Mishra P, et al. – In this study, researchers assessed the effect of medical scribe utilization on electronic health record (EHR) documentation burden, productivity and patient communication, and job satisfaction among primary care physicians (PCPs). According to results, physician burnout may be alleviated by employing medical scribes who can assist with EHR documentation upkeep—a significant source of burden and time-consuming task for physicians.

Methods

• Researchers designed a 12-month crossover study with 2 sequences and 4 periods.
• This study was conducted from July 1, 2016, to June 30, 2017, in two medical center facilities within an integrated health-care system and included 18 of 24 eligible PCPs.
• They randomized the PCPs to start the first 3-month period with or without scribes; exposure status was then alternated every 3 months for 1 year. PCPs, thus, served as their own controls.
• At the end of each study period, a six-question survey was completed by the PCPs.
• After scribed clinic visits, they surveyed the patients of participating PCPs.
• Main outcome and measures included PCP-reported perceptions of documentation burden and visit interactions, objective measures of time spent on EHR activity and required for closing encounters, and patient-reported perceptions of visit quality.

Results

• Overall, 18 PCPs (10 women; 12 internal medicine physicians; and 6 family practice physicians) were included in the analysis.
• Before a mean period of 13.7 (6.5) years from initiation of this study, the PCPs completed their graduation.
• Less self-reported after-hours EHR documentation was noted in scribed periods vs non-scribed periods (< 1 hour daily during week: adjusted odds ratio [aOR], 18.0 [95% CI, 4.7-69.0]; < 1 hour daily during weekend: aOR, 8.7 [95% CI, 2.7-28.7]).
• Researchers also noted an association of scribed periods with higher likelihood of PCP-reported spending > 75% of the visit interacting with the patient and < 25% of the visit on a computer.
• During scribed periods, higher likelihood of completion of encounter documentation by the end of the next business day was noted.
• A total of 61.2% of participants reported that scribes had a positive impact on their visits; only 2.4% reported a negative effect.