Login to Access Video or Poster Abstract: MP76-13
Sources of Funding: None

Introduction

Usability of the EMR has failed to fulfill its purported promise of increased efficiency in physician documentation. Although primarily used in the ER, medical scribes have been shown to provide high satisfaction rates for both physician and patients during urology office hours. With an aging population and shortage of physicians, urologists face pressure to see an increasing clinical workload in the office and need to maximize office based productivity and efficiency. We hypothesize that medical scribes can increase patient encounters, net revenue, and physician quality of life in the outpatient urology setting.

Methods

We retrospectively reviewed billable encounters of nine urologists practicing in an urban private and academic urologic practice. Number of billable encounters, scribe expense, revenue, and net revenue were compared between quarter 1 of 2015 (Q1-15) and 2016 (Q1-16). Medical scribes were integrated into the practice following a 6 month trial period and by Q1-16 the scribe – physician interaction had matured. A survey was administered to all physicians after Q1-16.

Results

Between Q1-15 and Q1-16 the average encounters per physician increased by 152 [range -22-382] and average revenue increased by $15,802.78 [$469 - $37,106]. Average scribe expense per physician for Q1-16 was $6,042.39 [$2,978.39 - $10,899.00] and therefore net change in revenue after accounting for scribe cost was $9,760.39 [-$2,509.39 - $26,207.00]. The average scribe cost per encounter was $8.58 [$6, $11]. We had a 100% response rate to our survey. On a scale of strongly disagree (1) to strongly agree (5), physicians reported an increase in productivity (4.4), increase in quality of life (4.8), and an average decrease in after-hours documentation of 5.9 hours.

Conclusions

Following incorporation of scribes, an increase in average encounters and net revenue per physician was observed. Self-assessed physician productivity and quality of life greatly increased, leading to an overwhelmingly positive impression of medical scribes within the urologic ambulatory practice.

Funding

None