There are 100s of Electronic Medical Records (EMRs) on the market, along with an even greater number of healthcare apps and software solutions that promise improved interoperability and efficiencies to end-users. Having visited HiMSS 2018 in March, I was overwhelmed by the volume of software technology on display. But while healthcare IT products are sold to doctors and practice administrators under the promise of delivering greater productivity and efficiency, that is not happening.
One question looms large in healthcare IT – one, I believe, that remains unaddressed, and is the primary cause of doctors’ IT woes: Who is going to input, organize, and manage all of this healthcare data into these EMRs and apps? To date, the answer, or assumption, has been: “Doctors and their nurses or MAs, of course! They’ll enter everything into the EMR when they have time.” However, this approach is not working, and is leading to reduced productivity and historically high stress levels among providers – not to mention, poor and incomplete charting.
We at Physicians Angels created our Virtual Scribe service in 2007 to address this very question. Our founders are a group of tech-savvy physicians in Ohio and Michigan frustrated with having to manage their EMR while also seeing patients. Their solution was to create a service that enabled real-time EMR management and data collection, through easy-to-use and secure technologies, that simultaneously would permit the doctor to focus on the patient and provide quality care. We modelled our Virtual Scribes after on-site medical scribe services in hospital ERs.
Our Virtual Scribes are full-time employees with our company, trained and certified to work as scribes and EMR data management experts, and whom we lease to clinics and hospitals throughout the United States. The difference with a Virtual Scribe is a matter of hours saved each clinic day for a provider, which leads to higher patient volumes and less provider burn-out.
Speak to enough doctors, and they will blame their EMRs and software for making them inefficient and stressed. They complain routinely about clumsy user interfaces, with too many difficult-to-find features and click boxes. Above all, doctors resent feeling reduced to acting as a typist for hours each clinic day.
But blaming the EMR, or giving more training to doctors to use their EMRs better, misses the larger point: How do doctors realistically manage their time with an EMR, while also providing quality care to their patients?
I would argue that the investments to date in EMRs and healthcare mobile applications now need to be matched by investments in a workforce to manage these IT tools and the mounds of data they are designed to produce. Specifically, what is needed are more EMR and healthcare IT data managers – medical scribes, be they on-site or virtual.
There is now a growing body of research that supports the use of medical scribes to successfully manage EMRs, reduce physician stress, and increase overall clinic productivity. The quantitative upsides with scribes are proven: patient volumes are up – thus, revenues are up; and patient encounters are more fully documented in a timely manner. And the qualitative benefits with medical scribes are strong, too: improved quality of life for healthcare providers not documenting all clinic day; plus, satisfied patients who have the doctors’ undivided attention on them, and not on a computer screen.
We like to talk about “big data.” However, our energy in healthcare mostly has been focused on analyzing data post-accumulation. First, data has to be collected accurately to make sure that the final assumptions and analyses are plausible. Currently, EMR data entry quality is a function of time/value. If a clinical provider has a tremendous amount of data to process with each patient encounter, they end up selecting only what has value to their financial well-being and patient care. Doctors are simply too pressed for time to chart accurately and well. Medical scribes can help.
We have invested billions in healthcare IT. Now we need to invest in people and services to manage that IT successfully.