The clinic flow efficiency of a pediatric gastroenterology department at a tertiary center was found to improve with the addition of medical scribes, according to the results of a study published in the Journal of Pediatric Gastroenterology and Nutrition.
Medical students (N=14) were recruited as medical scribes by the University of Iowa Children’s Hospital during the summer between the student’s first and second years of medical school in 2014. The students were trained for 10 hours and attended half-day shifts as scribes, supporting 7 faculty physicians, 2 fellows, and 1 physician assistant. The program was assessed for quality of documentation, clinic efficiency, and patient and physician satisfaction.
This study included 1970 clinical encounters, 35% of which were in the presence of a scribe. Approximately half (53%) of the patients included in these encounters were girls, and the median patient age was 9.8 years.
Clinical assessments that involved a scribe reduced time for all patient visits (median, 21 vs 23 minutes; P =.002) and visits with established patients (median, 18 vs 21 minutes; P =.003). Time was not reduced significantly by the presence of a scribe for new patient visits (median, 29 vs 29.5 minutes; P =.81).
The lag time of completing new patient records was significantly shorter with a medical scribe (median, 2 vs 3 days; P =.044). At day 3 after a patient visit, significantly more patient notes were finalized when a scribe was employed (63% vs 57%; P =.02).
Efficiency varied by physician. One clinician had a rate of note delinquency (unfinalized notes 7 days after patient visit) that decreased from 8% without a scribe to 3% with a scribe (P =.03), but another clinician had an increase in delinquency from 41% to 59% (P =.002) with scribes.
When surveyed, most patients (94%) indicated they had no concern about the presence of the medical scribe, and no difference was reported for overall experience with or without a scribe present (P =.51).
When the faculty were surveyed, 71% indicated they had the highest satisfaction with the program, and all indicated they would like to continue the program because they believed it allowed documentation to be easily completed in a timely manner.
The limitations of this proposed medical scribe program, which employed recruited medical students, include availability, turnover, and training needs.
The study authors concluded that a program that recruited medical students as medical scribes in a pediatric gastroenterology department increased clinic efficiency while maintaining patient and physician satisfaction.
Rahhal R, Goad L, Bishop W. Impact of a medical scribe program on outpatient pediatric gastroenterology clinic. J Pediatr Gastroenterol Nutr. 2021;72(2):220-225. doi:10.1097/MPG.0000000000002954