Documentation burdens consistently rank near the top of dermatologist concerns. One way physicians are winning back their time is with use of scribes. Scribes can work in the exam room during the patient encounter, or they can work remotely, transcribing the note through an audio connection. Scribes who work remotely are sometimes called e-scribes.
The benefits include better patient and physician satisfaction, reduced evening work hours, improved efficiency, improved workplace satisfaction, and more. Learn more about the benefits of using documentation aids such as scribes.
Finding a scribe
You do not have to hire staff directly to employ scribes. Instead, you can contract with a company that offers scribes as a service, with some examples offered below. Scribes are not licensed, but they are usually trained on popular EHRs and some are certified before they begin working in medical practices. Scribes may also be able to assist with minimal administrative tasks around the office.
Another option is for a dermatologist to ask their medical assistant to cross-train and act as a scribe, instead of hiring someone new. The advantage is that they are already accustomed to clinical and administrative duties and terminology. Be sure to follow state laws that may limit the tasks medical assistants can perform.
Before a scribe joins your team, explain the benefits to your other staff, especially how scribes can both improve and speed up clinical documentation. Give staff ample time to prepare for the change, especially where it impacts them.
“Documentation in the EHR is the least rewarding aspect of practicing medicine but needs to be done. A scribe has made it enjoyable to actually focus on my patients and building a connection, instead of furiously typing and staring at a screen during our encounters.”
Prepare the scribe by ensuring they understand how you document in the EHR. Go through a practice “visit” with another staff member and summarize the key points at the end, just as you would in a real patient encounter. Be sure the scribe documents medical terminology properly and populates the note correctly.
You should prepare patients if the presence of staff during the examination will be new. You can put up signs and offer handouts explaining why the scribe remains in the room, and how it helps the dermatologist focus on the patient. Most patients will not understand what a scribe does without an explanation, and some may be nervous about having an unfamiliar face in the room, so it is important that you inform them and ease their concerns.
When entering the exam room, introduce the scribe to the patient and briefly explain why the scribe will take notes on the visit. The patient may be reassured to hear that all the same privacy rules apply to the scribe. The patient will see that the scribe helps you give them your undivided attention.
“Scribes have cut in half the time that I spend doing documentation, but they need to be well-trained, and it helps to have good dot phrases for them to use.”
─ Dawn Eichenfield, MD, PhD, FAAD
Legal and state requirements
Scribes are considered part of your care team under federal privacy regulations, either directly or as a Business Associate (BA) if they are a vendor. As a result, the notice of privacy rights you give to patients covers the scribe, and no separate consent is required.
There are no limitations on using a scribe for MIPS reporting, but double check with your state and malpractice provider to see if there are any state laws on what exactly a scribe can do in practice.
Scribe vendors
The scribe companies below offer both in-person and remote scribe services. There are many more, but these are typical.*
* The Academy is able to share these resources on an informational basis only. This does not represent an endorsement by the Academy. Please compare, evaluate, and consider which ones best meet your needs.
