Have you ever waited in a doctor’s office, hearing the sound of typing as your provider hurriedly inputs information, and wondered what exactly they could be writing for so long? For physicians, who traditionally documented clinical notes, the growing necessity to also record billing details adds to their workload, leading to significant job dissatisfaction and burnout. A recent study from the University of Maryland’s School of Public Health presents a promising solution to notably decrease the time doctors spend on note-taking while retaining crucial information.
“Healthcare providers are already under immense pressure to see more patients while managing extensive documentation. Therefore, we explored how employing medical scribes and fostering teamwork in documentation can alleviate some of this strain,” explained Nate Apathy, an assistant professor in Health Policy and Management. Apathy’s ongoing research addresses the challenges posed by technology in healthcare and looks for ways to mitigate these issues.
Published today in JAMA Internal Medicine, Apathy’s study titled “Physician EHR Time and Visit Volume Following Adoption of Team-Based Documentation Support” involved collaborations with experts from the University of California, San Francisco, and the University of Minnesota. The findings reveal that working together on clinical documentation with other team members allows doctors and providers more time to focus on patient care. In this context, “team-based documentation” includes contributions from scribes or other clinicians, whether present in-person or connected remotely, but excludes AI scribes.
The study tracked documentation habits and weekly patient visits of over 18,000 outpatient doctors—primarily primary care physicians along with some specialists—in more than 300 healthcare organizations across the U.S. over a 9-month timeframe. Out of these, 1,024 doctors utilized a collaborative approach for note-taking.
“Our key finding is that it’s not just about having teamwork in documentation; it’s critical to look at how much the non-physician collaborators are contributing,” Apathy noted.
Among those employing scribes and other collaborative documentation methods, all saw an increase in their weekly patient visits. However, only those whose teams drafted at least 40% of their notes experienced a reduction in the doctors’ note-writing time.
On average, there was a 6% increase in visit volume and a 9.1% decrease in documentation time. After a 20-week adjustment period, visit volume rose by 10.8% while documentation time fell by 16.2%. For those high-intensity adopters (those with over 40% of their notes written by others), the time spent on documentation decreased by more than an hour—a significant time savings at 28.1%.
“Our study indicates that when doctors collaborate on their notes with a medical scribe present, utilizing a virtual note-taking service, or simply sharing note-writing responsibilities with other clinical team members, they can see more patients and considerably cut down on their time spent focused on computers,” Apathy remarked.
During each patient visit, providers must create clinical notes that encompass everything from vital signs to test outcomes and billing details. While many of these notes are essential for tracking patient health, the burden of administrative documentation required for insurance reimbursement can heavily impact the quality of care provided.
Many doctors report spending extra hours catching up on notes after work or between appointments, adding further strain to an already demanding job. The presence of a scribe can provide essential support, particularly when fully utilized.
This is the first study to analyze the real-world effectiveness of medical scribes on such a large scale. Apathy points out that innovations like virtual scribes are particularly appealing to primary care physicians due to their cost-effectiveness and ease of implementation, with the expense of a scribe often balanced out by the increased revenue from additional patient visits.
Even beyond the COVID pandemic, healthcare professionals report higher instances of stress and burnout than those in most other fields.
“This approach represents a win-win-win situation—for managing the business aspects of a clinic, assisting health systems in meeting high patient demand amid a significant provider shortage, and alleviating the administrative burdens on already overwhelmed doctors,” Apathy concluded.
