BACKGROUND: Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role. OBJECTIVES: Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs). METHODS: A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes. After training by a staff member with significant experience in implementing scribe programs, scribes provided 1-to-1 support to a provider as staffing allowed. Comparisons were made between scribed and nonscribed visits. RESULTS: There were 49,389 patient visits during the study period (39,926 adult [80.84%] and 9463 pediatric [19.16%] visits), of which 7865 (15.9%) were scribed. For adults, scribed visits produced 0.20 additional RVUs per patient (p < 0.001). Scribes generated additional RVUs in Emergency Severity Index (ESI) 2 (p < 0.001) and 3 (p < 0.001) patients. There were variable effects of scribes on RVUs by diagnostic codes. For pediatric patients, scribed encounters generated 0.08 fewer RVUs per patient (p = 0.007). ESI score had no effect on RVUs. The impact of scribes on pediatric diagnostic groupings was inconsistent. CONCLUSIONS: Scribes had a positive impact on RVUs in adult but not pediatric patients. Among adults, scribes led to higher RVUs in ESI 2 and 3 but not 4 and 5 patients, perhaps suggesting a limitation to improve revenue capture on lower-acuity patients.
BACKGROUND: Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role. OBJECTIVES: Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs). METHODS: A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes. After training by a staff member with significant experience in implementing scribe programs, scribes provided 1-to-1 support to a provider as staffing allowed. Comparisons were made between scribed and nonscribed visits. RESULTS: There were 49,389 patient visits during the study period (39,926 adult [80.84%] and 9463 pediatric [19.16%] visits), of which 7865 (15.9%) were scribed. For adults, scribed visits produced 0.20 additional RVUs per patient (p < 0.001). Scribes generated additional RVUs in Emergency Severity Index (ESI) 2 (p < 0.001) and 3 (p < 0.001) patients. There were variable effects of scribes on RVUs by diagnostic codes. For pediatric patients, scribed encounters generated 0.08 fewer RVUs per patient (p = 0.007). ESI score had no effect on RVUs. The impact of scribes on pediatric diagnostic groupings was inconsistent. CONCLUSIONS: Scribes had a positive impact on RVUs in adult but not pediatric patients. Among adults, scribes led to higher RVUs in ESI 2 and 3 but not 4 and 5 patients, perhaps suggesting a limitation to improve revenue capture on lower-acuity patients.
Authors: Anastasia Pozdnyakova; Neda Laiteerapong; Anna Volerman; Lauren D Feld; Wen Wan; Deborah L Burnet; Wei Wei Lee Journal: J Gen Intern Med Date: 2018-04-26 Impact factor: 5.128
Authors: Jordan R Pollock; M Lane Moore; Aaron C Llanes; Joseph C Brinkman; Justin L Makovicka; Donald L Dulle; Nathaniel B Hinckley; Anthony Barcia; Matthew Anastasi; Anikar Chhabra Journal: Arthrosc Sports Med Rehabil Date: 2022-04-08
Authors: Paul R Shafer; Melissa M Garrido; Elsa Pearson; Sivagaminathan Palani; Alex Woodruff; Amanda M Lyn; Katherine M Williams; Susan R Kirsh; Steven D Pizer Journal: Contemp Clin Trials Date: 2021-05-25 Impact factor: 2.261
Authors: Heather A Heaton; David M Nestler; William J Barry; Richard A Helmers; Mustafa Y Sir; Deepi G Goyal; Derek A Haas; Robert S Kaplan; Annie T Sadosty Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2019-02-26
Authors: Katherine Walker; Michael Ben-Meir; William Dunlop; Rachel Rosler; Adam West; Gabrielle O'Connor; Thomas Chan; Diana Badcock; Mark Putland; Kim Hansen; Carmel Crock; Danny Liew; David Taylor; Margaret Staples Journal: BMJ Date: 2019-01-30