Brigham and Women's Hospital is looking to hire medical data-entry clerks known as scribes to help doctors spend less time navigating clunky software systems and more time talking to patients.
Brigham already uses a handful of scribes at its Urgent Care Center in Foxboro, which has been welcomed by doctors and patients, according to Dr. Adam Landman, an emergency physician and chief medical information officer at Brigham.
"It lets me sit next to the patient and focus 100 percent of my attention on the patient," Landman said. "There are a few patients who don't want the scribe involved in their care, and then I ask the scribe to leave."
A scribe follows a doctor into a patient visit and takes real-time electronic notes while the doctor and patient talk. A scribe can be particularly helpful in hectic clinics, where health care providers have to move quickly to see lots of patients.
"Scribes allow us, as caregivers, to see and treat patients more efficiently by assisting in the documentation and allowing us to focus on … history-taking, performing exams and medical decision-making," said Dr. Christopher Baugh, who was medical director of Brigham's Urgent Care Center when the scribes were hired.
The growth of modern-day scribes is one way some hospitals and clinics are responding to an environment where doctors by some estimates spend 80 percent of their time clicking and tapping devices and just 20 percent seeing patients. That technology burden is the cause of much dissatisfaction among doctors, according to a recent American Medical Association survey.
Modern-day scribes started becoming popular as electronic health records started replacing paper records.
"The data-entry piece is so time-consuming," said Dr. Michael Murphy, CEO of ScribeAmerica, a Florida-based company that supplies scribes to Brigham and hundreds of other hospitals.
"The physician is basically becoming a data-entry clerk, which is decreasing their productivity. (Scribes) are really a business tool to allow physicians to increase their productivity."
There are about 12,000 scribes across the country, including 3,800 employed by ScribeAmerica, Murphy said. Scribes are rare in Boston's academic medical centers because residents, training to become doctors, often do the work of scribes, he said.
Brigham is working to expand its use of scribes beyond the Urgent Care Center. But that may be a short-term fix, Landman said. The hope is to have an electronic health record system that is so seamless and user-friendly that doctors can use it without sacrificing patient time.
"Do we need to change the way our systems work so that we don't need scribes?" Landman said. "That's the question."
Dr. Keith Dreyer, radiologist at Massachusetts General Hospital, indicated at a recent forum on medical technology that it could be many years before that happens.
"It's probably going to take a couple decades before this technology is optimized for user experience," he said. "We're in a frustrated user mode today."
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