SCGhealth Blog

The Case for Medical Scribes

Wednesday, November 29, 2017

By Audrey Landers, Intern

The idea of medical scribes can be strange to some. Even the word “scribe” brings thoughts of ancient civilizations. They almost seem like a step back in our fast-paced, technology-driven world. When it comes to patient care, however, they could be a step in the right direction. From improved communication to a drop in physician overwork, the potential of medical scribes to improve the quality of care is enormous.

Articles in the New York Times and Wall Street Journal point to the overuse of Electronic Medical Records (EMR) and poor communication as key factors in unhappy patients. From the patient’s perspective, physicians who use EMR heavily in the exam room ask fewer questions and appear uncaring. This is because EMR often requires a physician’s full attention, mean very little eye-contact and a lot of time spent with their back to the patient. It isn’t only the patients who notice the lack of communication, according to a survey by Merritt Hawkins, 48% of physicians feel that their time with patients is limited. Untrusting patients and poor communication isn’t the only problem caused by EMR. As physicians have been forced more and more to balance administrative and clinical work, burnout has risen. According to a study performed by the Mayo Clinic, 1 in 50 physicians plan to leave the medical profession in lieu of a different career path.

Medical scribes have the potential to solve both of these issues. By allowing a scribe to document patient encounters, the burden of keeping accurate records would be lifted from the physician, allowing them to focus all of their attention on their patients. While some might argue that patients may be intimidated by having an extra person in the room, it is easy enough to explain their importance in helping the physician give the best care possible.

The real issue many have with medical scribes is cost. There is no denying that it is expensive to hire an entire new employee to do a job that some administrators may see as the physician’s responsibility. In actuality, medical scribes can help a practice save money and time. One 2013 study found that scribes can allow a practice to save as much as $2,398 per patient with the time cut from each appointment, as well as the extra patients that each physician and scribe team is able to see. This money does not come at the cost of patient satisfaction either, as practices that use scribes find that their patients are happier. Because the physician is able to give the patient their full attention, more patients leave feeling satisfied with their service.

Medical assistants, credentialing and Meaningful Use: what you need to know

Tuesday, August 16, 2016

by Elizabeth Lauzon, Public Relations Coordinator

There’s a great deal of focus being spent on a national standard for credentialing of medical assistants and or certification for scribes. And when it comes to Meaningful Use and certified electronic health records (EHRs), there are lots of questions surrounding the topic. So let’s work on clearing up a few of them.

What are the credentialing requirements for medical assistants and/or scribes?
As of January 2013, only certain clinical staff are permitted to enter medication, radiology and laboratory orders into the EHR to count toward meeting Meaningful Use thresholds. Meaningful Use guidelines from the Centers for Medicare & Medicaid Services (CMS) state:

“Any licensed healthcare professionals and credentialed medical assistants can enter orders into the medical record for purposes of including the order in the numerator for the objective of computerized physician order entry (CPOE) if they can originate the order per state, local and professional guidelines.”

This requirement ensures orders are entered by someone who can exercise clinical judgment should the entry generate a drug interaction alert or other clinical decision support aid. This necessitates having the entry occur when the order first becomes part of the patient’s medical record, and before any action is taken on the order.

CMS doesn’t specify a particular credentialing agency for medical assistants. But it does say credentialing must be obtained from an organization other than the employing agency.

Here's what we know. Most states do not yet require licensing of medical assistants. Likewise, scribes are not a licensed healthcare profession yet. Thus, you can turn to education and certification programs to meet these requirements. Some community colleges have started certifying their medical assistants and several national programs exist for certifying medical assistants and scribes.

What about scribes?
Because scribes aren’t licensed or credentialed, their qualifications can’t be guaranteed. For this reason, scribes (without further education) aren’t qualified to enter orders in the EHR under CMS guidelines. BUT, if they get a certification they then can qualify for order entry. Numerous certification entities exist across the country, some are specialty specific and others are more broad. The key fundamental to the certifications is training on medical terminology, system awareness (terminology) and typing skills.

How can I avoid a CMS audit?
To qualify for payments under EHR incentive programs, providers must present documentation of all orders, many of which are automatically entered by the EHR system. If auditors find an order was entered by someone other than a licensed professional or credentialed clinical staff, it could constitute a violation of CMS guidelines. It’s also possible the entry wouldn’t count toward meeting Meaningful Use thresholds. As a result, the eligible professional may not meet all core objectives required to receive an incentive.

Remember, credentialed medical assistants and scribes benefit your organization by providing a reliable quality assurance mechanism, more efficient use of resources, and more EHR entries counted toward CMS incentive programs. So check them out. And be sure to keep documentation of the licensure and credentialing of any staff doing order entry, just so that you are ready for an audit.

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