July 12, 2016

3 Ways Scribes Ease the Transition to Post-Acute Care

After the dust settles from an acute-care encounter, what happens? Discharge doesn’t mean a patient is no longer your responsibility. The transition from acute care to post-acute care is just as vital as treating the immediate health threat, particularly in cases of chronic disease or when recovery time from a complicated procedure is a long one that requires careful monitoring of the patient’s condition after an acute episode of care. So what can you do to smooth the handover to other providers?

The use of certified medical scribes by healthcare providers and hospitals has been shown to enhance efficiency and quality of care in the acute hospital setting. However, the work they do lives on long after discharge. Here are three ways scribes’ efforts link up the continuum of care.

1. Starting with the end in mind

There’s a saying about stuff flowing downstream, and it’s just as true for positive ‘stuff’. Starting with efficiency reaps rewards as the patient moves through the care process. Certified medical scribes are highly-skilled, trained support staff that relieve physicians of the non-medical burdens of electronic data collection and billing procedures, thus freeing up physician time to concentrate fully on the task of treating the patient. That way, clinicians who see the patient post-discharge will have an accurate record of the patient presentation, medical history, and all decisions and actions leading to a patient’s diagnosis and treatment. Additionally, scribes can help physicians to coordinate the myriad tasks necessary for seamless treatment in the hospital (such as updating the physician of current clinical status, organizing lab tests and appointments with other collaborating specialists, delivering messages to other clinicians). Streamlining and appropriately delegating non-medical tasks helps ensure patients receive timely, effective treatment which, in turn, can yield faster recovery, shorter hospital stays and more efficient discharge. In addition, when thorough documentation is available to providers not involved in the acute encounter, ongoing patient care is better supported, which can help prevent readmissions.

2. Building a bridge between acute treatment and post-acute care

The accurate, thorough documentation produced by medical scribes is a crucial communication connection between acute and post-acute care that helps post-acute providers gain a clear understanding of the history and current state of the patient. Being able to access a detailed picture of the acute encounter saves time and lets post-acute providers deliver better-tailored treatment to the patient, without wasting time on trial and error. Furthermore, using scribes in the outpatient setting can improve quality of care by yielding more-efficient patient visits, improved patient satisfaction, higher-quality patient interaction and lower costs .

3. Enhancing economic and qualitative benefits

As the healthcare system shifts from volume- to value-based payments, and payments for entire episodes of care, — such as Medicare’s Bundled Payment Care Initiative (BPCI) — scribes present an opportunity to make better use of increasingly limited resources. In BPCI models 2 and 3 (model 2: both acute and post-acute; model 3: only post-acute), the cost of every component of an entire treatment — from, say, surgery through to physiotherapy — is reimbursed according to Medicare’s estimated target cost and delivered in a ‘bundle’ to all contributing parties. When actual costs fall below the target amount, healthcare providers are rewarded for their efficiency by being allowed to keep the cost difference. However, when actual costs exceed the target amount, the difference must be absorbed and Medicare paid back. Medical scribes can help to tip this risk/reward balance into positive territory by decreasing duplication of post-acute care visits and documentation tasks, as well as making it easy to generate take-home information for patients. This support strategy is especially helpful for BPCI model 2, which relies on information sharing to avoid mistakes and prevent readmissions during the transition phase between acute and post-acute care. Additionally, the thoroughness of documented data provides transparency that can aid both acute and post-acute healthcare providers seeking to back up their reasoning for particular modes of treatment during the reconciliation phase of Medicare payment.