Evidence map›Paper›PMID 34247600›Full record

ArticleBMC health services research2021

Impact of a medical scribe on clinical efficiency and quality in an academic general internal medicine practice.

Anastasia Pozdnyakova Piersa, Neda Laiteerapong, Sandra A Ham, Felipe Fernandez Del Castillo, Sachin Shah, Deborah L Burnet, Wei Wei Lee

Abstract read
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anastasia Pozdnyakova PiersaPritzker School of Medicine, University of Chicago, Chicago, USA.
Neda LaiteerapongDepartment of Medicine, University of Chicago, Chicago, IL, USA.
Sandra A HamUniversity of Chicago Center for Health and the Social Sciences, Chicago, USA.
Felipe Fernandez Del CastilloDepartment of Medicine, University of Chicago, Chicago, IL, USA.
Sachin ShahDepartment of Medicine, University of Chicago, Chicago, IL, USA.
Deborah L BurnetDepartment of Medicine, University of Chicago, Chicago, IL, USA.
Wei Wei LeeDepartment of Medicine, University of Chicago, Chicago, IL, USA. wlee6@uchicago.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundScribes have been proposed as an intervention to decrease physician electronic health record (EHR) workload and improve clinical quality. We aimed to assess the impact of a scribe on clinical efficiency and quality in an academic internal medicine practice.

methodsSix faculty physicians worked with one scribe at an urban academic general internal medicine clinic April through June 2017. Patient visits during the 3 months prior to intervention (baseline, n = 789), unscribed visits during the intervention (concurrent control, n = 605), and scribed visits (n = 579) were included in the study. Clinical efficiency outcomes included time to close encounter, patient time in clinic, and number of visits per clinic session. Quality outcomes included EHR note quality, rates of medication and immunization review, population of patient instructions, reconciliation of outside information, and completion of preventative health recommendations.

resultsMedian time to close encounter (IQR) was lower for scribed visits [0.4 (4.8) days] compared to baseline and unscribed visits [1.2 (5.9) and 2.9 (5.4) days, both p < 0.001]. Scribed notes were more likely to have a clear history of present illness (HPI) [OR = 7.30 (2.35-22.7), p = 0.001] and sufficient HPI information [OR = 2.21 (1.13-4.35), p = 0.02] compared to unscribed notes. Physicians were more likely to review the medication list during scribed vs. baseline visits [OR = 1.70 (1.22-2.35), p = 0.002]. No differences were found in the number of visits per clinic session, patient time in clinic, completion of preventative health recommendations, or other outcomes.

conclusionsWorking with a scribe in an academic internal medicine practice was associated with more timely documentation.

Indexed as

DocumentationPhysiciansEfficiencyElectronic Health RecordsHumansInternal MedicineClinical efficiencyElectronic health recordsPrimary careQuality of careScribe

Identifiers

PMID34247600
PMCPMC8272908

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.