Abstract: PNFLBA-06
Sources of Funding: none

Introduction

The advent of electronic health records (EHR) has been determined to be a major cause of physician frustration and burnout. One strategy has been the use of scribes to assist with completion of medical records during office visits. Although data suggests that patients accept the presence of scribes and scribes can improve physician satisfaction, there is conflicting data on whether scribes improve productivity and no studies on the impact of scribes specifically in urology. We sought to determine whether the use of scribes improved provider productivity in our urology practice.

Methods

We instituted a voluntary scribe program at our multi-site large urology practice. A total of 20 providers participated in the scribe program (user group, UG). 18 providers practicing in the same physical offices who declined the use of scribes served as a control group (non-user group, NUG). Provider productivity as measured by total evaluation and management (E&M)visits and relative value units (RVUs) visits were aggregated and compared for the 6 months pre- and post-adoption of the scribe. The month the scribe started was considered a training month and excluded from analysis. Coding patterns were assessed for UG and NUG pre- and post-scribe as well. Statistical analysis pre- and post-scribe for each provider was performed using Student's paired t-test.

Results

Pre-scribe E&M visits for UG and NUG were 1613.8 and 1661.1, respectively (difference 47.3, p=0.72). Pre-scribe RVUs for UG and NUG were 11567.7 and 10475.6, respectively (difference 1092.1, p=0.22). For UG post-scribe, significant increases in both E&M visits and total RVUs were observed (E&M visits 1836.9, +13.8%, p=0.00; RVUs 12467.7, +7.8%, p=0.05). Conversely, there was no significant change in either E&M visits or RVUs for NUG (E&M visits 1651.6, -0.6%, p=0.76; RVUs 10576.0, +1.0%, p=0.67). Post-scribe, the difference in RVUs between UG and NUG was significant (1891.7, p=0.05) while the difference in RVUs approached, but did not reach, significance (185.3, p=0.08).

Conclusions

To date, there has been no analysis on the impact that the addition of scribes has on productivity in the urology office. Our data suggests that productivity as measured by both office E&M visits as well as total RVUs is significantly improved by the addition of scribes. When combined with other data regarding scribe acceptance by patients and improvements in physician satisfaction, the utilization of scribes is a viable option for urology practices seeking to manage EHR fatigue in their providers.

Funding

none