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December 31, 2013

It’s Vital That All Medical Scribes Certify with ACMSS

What exactly makes a medical scribe a medical scribe? The American College of Medical Scribe Specialists (ACMSS) knows, and they’re working hard to get all scribes certified with them, through the Medical Scribe Certification and Aptitude Test (MSCAT).

ACMSS was founded back in 2010 in response to increasing numbers of new medical scribe companies. ACMSS determined that creating minimal performance standards, substantiating a medical scribe’s prior training and requiring a rigorous 2-hour examination, would be essential elements of national certification process. ACMSS Executive Director Kristin Hagen states that “ACMSS protects the medical scribe industry, and we’re going to do that by certifying minimum performance standards,”

Test time

The primary offerings of ACMSS are a certification exam for scribes from medical scribe programs and a certification of academic institutions that already have provided their students with a comprehensive medical scribe curriculum. To date hundreds of medical scribes have passed the certification exam and received the designation of “Certified Medical Scribe Specialist” formerly known as “Clinical Information Manager”. In order to sit for the exam, the scribe has to have completed his/her pre-clinical training and initial competency training as a clinical medical scribe.

To ensure that scribes from medical scribe programs taking the test have met the prerequisites, they must sign an affidavit attesting to having successfully completed their training. These test takers must also have successfully passed their 90-day employment probation and have recorded at least 200 hours of clinical work.  In contrast, students of ACMSS’ Certified Academic Partners, who already carry a certification or license in the medical field, are allowed to sit for the exam after 50 hours of clinical training and without the 90-day probation requirement.

The scribes are then able to sit for the two-hour exam that tests the major competencies for medical scribing:

ACMSS’ mission is to provide meaningful certification and while ACMSS does not provide medical scribe training per se, it has partnered with colleges,, vocational schools, and medical scribe companies  who have developed their own medical scribe training.

Advocacy for a growing industry

Dr. Moreno, ACMSS President, envisions ACMSS as a “brain lab” of scribes from various medical scribe companies and schools. “We’ve created bridges where companies can come together to work on national scribing standards and lobby regulators on behalf of the industry.”

In fact, ACMSS is already doing this. Moreno cites an example of advocacy from 2011, when ACMSS successfully lobbied The Joint Commission. The Joint Commission’s May 18, 2011 FAQ was interpreted by some to exclude the use of scribes with physician assistants. The impact of this interpretation was that the medical community that relied on the efficiency of their PA, had to suspend adding scribes to the PA shifts. This resulted in a decrease in PA productivity due the inherent inefficiency of unassisted data entry into EHR. ACMSS initiated discussions with Tricia Marriott, PA-C, MPAS, Interim Vice President of Constituent Organization Development at the American Academy of Physician Assistants who agreed with ACMSS perspective that medical scribe use with PAs was both efficient and a safe practice that needed to be preserved. ACMSS’ subsequent letter to The Joint Commission resulted in the July 12, 2012 FAQ, which unambiguously supported the use of medical scribes with Physician Assistants.

Despite documented successes like that, interest from other medical scribe companies in membership with ACMSS has so far been limited. ACMSS does charge an annual membership fee for a seat on their board,. However as part of a retooling effort the fee has been lowered significantly.

Even without an annual fee many still have concerns about the relationship between ScribeAmerica and ACMSS. They are not convinced that the two are really independent of each other. This, says Moreno, is just not true.

ACMSS plans to hold elections for leadership of the organization once it has more members. But at the moment the group is supported financially by ScribeAmerica.

Looking to the future

Since 2008, medical scribes have become an essential part of many hospital emergency departments nationwide. Moreno notes though, that the new model of doctor-scribe teams will only become more prevalent as time goes on. He cites the switchover to EHRs and the mandated implementation of ICD-10 codes, as reasons why growth in the scribing industry is inevitable.

It’s because of this enormous potential for growth that Moreno sees the future role of ACMSS as increasingly important.

“Just look at the growth of the medical scribe industry, its just exploded,” said Moreno. “The whole paradigm of the standalone physician who documents his medical records by himself, that’s a dinosaur, that’s over.”

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