Abstract
Purpose :
To evaluate the impact of medical scribes on performance metrics in an academic ophthalmology practice across a variety of subspecialties
Methods :
Data from the Department of Ophthalmology at Northwestern Medicine from November 2020-November 2023 was gathered from 6 ophthalmologists comprising 5 subspecialties including[GM1] retina (n=79 unscribed encounters, n=497 scribed encounters), cornea (n=243 unscribed, n=615 scribed), uveitis (n=334 unscribed, n=276 scribed), glaucoma (n=31 unscribed, n=500 scribed), and general ophthalmology (n=155 unscribed, n=293 scribed). Metrics were compared between scribed vs unscribed encounters for each individual doctor and then further compared by subspecialty. Dependent variables included patients seen per day, patients seen per hour, patient appointment time, patient wait time, relative value units (RVUs) per hour, and time until chart closure. A Welch’s t-test was used for statistical analysis. Significance was set at p < 0.05.
Results :
The patients seen per day significantly increased with the presence of a scribe in all subspecialty clinics including Cornea (p < 0.01), Retina (p < 0.01), Uveitis (p < 0.01), and Glaucoma (p < 0.01) clinics, while the General ophthalmology clinic showed no significant change (p = 0.905). Patients seen per hour followed a similar pattern, with Retina (p < 0.01.), Uveitis (p < 0.01), and Glaucoma (p < 0.01) exhibiting significant differences. Patient appointment time in Uveitis significantly decreased (p < 0.01). Only the General (p < 0.01) and Cornea (p < 0.02) clinics had a significant change in mean wait time. Epic RVUs per hour showed significant increases in Cornea (p < 0.01), Retina (p = 0.035), Uveitis (p < 0.01), and Glaucoma (p < 0.01). Chart closure time significantly decreased in Uveitis (p < 0.01). Amongst all subspecialties in aggregate, there was a significant improvement with the presence of a scribe in patients seen per day, patients seen per hour, mean appointment time, RVUs per hour, and chart closure time (p < 0.01).
Conclusions :
There was an improvement in performance metrics with the presence of a scribe in most all efficiency metrics across all subspecialties. Most notably, RVUs were increased in all subspecialties (except for general ophthalmology). This pilot study supports the utilization of scribes in an academic ophthalmology setting by enhancing both efficiency and productivity.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.