Medical Documentation serves many purposes in the healthcare field. It serves as communication between healthcare providers, evidence of patient care and justification of insurance claims. These aspects of documentation prevent malpractice allegations while also obtaining appropriate reimbursement for services rendered (Pohlig, 2018). Due to the demands of being accurate and concise on patients' information, service rendered and follow up care, documenting has become tedious and time-consuming. Rendering a feedback consequence which decreases the quality time between patients and their healthcare provider (Collins et al., 2013). With this issue on the rise, a solution provided in the context of medical scribes.
Medical Scribes are individuals who specialize in charting healthcare provider-patient encounters in real-time (Gooch, 2016). There are various nationwide and state-wide companies that offer these services to associated hospitals and healthcare facilities. Even though there is an extra body during medical examinations, this form of service allows the healthcare provider to focus solely on the patient. This service is also beneficially to scribes who want a deeper and clearer insight into the healthcare field. This mutually symbiotic relationship has statistics of its advantage, so why is Amazon trying to break it up?
Amazon is currently taking a giant step in the health care field with voice transcription technology. The introduction of Amazon Transcribe Medical happened earlier this month and the service will allow real-time doctor-patient interactions and plugs the text straight into the medical record (Farr, 2019). With built-in grammar applications, linked Amazon Comprehend Medical system and cloud storage interface; Amazon Web Services (AWS) is trying to make healthcare documentation easy, grammatically correct, and accessible across multiple private platforms through the cloud. AWS has confirmed that it is HIPPA eligible and even though Amazon is a huge consumer company with tons of customer data, it is also HIPPA compliant with the Privacy and Security rules (Farr, 2019).
AWS is proud of its transcription technology. The company put in extensive measures to make sure that medical jargon is correctly annotated and that transcription has high accuracy. The only thing Amazon is yet to do is to provide statistics for their accuracy against other transcribing companies, but they are currently in the works for that too (Farr, 2019).
Bloggers Note: I have an indifferent view of this topic. There are many hurdles to look at, especially with the cloud and patients' privacy also with a single company having so much information on a single individual. This also disrupts a scribe and a medical professions relationship in terms that many MD's, DO's, PA's, RNP's, etc. of today were scribes of yesterday, but keeping in mind that technology is the future. I don't know though, that's just me 🤷🏿♀️ 🧐... Also, Medical Documentation should be a credit course or course block in healthcare schools, I'm just saying 🐸☕️
Farr, Chrissy. (2019, December 2). Amazon lets doctors record your conversations and put them in your medical files. Retrieved December 3, 2019, from https://www.cnbc.com/2019/12/02/amazon-web-services-unveils-transcribe-medical-software.html.
Pohlig, C. (2018, September 14). Document Patient History. Retrieved December 3, 2019, from https://www.the-hospitalist.org/hospitalist/article/123646/document-patient-history.
Collins, S. A., Cato, K., Albers, D., Scott, K., Stetson, P. D., Bakken, S., & Vawdrey, D. K. (2013). Relationship between nursing documentation and patients' mortality. American journal of critical care: an official publication, American Association of Critical-Care Nurses, 22(4), 306–313. doi:10.4037/ajcc2013426
Gooch, K. (2016, January 26). 17 things to know about medical scribes: As physicians look for ways to reduce the clerical load associated with EHR data entry, they are increasingly turning to medical scribes. Retrieved December 3, 2019, from https://www.beckershospitalreview.com/hospital-physician-relationships/17-things-to-know-about-medical-scribes.html.
Super interesting post. I was a medical scribe in an ER for some time (and will probably pick it up again in another clinic) so this is incredibly pertinent to my interests. I had no idea that Amazon was coming out with this technology for online scribing. The idea of transcription technology reminds me about another subset of scribing which is remote scribing. There are lots of companies now that use scribes remotely from home where they listen in through a computer and document the patient record from wherever they are. Having scribed in a busy busy busy ER, this sounds enticing, but my opinion on this is that nothing beats physical scribing. You make a great point about the physician-scribe relationship and it was because of the relationships I made with providers that gave me a super strong foundation in a class like physiology. I also share the concern of the privacy of patients and entrusting that in a company like Amazon. The concept of transcription technology is really cool and could be incredibly beneficial, but as you said, there are lots of hurdles to jump through. I'm curious to see where this will go in the future.
ReplyDeleteI think this is sad to hear. As a current scribe who has gained so much from my experience, I think disrupting this learning opportunity to create better physicians of the future would be disappointing. I also think the largest benefit that scribes provide is another set of eyes and ears to catch things. Sometimes in a busy shift in the ED physicians will forget to order something and a scribe can help remind you. Also, working in out patient psychiatry, I have seen the great benefit to patient as they can directly talk to their psychiatrist without a screen between them. This direct eye contact can help with non verbal communication and forming of a strong physician-patient relationship which is especially important in psychiatry. It's great to see new technology to help improve the efficiency of medical care, but I hope the medical community continues to see the unique value of medical scribes.
ReplyDeleteI agree, this is a super interesting post! As Amanda already mentioned, I also scribe in the ED and I have noticed that a lot of doctors and residents use a program that's called "Dragon". It is essentially what you (Tumi) already described where the doctor is able to dictate everything into their phone while they are on the hospital floor. However, typically they use it in conjunction with a scribe because the scribe will typically write the 'history of present illness', 'review of systems', and 'physical exam' in real time. The doctors usually use it for medical decision making and for the ED course where they are describing updates for the patient. And as you said, I think scribes are the doctors of tomorrow. It allows scribes to decide whether or not being a doctor is something they would like to pursue.
ReplyDeleteAccording to a study, there was no difference data entry through voice recognition versus hand-typed for the amount of time spent in charts as well as the amount of direct patient care. However, the study does note that there was a decreased number of workflow interruptions. However, in another study looking at medical scribes, there was a 50% decrease in the amount of time that physician's spent time in electronic health records (EHR). I think in general, more research probably needs to be done to actually see if there is any improvement in overall direct patient care, productivity, and the amount of time it takes to write charts.
Dela Cruz, J. E., Shabosky, J. C., Albrecht, M., Clark, T. R., Milbrandt, J. C., Markwell, S. J., & Kegg, J. A. (2014). Typed versus voice recognition for data entry in electronic health records: emergency physician time use and interruptions. The western journal of emergency medicine, 15(4), 541–547. doi:10.5811/westjem.2014.3.19658
Kimberly A Taylor, Deborah McQuilkin, Ronda G Hughes, Medical Scribe Impact on Patient and Provider Experience, Military Medicine, Volume 184, Issue 9-10, September-October 2019, Pages 388–393, https://doi.org/10.1093/milmed/usz030