March 9, 2014
Notes: Balwanz, Christopher R
Singh, Gagan D
Armstrong, Ehrin J
Southard, Jeffrey A
Wong, Garrett B
Yeo, Khung Keong
Low, Reginald I
Laird, John R Jr
Rogers, Jason H
Am Heart J. 2013 Mar;165(3):310-6. doi: 10.1016/j.ahj.2012.10.014. Epub 2012 Nov 17.
Author Address: Division of Cardiovascular Medicine, University of California, Sacramento, CA, USA.
Reference Type: Journal Article
Record Number: 520Author: Bank, A. J., Obetz, C., Konrardy, A., Khan, A., Pillai, K. M., McKinley, B. J., Gage, R. M., Turnbull, M. A. and Kenney, W. O.
Title: Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a prospective study
Journal: Clinicoecon Outcomes Res
Short Title: Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a prospective study
Alternate Journal: ClinicoEconomics and outcomes research : CEOR
ISSN: 1178-6981 (Electronic)
Accession Number: 23966799
Abstract: OBJECTIVE: Scribes have been used in the emergency department to improve physician productivity and patient interaction. There are no controlled, prospective studies of scribe use in the clinic setting. METHODS: A prospective controlled study compared standard visits (20 minute follow-up and 40 minute new patient) to a scribe system (15 minute follow-up and 30 minute new patient) in a cardiology clinic. Physician productivity, patient satisfaction, physician-patient interaction, and revenue were measured. RESULTS: Four physicians saw 129 patients using standard care and 210 patients with scribes during 65 clinic hours each. Patients seen per hour increased (P < 0.001) from 2.2 +/- 0.3 to 3.5 +/- 0.4 (59% increase) and work relative value units (wRVU) per hour increased (P < 0.001) from 3.5 +/- 1.3 to 5.5 +/- 1.3 (57% increase). Patient satisfaction was high at baseline and unchanged with scribes. In a substudy, direct patient contact time was lower (9.1 +/- 2.0 versus 12.9 +/- 3.4 minutes; P < 0.01) for scribe visits, but time of patient interaction (without computer) was greater (6.7 +/- 2.1 versus 1.5 +/- 1.9 minutes; P < 0.01). Subjective assessment of physician-patient interaction (1-10) was higher (P < 0.01) on scribe visits (9.1 +/- 0.9 versus 7.9 +/- 1.1). Direct and indirect (downstream) revenue per patient seen was $142 and $2,398, with $205,740 additional revenue generated from the 81 additional patients seen with scribes. CONCLUSION: Using scribes in a cardiology clinic is feasible, produces improvements in physician-patient interaction, and results in large increases in physician productivity and system cardiovascular revenue.