The emergence of new data work occupations in healthcare: The case of medical scribes.

PURPOSE

Increasing demand for more and better documentation as well as digitalization of healthcare entail shifts in competencies and roles of healthcare occupations and professions. As a result of this data-centric technological development, new kinds of work and occupations emerge of which medical scribes are an example. To investigate and provide a case of an emergent occupation focused on 'data work', we describe the emergence, growth and stabilization of medical scribes, outline their history and provide a literature overview.

METHOD

We conducted a review of the literature on medical scribes in academic journals until 2017. These publications are categorized according to the country of study, medical specialization, method, focus, attitude to the use of medical scribes, and the reasons given for the use of medical scribes. We outline the history of the emergence of medical scribes and provide a summary of the existing research publications on medical scribes.

FINDINGS

We identified 60 papers of which a majority are based on cases from the USA; conducted in emergency departments; based on quantitative methods; focus on economic feasibility and satisfaction; are positive towards the use of medical scribes; and link the use of medical scribes to the implementation of electronic health records (EHR). There is a distinct lack of research on medical scribes themselves and their interaction with physicians, patients, and EHR.

CONCLUSIONS

Medical scribes have emerged as a new data-work occupation as a response to increased demands for documentation and digitalization through EHRs. Research on medical scribes has hitherto focused on efficiency and economic feasibility of scribes, and there is a need to look into the interaction of medical scribes with physicians and patients as well as look at opportunities for redesign of EHR. More generally, there is a need to look beyond the most prominent professions such as physicians and nurses in discussions of digitization and datafication of healthcare, and investigate how new and previous tasks are (re)distributed between occupations and professions.