November 19, 2013
Doing more with less, today’s new health care

Scribe-America-Doing-More-With-Less

To anyone who’s read the news lately, it’s no secret that America’s healthcare system is changing. This change is taking place in many forms, from EHR’s, to more federal mandates, decreased reimbursements and the Affordable Care Act. But each has the characteristic of asking hospitals and doctors to do more with less.

A doctor’s traditional role is that of a caregiver, not an administrator or data entry specialist. Yet with each successive year we’ve seen your average doctor in both the hospital and office setting saddled with more administrative responsibility. As one example hospitalists now need to administer and accurately document the answers to a 12 question survey for each patient before admitting them.

For many doctors EHR’s have become more of a curse than a blessing. Federal grant money has made many EHR companies overzealous in selling their systems despite obvious technical shortcomings and steep learning curves in some cases. But even if EHRs are working well for a doctor, by this time next year they will have to learn an entirely new set of medical codes when ICD-10 goes into effect.

A Catch 22

Even though many hospitals may not like it, they are required to follow these mandates in order to stay compliant and not lose extra funding or reimbursements. But many patients aren’t aware of these extra administrative burdens.

A patient might be taken aback by a doctor typing away at their EHR as they’re inputing medical decision making. In that case they might perceive the doctor as distracted, frazzled, or detached from their situation. That in turn will likely be reflected in the HCAHPS survey or Press Ganey results, which then continue to feed the cycle of pressure for doctors being told that their survey scores are low.

Not to mention that the need to stay compliant with all of these mandates will likely be exacerbated next year with the implementation of the Affordable Care Act (ACA). While the ACA takes aim at some of the worst practices in the health insurance industry, it brings with it a whole slew of new compliance regulations.

The net result of the ACA for hospitals, at least those participating in Medicaid and health insurance exchange plans, will be an overall increase in the number of patients. Coupled with the existing and new administrative burdens, the ACA will only serve to put more pressure on doctors. But how will hospitals and private practices adapt to the ever mounting mandates and provide greater access to the communities they support?

One compelling argument is for physicians to see more patients per hour.  However, for every new patient that is seen an additional 15 minutes of documentation will be required.  So if a provider wants to provider better access to care and now see 40 patients per day instead of 30, an additional documentation burden of 150 minutes will occur.  This unfortunate burden needs to be carefully analyzed and consider; family time, risk, compliance and what revenues will actually be achieved.

The answer to these new administrative burdens: Medical Scribes.

On average a medical scribe is able to complete 70 to 80 percent of a doctor’s administrative work for them. This dramatically decreases the amount of time doctors have to spend keeping up with paper work. By having that extra help doctors are able to focus on their core tasks, see more patients which in turn will provide better access to the community, boost HCAHPS scores and benefits the hospital or practice as a whole.

Suddenly when medical scribes are introduced into the equation, staying compliant becomes easier and hospitals are not caught in the catch 22 of being compliant with the law but suffering in productivity and lower over all provider and patient satisfaction.

By using medical scribes doctors can focus on what’s really important, the patient.

By Michael Murphy, MD

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