• Sarah T Florig, Sky Corby, Tanuj Devara, Nicole G Weiskopf, Jeffrey A Gold, and Vishnu Mohan.
• From the Division of Pulmonology, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland, OR (STF, SC, TD, JAG); Department of Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA (STF, NGW, JAG, VM).
• J Am Board Fam Med. 2024 Mar 1; 37 (2): 228241228-241.

BackgroundMedical scribes have been utilized to reduce electronic health record (EHR) associated documentation burden. Although evidence suggests benefits to scribes, no large-scale studies have quantitatively evaluated scribe impact on physician documentation across clinical settings. This study aimed to evaluate the effect of scribes on physician EHR documentation behaviors and performance.MethodsThis retrospective cohort study used EHR audit log data from a large academic health system to evaluate clinical documentation for all ambulatory encounters between January 2014 and December 2019 to evaluate the effect of scribes on physician documentation behaviors. Scribe services were provided on a first-come, first-served basis on physician request. Based on a physician's scribe use, encounters were grouped into 3 categories: never using a scribe, prescribe (before scribe use), or using a scribe. Outcomes included chart closure time, the proportion of delinquent charts, and charts closed after-hours.ResultsThree hundred ninety-five physicians (23% scribe users) across 29 medical subspecialties, encompassing 1,132,487 encounters, were included in the analysis. At baseline, scribe users had higher chart closure time, delinquent charts, and after-hours documentation than physicians who never used scribes. Among scribe users, the difference in outcome measures postscribe compared with baseline varied, and using a scribe rarely resulted in outcome measures approaching a range similar to the performance levels of nonusing physicians. In addition, there was variability in outcome measures across medical specialties and within similar subspecialties.ConclusionAlthough scribes may improve documentation efficiency among some physicians, not all will improve EHR-related documentation practices. Different strategies may help to optimize documentation behaviors of physician-scribe dyads and maximize outcomes of scribe implementation.© Copyright 2024 by the American Board of Family Medicine.

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