Virtual Scribes: Valuable New Tool is Being Rolled Out Across the Practice
Among the key members of Dr. Douglas Hildrew’s practice is a colleague named Amber. Dr. Hildrew and Amber are so in sync that she anticipates his needs before every patient visit, enables him to spend more time with each patient, and can even tell if he’s concerned about something by changes in his voice.
But Dr. Hildrew and Amber have never actually met.
Amber is a “virtual scribe” – a certified medical scribe who documents patient visits from a remote location. With the patient’s permission, virtual scribes listen to each patient encoun- ter and provide synchronous, off-site scribing services including note creation and docu- mentation, chart navigation, and pending of nonmedication orders.
The use of virtual scribes has been shown to significantly reduce the amount of time physi- cians have to spend after hours documenting patient encounters in the electronic medical record – some have even described it as “life-changing.” At the same time, it allows doctors to spend more time focusing on patients and less time on the computer during patient visits.
Following a successful pilot in 2018, Yale Medicine is now preparing to make virtual scribes available to physicians across the practice, through a phased deployment that will begin in early 2019. While virtual scribes are not right for everyone, they will be an option for all YM providers who choose to use them.
Douglas Hildrew, an otolaryngologist, talks with a patient while a virtual scribe listens in remotely though a conference speaker phone and documents the session in Epic.
A Promising Pilot
In 2017–18, 49 YM and Northeast Medical Group providers across multiple specialties took part in the vir- tual scribe pilot, and the results were extremely positive. For example, after-hours Epic use by participating physicians went from 11 days per month to five days per month. The number of days to close encounters decreased from approximately four days to 1.5 days.
A physician survey and a review of key metrics also found increased physician satisfaction and well-being; the ability to see more patients, if desired; and an increase in relative value units (RVU) per visit and RVU per day. In addition, the use of virtual scribes significantly improved patient satisfaction, allowing doctors to focus exclusively on their patients without being distracted by typing notes and navigating within Epic.
An Extension of the Care Team
Dr. Hildrew, who specializes in otology, neurotology, and skull base surgery, is one of the YM physicians who took part in the virtual scribe pilot. He especially likes the fact that M*Modal, the company that pro- vides virtual scribe services to YM, works hard to match physicians and scribes who will work well together.
“They do a really good job of pairing you with someone who’s a partner. Amber is much more than a scribe; she’s really an extension of my care team.” For example, when Dr. Hildrew begins a patient encounter, Amber has already started the note and brought his attention to lab results, imaging results, and any other updates since the patient’s last visit.
“That saves me a lot of clicks, which improves my workflow and saves me a lot of time that’s not directly involved in the patient encounter,” Dr. Hildrew says. “I can take all that time that I would have spent clicking, and I can now spend it with my patients. I think patients feel that I’m more engaged with them.”
In addition to patients, referring providers also benefit from the use of virtual scribes by YM specialists, Dr. Hildrew says. Amber copies referring providers on all patient notes, and Dr. Hildrew now has more time to provide them with additional information if their patient has an especially complex condition.
“I’ve had a lot of positive feedback from referring providers on the quality of the note and the speed and efficiency with which they receive it,” Dr. Hildrew says. “The more they know, the better the bond is with their patient.”
The bottom line? Virtual scribes are “game-changing,” says Dr. Hildrew. “In a postelectronic medical world that is so burdened with clicks, it once again gives us the power back to do what we really want to do – patient care.”