A Cost-Benefit Analysis of Medical Scribes and Electronic Medical Record System in an Academic Urology Clinic
Electronic medical records have introduced an additional level of complexity to the patient-provider encounter and medical scribes may offer a solution. We examined how a medical scribe system could support an academic urology clinic. To assess the financial feasibility of this model, we analyzed the additional costs associated with adding medical scribes and we discuss the potential benefits of this system.
We measured total patient wait and interaction times with staff, and estimated the additional staff required to maintain an increased patient load if medical scribes were introduced. We then calculated the average revenue per patient during the most recent 9 months of data to estimate the minimum increase in the number of patient visits needed to offset the additional staffing needs.
Mean ± SD total wait time was 23 minutes 28 seconds ± 13 minutes 4 seconds. Average monthly expenses would increase by $17,452.50 for 6 additional staff members, including 1 nursing assistant, 1 patient service specialist, 1 nurse and 3 scribes. There was an average of 666 monthly office visits and average net revenue to the department was $107.78 per patient visit. The increase in the number of patient visits required to break even would be 162 additional patients per month, representing a 24.3% increase. Additional downstream revenue was considered.
A medical scribe system in the example of an academic urology clinic setting could increase patient flow and decrease the burden on medical providers by reducing computer charting. This model is only financially prudent if the increased expenses are offset by additional revenue from increased patient visits.
- 1 : Cost-benefit analysis of electronic medical record system at a tertiary care hospital. Healthc Inform Res2013; 19: 205. Google Scholar
- 2 : A cost-benefit analysis of electronic medical records in primary care. Am J Med2003; 114: 397. Google Scholar
- 3 : Costs and Benefits of Health Information Technology. Evidence Reports/Technology Assessments, No. 132. Report No. 06-E006. Rockville: Agency for Healthcare Research and Quality2006. Google Scholar
- 4 : Electronic health records lifecycle cost. J Health Care Finance2013; 39: 36. Google Scholar
- 5 Bhargava HK and Mishra AN: Electronic Medical Records and Physician Productivity: Evidence from Panel Data Analysis. November 1, 2011. Available at http://dx.doi.org/10.2139/ssrn.1952287. Accessed July 15, 2014. Google Scholar
- 6 : Electronic medical records and physician stress in primary care: results from the MEMO Study. J Am Med Inform Assoc2014; 21: e100. Google Scholar
- 7 : The use of electronic medical records communication patterns in outpatient encounters. J Am Med Inform Assoc2001; 8: 610. Google Scholar
- 8 : Primary care physicians’ use of an electronic medical record system: a cognitive task analysis. J Gen Intern Med2009; 24: 341. Google Scholar
- 9 : The impact of electronic medical records on patient-doctor communication during consultation: a narrative literature review. J Eval Clin Pract2009; 15: 641. Google Scholar
- 10 : The relationship between patient’s perceived waiting time and office-based practice satisfaction. N C Med J2006; 67: 409. Google Scholar
- 11 : Prospective evaluation of a scribe program's impacts on provider experience, patient flow, productivity, and teaching in an academic emergency medicine practice. Ann Emerg Med2013; 62: S1. Google Scholar
- 12 : Scribes in an ambulatory urology practice: patient and physician satisfaction. J Urol2010; 184: 258. Link, Google Scholar
- 13 : Use of scribes increases physician productivity and revenue. PharmacoEconomics & Outcomes News2013; 685: 9. Google Scholar
- 14 : Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a prospective study. Clinicoecon Outcomes Res2013; 5: 399. Google Scholar
- 15 : Medical scribes: are scribe programs cost effective in an outpatient MFM setting?. Am J Obstet Gynecol2013; 208: S240. abstract 560. Google Scholar
- 16 : An ED scribe program is able to improve throughput time and patient satisfaction. Am J Emerg Med2014; 32: 399. Google Scholar