Selection and Implementation of Virtual Scribe Solutions to Reduce Documentation Burden: A Mixed Methods Pilot

Overview

Journal AMIA Jt Summits Transl Sci Proc

Specialty Biology

Date 2024 Jun 3

PMID 38827085

Authors

Carly Hudelson

Melissa A Gunderson

Debbie Pestka

Tori Christiaansen

Bret Stotka

Lynn Kissock

Rebecca Markowitz

Sameer Badlani

Genevieve B Melton

Affiliations

Soon will be listed here.

Abstract

Electronic health record (EHR) documentation is a leading reason for clinician burnout. While technology-enabled solutions like virtual and digital scribes aim to improve this, there is limited evidence of their effectiveness and minimal guidance for healthcare systems around solution selection and implementation. A transdisciplinary approach, informed by clinician interviews and other considerations, was used to evaluate and select a virtual scribe solution to pilot in a rapid iterative sprint over 12 weeks. Surveys, interviews, and EHR metadata were analyzed over a staggered 30 day implementation with live and asynchronous virtual scribe solutions. Among 16 pilot clinicians, documentation burden metrics decreased for some but not all. Some clinicians had highly positive comments, and others had concerns regarding scribe training and quality. Our findings demonstrate that virtual scribes may reduce documentation burden for some clinicians and describe a method for a collaborative and iterative technology selection process for digital tools in practice.

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References

Benko S, Idarraga A, Bohl D, Hamid K . Virtual Scribe Services Decrease Documentation Burden Without Affecting Patient Satisfaction: A Randomized Controlled Trial. Foot Ankle Spec. 2020; 15(3):252-257. DOI: 10.1177/1938640020950544. View

Soares Falcetta F, Kude de Almeida F, Lemos J, Goldim J, da Costa C . Automatic documentation of professional health interactions: A systematic review. Artif Intell Med. 2023; 137:102487. DOI: 10.1016/j.artmed.2023.102487. View

Ghatnekar S, Faletsky A, Nambudiri V . Digital scribe utility and barriers to implementation in clinical practice: a scoping review. Health Technol (Berl). 2021; 11(4):803-809. PMC: 8169416. DOI: 10.1007/s12553-021-00568-0. View

Corby S, Whittaker K, Ash J, Mohan V, Becton J, Solberg N . The future of medical scribes documenting in the electronic health record: results of an expert consensus conference. BMC Med Inform Decis Mak. 2021; 21(1):204. PMC: 8240616. DOI: 10.1186/s12911-021-01560-4. View

Brady K, Shariff A . Virtual medical scribes: making electronic medical records work for you. J Med Pract Manage. 2013; 29(2):133-6. View

Micek M, Arndt B, Baltus J, Broman A, Galang J, Dean S . The effect of remote scribes on primary care physicians' wellness, EHR satisfaction, and EHR use. Healthc (Amst). 2022; 10(4):100663. DOI: 10.1016/j.hjdsi.2022.100663. View

Harris P, Taylor R, Minor B, Elliott V, Fernandez M, ONeal L . The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95:103208. PMC: 7254481. DOI: 10.1016/j.jbi.2019.103208. View

Pozdnyakova A, Laiteerapong N, Volerman A, Feld L, Wan W, Burnet D . Impact of Medical Scribes on Physician and Patient Satisfaction in Primary Care. J Gen Intern Med. 2018; 33(7):1109-1115. PMC: 6025675. DOI: 10.1007/s11606-018-4434-6. View

Grando A, Ancker J, Tao D, Howe R, Coonan C, Johns M . Design and evaluation of a Women in American Medical Informatics Association (AMIA) leadership program. J Am Med Inform Assoc. 2021; 29(1):163-170. PMC: 8714266. DOI: 10.1093/jamia/ocab232. View

10.

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

11.

Corby S, Ash J, Mohan V, Becton J, Solberg N, Bergstrom R . A qualitative study of provider burnout: do medical scribes hinder or help?. JAMIA Open. 2021; 4(3):ooab047. PMC: 8358329. DOI: 10.1093/jamiaopen/ooab047. View

12.

Gesner E, Gazarian P, Dykes P . The Burden and Burnout in Documenting Patient Care: An Integrative Literature Review. Stud Health Technol Inform. 2019; 264:1194-1198. DOI: 10.3233/SHTI190415. View

13.

van Buchem M, Boosman H, Bauer M, Kant I, Cammel S, Steyerberg E . The digital scribe in clinical practice: a scoping review and research agenda. NPJ Digit Med. 2021; 4(1):57. PMC: 7997964. DOI: 10.1038/s41746-021-00432-5. View

14.

Gaffney A, Woolhandler S, Cai C, Bor D, Himmelstein J, McCormick D . Medical Documentation Burden Among US Office-Based Physicians in 2019: A National Study. JAMA Intern Med. 2022; 182(5):564-566. PMC: 8961402. DOI: 10.1001/jamainternmed.2022.0372. View

15.

Murthy V . Confronting Health Worker Burnout and Well-Being. N Engl J Med. 2022; 387(7):577-579. DOI: 10.1056/NEJMp2207252. View

16.

Stephens J, Kieber-Emmons A, Johnson M, Greenberg G . Implementation of a Virtual Asynchronous Scribe Program to Reduce Physician Burnout. J Healthc Manag. 2022; 67(6):425-435. PMC: 9640286. DOI: 10.1097/JHM-D-21-00329. View

17.

Gold J, Becton J, Ash J, Corby S, Mohan V . Do You Know What Your Scribe Did Last Spring? The Impact of COVID-19 on Medical Scribe Workflow. Appl Clin Inform. 2020; 11(5):807-811. PMC: 7725591. DOI: 10.1055/s-0040-1721396. View

18.

Marwaha J, Landman A, Brat G, Dunn T, Gordon W . Deploying digital health tools within large, complex health systems: key considerations for adoption and implementation. NPJ Digit Med. 2022; 5(1):13. PMC: 8795422. DOI: 10.1038/s41746-022-00557-1. View

19.

Miksanek T, Skandari M, Ham S, Lee W, Press V, Brown M . The Productivity Requirements of Implementing a Medical Scribe Program. Ann Intern Med. 2020; 174(1):1-7. DOI: 10.7326/M20-0428. View

20.

Shah S, Switzer S, Shippee N, Wogensen P, Kosednar K, Jones E . Implementation of an Anticoagulation Practice Guideline for COVID-19 via a Clinical Decision Support System in a Large Academic Health System and Its Evaluation: Observational Study. JMIR Med Inform. 2021; 9(11):e30743. PMC: 8604256. DOI: 10.2196/30743. View