CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2020; 12(02): e273-e276
DOI: 10.1055/s-0040-1721066
Research Article

Effect of Scribes on Efficiency in Academic Ophthalmology Practice

Meredith Furst
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Edward Chu
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Kendall Wannamaker
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Brian Planchard
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Lisa Pacheco
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Laura Vigil
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Tarana Ahmed
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
Daniel Johnson
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
,
1   Department of Ophthalmology, UT Health San Antonio, San Antonio, Texas
› Author Affiliations

Abstract

Objective The aim of the study is to determine the effects of scribes on efficiency in an academic ophthalmology practice.

Design This is a quality improvement study conducted by two ophthalmologists at an academic ophthalmology practice at UT Health San Antonio from January 2018 to April 2018. Implementation of scribes in practice was the primary intervention. Session time, patient encounter time, and template time adherence were recorded pre- and post-intervention. A second retrospective arm of the study at the same institution was performed to evaluate long-term effects of scribes on efficiency in ophthalmology practice on session times and patient volume 12 to 18 months after intervention.

Main Outcome Measures Primary study outcomes and measures were the effect of scribes in academic ophthalmology practice on physician efficiency in terms of clinic session time, individual encounter time, and amount of patients seen per session, in addition to time adherence based on type of patient encounter.

Results Eighty-three patients and 17 half-day clinic sessions and 169 patients and 21 half-day clinic sessions were included in the preintervention and post-intervention datasets, respectively. Number of patients per session was approximately 15 and was kept similar pre- and post-intervention (p = 0.45). Mean preintervention session time was 265.0 ± 31.4 minutes, in contrast to 223.4 ± 19.9 minutes after intervention (p < 0.001). Mean preintervention patient encounter time was 15.0 ± 8.3 minutes, while the mean encounter time after intervention was 10.9 ± 7.0 minutes (p < 0.005). In a retrospective analysis of 20 clinic sessions and 438 patients 12 to 18 months after intervention, session time increased to 266.0 ± 22.0 minutes on average, but the average number of patients per session increased to 21.9 ± 2.8 minutes.

Conclusion Utilizing scribes in an ophthalmology practice can increase efficiency, allowing more patients to be seen or allowing time for other activities such as teaching or research.



Publication History

Received: 20 January 2020

Accepted: 22 September 2020

Article published online:
26 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Pozdnyakova A, Laiteerapong N, Volerman A. et al. Impact of medical scribes on physician and patient satisfaction in primary care. J Gen Intern Med 2018; 33 (07) 1109-1115
  • 2 Gidwani R, Nguyen C, Kofoed A. et al. Impact of scribes on physician satisfaction, patient satisfaction, and charting efficiency: a randomized controlled trial. Ann Fam Med 2017; 15 (05) 427-433
  • 3 Lam JG, Lee BS, Chen PP. The effect of electronic health records adoption on patient visit volume at an academic ophthalmology department. BMC Health Serv Res 2016; 16: 7
  • 4 Shultz CG, Holmstrom HL. The use of medical scribes in health care settings: a systematic review and future directions. J Am Board Fam Med 2015; 28 (03) 371-381
  • 5 Redd TK, Read-Brown S, Choi D, Yackel TR, Tu DC, Chiang MF. Electronic health record impact on productivity and efficiency in an academic pediatric ophthalmology practice. J AAPOS 2014; 18 (06) 584-589
  • 6 Gardner RL, Cooper E, Haskell J. et al. Physician stress and burnout: the impact of health information technology. J Am Med Inform Assoc 2019; 26 (02) 106-114
  • 7 Sinsky C, Colligan L, Li L. et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med 2016; 165 (11) 753-760
  • 8 Goldstein IH, Hwang T, Gowrisankaran S, Bales R, Chiang MF, Hribar MR. Changes in electronic health record use time and documentation over the course of a decade. Ophthalmology 2019; 126 (06) 783-791
  • 9 Read-Brown S, Hribar MR, Reznick LG. et al. Time requirements for electronic health record use in an academic ophthalmology center. JAMA Ophthalmol 2017; 135 (11) 1250-1257
  • 10 Chiang MF, Read-Brown S, Tu DC. et al. Evaluation of electronic health record implementation in ophthalmology at an academic medical center (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2013; 111: 70-92
  • 11 Martel ML, Imdieke BH, Holm KM. et al. Developing a medical scribe program at an Academic Hospital: the Hennepin County Medical Center Experience. Jt Comm J Qual Patient Saf 2018; 44 (05) 238-249
  • 12 Hess JJ, Wallenstein J, Ackerman JD. et al. Scribe impacts on provider experience, operations, and teaching in an academic emergency medicine practice. West J Emerg Med 2015; 16 (05) 602-610
  • 13 Koshy S, Feustel PJ, Hong M, Kogan BA. Scribes in an ambulatory urology practice: patient and physician satisfaction. J Urol 2010; 184 (01) 258-262
  • 14 Zallman L, Finnegan K, Roll D, Todaro M, Oneiz R, Sayah A. Impact of medical scribes in primary care on productivity, face-to-face time, and patient comfort. J Am Board Fam Med 2018; 31 (04) 612-619
  • 15 Resnikoff S, Felch W, Gauthier TM, Spivey B. The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200,000 practitioners. Br J Ophthalmol 2012; 96 (06) 783-787