Abstract
Purpose :
Studies have shown that implementing a medical scribe can help to improve physician satisfaction and efficiency measures in a broad range of specialties. However, little information exists on the use of a scribe within ophthalmology and previous studies are overwhelmingly retrospective. This prospective study aims to comprehensively investigate the 1-year impact of a scribe working in an academic ophthalmology clinic.
Methods :
This study follows one scribe working in an academic eye center over a 1-year period, utilizing 4 effectiveness metrics: physician satisfaction, patient satisfaction, productivity, and financial implications. The scribe began working on 5/14/18, rotating between 9 participating physicians. Allowing for a two-month training period, data started recording on 7/14/18. For physician satisfaction, participating providers receive a validated quarterly survey measuring their perceptions of documentation accuracy, changes to clinic flow, and views on patient interactions. Patient satisfaction uses an optional questionnaire offered during check-out, regardless of whether a scribe was present during their visit. The questionnaire scales satisfaction levels of the patient’s visit experience and their impression of received care. To measure productivity and clinic flow, patient wait-times and physician RVUs are analyzed each quarter for comparison. Data is stratified according to provider, day of the week, session (AM vs PM), and patient volume. The tracked productivity measures will then be used at the end of the study to compare the physicians average RVUs, with a scribe vs without a scribe, capturing the total revenue generated by the scribe and the cost-effectiveness of the program.
Results :
First quarter physician survey data indicates that a scribe in clinic caused an increase from baseline in the average physician satisfaction by 14.28% on responses discussing eye-contact during patient interaction, frequency of clinic delays, clinic workflow and overall patient interaction. Preliminary data for patient satisfaction, wait-times and RVUs are inconclusive until enough data is collected this winter.
Conclusions :
Initial results indicate an increase in physician satisfaction, but further data must be collected to determine accurate conclusions on the other metrics. It is expected that as the scribe develops closer working relationships with the physicians, productivity levels will continue to increase.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.