Many of us Medgadget editors are physicians or medical students, so we are all-too-familiar with the problems of burnout. Reports that nearly half of our doctors would not go into medicine if they could do it all over again have been widely covered by the media. One of the main reasons cited is the excessive paperwork that reduces the amount of time clinicians can actually spend with their patients.
Medical scribes are a (non-technical) solution to this problem that is gaining increasing traction. We spoke with Dr. Michael Murphy, the CEO of ScribeAmerica which documented 7 million patient visits in 2012, about scribes and how they may effectively reduce physician burnout while also improving workflow.
Shiv Gaglani, Medgadget: What inspired you to start ScribeAmerica?
Dr. Michael Murphy: I was a scribe in 2000 and saw the benefit scribes brought to physicians. The physicians were happier, spent more time with the patients and together we got them admitted, discharged or transferred much faster. In the end the patient benefited the most, I am very passionate about this. With this we saw the benefit on a national scale.
Medgadget: Can you describe the traction you’ve achieved thus far?
Murphy: Currently we are in 400 hospitals across 41 states and employ over 3700 scribes. We have 3 divisions ou ED, Hospital and Outpatient.
Medgadget: Who pays for scribes and how does a clinician know he or she could benefit from one?
Murphy: We have almost a 50/50 split between physicians or physician groups and hospitals themselves.
Medgadget: Can you provide any economic calculations for clinicians looking to get a scribing solution?
Murphy: The average cost of a scribe is $20-$22 per hour, in a 8 hour day you are looking at paying $160 dollars or so. With the average reimbursement for outpatient physicians of $80 per patient you need to see 2 additional patients to break even. Where most are seeing 8 additional which the rest allows for raises to existing staff or profit to a group.
Medgadget: Does your company have any competitors?
Murphy: Yes, when we started in 2004 their was one competitor in Texas, we were in California. We then took the concept nationwide in 2007 which today their are probably 10-12 companies across the country.
Medgadget: What do you think of automated dictation systems?
Murphy: This is a good one, can you say Siri? The difference between medical scribes and automated dictation comes back to a concept of in sequence or in parallel work flow. No matter how good automated systems get it will still have the physician doing everything. The physician still has to see the patient, why not leave your room and your chart is complete?
Medgadget: What do you think of Google Glass solutions for scribing, e.g. Augmedix?
Murphy: Glass is far from being more than a $1500 toy for the tech fan. Glass battery life is horrible to say the least. We extensively tested this both with video streaming and audio, neither will stand the test of a full days work by a physician. How bad you ask, well with video function it is only 30 minutes. Try hooking up Mophie or a direct power source and the device overheats and shuts it self down. Want regular function with no communication (audio or video) then you are looking at a max of 4-5 hours. The most I can see from Augmedix is a good data retrieval system from the EHR, which vendors like Epic etc. are already stellar at. The retrieval of data from a EHR is not the problem, let me repeat that, the data retrieval is not the problem, the data entry is.
Augmedix quoted a live Siri, well how well is Siri working out…? I think the concept is great, that is why scribes are needed so much, real time documentation. But to actually do data entry on a wearable object with a tiny screen and no battery life is pretty far from being mission ready.
Medgadget: Where do you see your company in the next year? In five years?
Murphy: We are on a rapid growth phase and with ICD-10 coming and the documentation impact with that it should continue to rise. In five years is hard to tell but we hopefully will have revolutionized how provider documentation and patient care will be delivered.