Medical scribes and the impact on EHR development

I recently attended a session at HIMSS16 entitled Rise of the Medical Scribe Industry – Risk to EHR Advancement presented by George Gellert, MD, MPH, MPA, and S. Luke Webster, MD of Christus Health.

NEMT CEO Linda Sullivan

It’s common knowledge that the everyday experience of healthcare providers with EHRs is often less than ideal.  The premise of the presentation is that the rise of scribes has been in response to the deficits of the EHR experience. The concern of the speakers is that the scribe phenomenon will become institutionalized and thereby take pressure off development of necessary improvements that need to be realized in the evolution of EHRs. The speakers expressed concern that unlicensed individuals are entering patient information including CPOE into the EHR. And at times being put in the position of having to make decisions for which they are not trained.  JCAHO strongly recommends that scribes not enter CPOE.

How do scribes differ from medical language specialists? This question was posed by a member of the audience. Dr. Webster responded that patient information entered by a medical scribe is not the same thing as the process of dictation/transcription.”It’s not a fair analogy because the process of dictation and transcription still involves the physician as the central actor intellectually and cognitively. That content is generated by the skill set, training and experience of that physician cumulatively.”

One other issue that stands out is the presence of a third party in the examination room. It’s one thing if we’re being seen for an upper respiratory issue but do we want another non-medical individual in the room when having a thorough physical exam?

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