be assigned to your specific site in order to best accommodate and coordinate with the members of your group as implementation moves forward, and thereafter.
Hiring & Pre-Clinical Training
In the event that the location of the client’s practice is within a reasonable proximity to another established site, fully trained Medical Scribes from one location may be provided with advanced training to suit the specific specialization of the physicians in question. This allows for an expedited implementation process and defers the recruitment period to a time when deemed necessary. For inpatient specialists in new regions, standard MSC recruitment procedures will be used, as follows.
Through established connections with premedical departments of local postsecondary institutions and through partnerships with supporting government programs, MSC will develop a deep applicant pool from which to select candidates according to it’s strict and extensive hiring procedures.
Applicants selected from this group will be invited to participate in a panel interview conducted by an MSC representative, a healthcare site representative, and a member of the medical community. While not yet hired, those selected from the interview process will undergo preclinical training, beginning with MSC’s proprietary CAMELOT Medical Scribe Training Program, as well as mandatory training in patient confidentiality, infection prevention, patient management and workplace safety. As an additional component of MSC’s CAMELOT Program, we are in the process of developing and adding a number of specialty-specific modules to suit the specific needs of our specialist clients. Based on this training, prospective hires will be tested for their knowledge and competency, with those achieving the necessary passing grade on these tests will move on to the final stage of preclinical training in a classroom-based training and evaluation session. Upon completion of preclinical training, the new Medical Scribe in Training will be offered a probationary contract to last the duration of their clinical training period. Medical Scribes in Training will participate in a site orientation, as well as any other site-specific training and certifications mandated by the department or hospital as will have been organized following MSC’s initial site assessment.
Clinical Training & Upkeep
Ahead of scribe clinical training shifts, physicians will be offered brief and thorough resources demonstrating how best to make use of their new scribe. A senior Medical Scribe from an established MSC Inpatient Ward, who will go on to act as the Medical Scribe Supervisor for the duration of the department’s Scribe implementation clinical shifts, will scribe for the physicians who will first be using scribes on their shifts in order to accustom the physician. After the physician is accustomed to working with a scribe, the new Medical Scribe in Training will begin their clinical training on shift, supervised by both a physician and the Medical Scribe Supervisor. Continuous evaluation and feedback are provided during this time. Once deemed able to work independently by both the Medical Scribe Supervisor and physician, the new hire is recognized as having completed their training and probationary period, and will be considered certified to work as an MSC Medical Scribe.
Depending on the size of the department and the number of physicians intending to trial a use of scribes, this process will be repeated concurrently with either the same or another physician and between 1 and 3 additional full-time Medical Scribes in training, allowing the department to carry on self-sufficiently. Once the first tier of full-time scribes has worked the requisite hours to be adequately experienced and adept, they themselves will undergo MSC training to become Medical Scribe Supervisors, allowing for them to supervise the clinical training of future MSC scribe cohorts. As demand for scribe services within the clinic increases and begins to exceed MSC’s available capacity, this recruitment process begins anew, albeit with a site-trained supervisor from the outset.
Once in place, an MSC Medical Scribe program will provide coverage tailored to the specific needs of your department, 24 hours a day, 365 days a year, using only the most highly qualified scribes.
Medical Scribes of Canada is happy to discuss your site-specific needs and how we can best tailor our program implementation to your unique situation. If you would like to explore using scribes, please email email@example.com.