![]() For example, Google evaluated an ambient automatic speech recognition–based approach to transcribing patient–physician conversation 29 and later assessed the feasibility of extracting structured information (eg, symptoms) from the transcripts. There is currently a growing interest in developing such technologies. In contrast, conservation-based, ambiently listening systems seek to emulate the key function of human medical scribes by capturing clinically relevant information in the background while a clinician is conducting a patient interview in the exam room. 21–23 Therefore, researchers and technology companies have started to explore the feasibility of using technology-based solutions to provide medical scribing, hereafter referred to as “digital scribes.” 27, 28 It should be noted that digital scribes discussed in this article differ from the existing automatic speech recognition–based solutions, such as Dragon Medical (Nuance, Burlington, MA), that offer merely 1-on-1 dictation capability to facilitate entering data into computerized systems. Besides wages, employment of scribes would also incur additional costs associated with recruitment, training, and management, 23 limiting their affordability to only few settings such as specialty clinics and emergency departments. Medical scribes are however cost-prohibitive for most healthcare environments. ![]() hospitals and clinics has been doubling annually since 2014, with the industry expecting “ ranks to swell to 1 00 000 by 2020.” 26 According to the American College of Medical Scribe Specialists (ACMSS), the number of medical scribes employed in U.S. 20, 24, 25 As a result, the workforce of medical scribes in the United States has grown substantively in the past few years. 18 Several studies have shown that medical scribes could contribute to higher patient volume, 19, 20 increased revenue, 21–23 and better patient and provider satisfaction. 17 As individuals “hired to chart patient–clinician encounters in real time,” medical scribes’ work helps to share much of the burden associated with documenting in the EHR from healthcare practitioners. These could be clinically trained personnel (eg, nurses and medical assistants), or individuals with no formal medical training. Department of Health and Human Services to develop strategies to “reduce EHR-related burdens that affect care delivery.” 16Īmong healthcare organizations (HCOs), one popularly used approach to reducing clinician burnout is to employ medical scribes. 11–15 Indeed, in the 2016 21st Century Cures Act, U.S. 9 The increasing documentation burden is believed to be a key factor contributing to clinician burnout, 10 which has been found to be associated with anxiety and stress, job dysfunction, and potential patient harms. 5 In addition, many studies have reported that, in the post-EHR era, clinicians spend substantially more time practicing “desktop medicine.” 6 For example, research based on EHR logs or time and motion observations has shown that many clinicians, after meeting documentation requirements, were only able to allocate a quarter of their time to direct patient care activities, 6–8 with 1 study noting that primary care physicians spend nearly 6 hours a day working with the computer. While the use of EHR brings about many benefits, their rapid adoption has also been associated with a wide range of unintended adverse consequences, such as workflow disruption, 3 diminished quality of patient–provider interaction, 4 and new types of medical errors. ![]() Office of the National Coordinator for Health Information Technology, 96% of nonfederal acute care hospitals and 80% of office-based physicians had adopted certified EHRs in 2017. According to recent statistics reported by the U.S. hospitals and clinics has become nearly ubiquitous. As a result of policy mandates and financial incentives, the use of electronic health records (EHRs) in U.S.
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