Written By: Kristin Hagen, CPEHR, CPHIE, CPHIT, ACMSS Executive Director
Luis Moreno, MD, ACMSS Vice President
With the digitization of the patient care record, documentation within the EHR has become increasingly detailed, complex, and time-consuming. Reports indicate it will take the provider 15 minutes in order to complete Medicare mandated patient charting. The toll on patients in the waiting room is predictable with average national ER wait times approaching 3 hours. Financially speaking, physician time spent on documentation, and not on bedside care, costs the hospital system $18 per minute.
The electronic medical record (EMR) has rendered the traditional model of the provider documentation as uneconomical. Scribes have emerged as a specialized proficient healthcare documentation professional. Physicians are meeting the increased documentation demands by utilizing scribes, who typically comprise a pre-health demographic at the nation’s college campuses.
As a result, the scribe industry is growing. One estimate reports there are 3500 working scribes in 300 Emergency departments nationwide. The American College of Emergency Physicians (ACEP) hosted 7 scribe companies at this year’s national conference, compared to one in 2008. Scribe employment is clearly on the rise. However, to be an effective workforce, employers need to know what level of service scribes should be providing and establish boundaries. In an area as regulated as the healthcare industry, it is only a matter of time before scribes will need to demonstrate their credentials. Up until now, no such attempts have been made to develop minimal performance standards for scribes.
Training programs vary nationally. A well-rounded professional scribe should be tested on core competency models that include an academic curriculum of medical terminology, anatomy & physiology, disease processes, pharmacology, laboratory, electronic medical record simulation, medicolegal/HIPAA, CMS/TJC, medical coding/reimbursement, clinician workflow, in addition to real-time documentation at the point of care. This is the best opportunity to evolve the healthcare system integration seamlessly.
The American College of Clinical Information Managers (ACMSS) was formed to define our specialty and help employers protect patients and mitigate risk in the electronic healthrecord environment. A national certification testing program is available to confer the distinction of Certified Medical Scribes (CMS) among medical scribes who demonstrate excellence. With successful completion, ACMSS aims to set standards that can be utilized by scribe companies, emergency departments, hospitals, facilities, and our nation’s clinicians looking to hire this new class of employee.
1. Optimizing Physician Time. Bukata, MD, W. Richard. 3, March 2009, Emergency Medicine and Acute Care Essays, Vol. 33.