EHR stressed docYou don’t need a cadre of studies to tell you that physicians in private practice have to handle more administrative chores than ever. More notable, a recent study found that administrative duties are the top stress producer for most physicians.
Data entry and reporting tasks associated with care coordination, value-based purchasing, ICD-10, and population health add to the burden of modern practice. And according to the MGMA, every new patient now requires an additional 12 to 15 minutes of documentation. In some cases, physicians are spending more time entering data into their EMRs than with patients. Nearly half the day, or approximately “4,000 clicks” per shift as one doctor put it.
Many physicians cite EHRs as a prime source for stress. Even if a practitioner is adept at recording visit notes and data entry, doing so while seeing patients can be alienating for the patient. Electronic systems can disrupt a doctor’s sense of caring for a patient and may seem especially invasive if the clinician is hunting for the right data field or reviewing entries to get rid of an error message.
Maybe it’s a consolation to know that newly minted, ostensibly tech-savvy physicians make the same kinds of mistakes—such as turning their backs on a patient or apologizing for using a screen—as their older colleagues.
Some larger practices are looking to scribes as a way to properly enter data during patient visits. This approach to clearing administrative logjams has both good points and bad.
Scribes are personnel hired to enter information into an EHR or chart at the direction of a practitioner, according to guidelines issued by The Joint Commission. Since 2012, the use of scribes has increased dramatically, with some practices benefiting greatly.
For others, use of scribes has produced mixed results.

  1. Many scribes are pre-med or medical students and aren’t likely to be longtime employees. They may also seek salaries too high for smaller practices to afford.
  2. Scribes require training on all electronic systems in use, meaning no instant efficiency boost for most practices.
  3. Although scribes can spare practitioners from tedious data entry, the practitioners must review and sign off on scribes’ entries, and there is still the risk that improperly entered or erroneous information (such as incorrect prescription order entry) will get through if a physician doesn’t thoroughly scan the scribe’s work.
  4. Scribes function in a regulatory gray area because they’re unlicensed persons entering information into an EHR. The HIMMS 2016 conference last week featured a session devoted to scribes that examined this issue, called “Rise of the Medical Scribe Industry—Risk to EHR Advancement.”
  5. The increasing use of medical scribes to record patient data could impede the development of EHR management systems as well.

Investing in scribes might not save money for the practice, nor bring in new patients. One way to figure out the ROI can be found here.
For some practices, a better approach might be to invest in an EHR that is easy for doctors to use and includes robust reporting, analytics, and administrative features.
The future does look increasingly bureaucratic, no matter how you approach it, but there are options for taming administrative work. The trick is doing so without breaking the bank while avoiding regulatory snags.