The Productivity Requirements of Implementing a Medical Scribe Program.

BACKGROUND

Economic analyses of medical scribes have been limited to individual, specialty-specific clinics.

OBJECTIVE

To determine the number of additional patient visits various specialties would need to recover the costs of implementing scribes in their practice at 1 year.

DESIGN

Modeling study based on 2015 data from the Centers for Medicare & Medicaid Services (CMS) and National Ambulatory Medical Care Survey. Scribe costs were based on literature review and a third-party contractor model. Revenue was calculated from direct visit billing, CPT (Current Procedural Terminology) billing, and data from the National Ambulatory Medical Care Survey.

DATA SOURCES

2015 data from CMS and the National Ambulatory Medical Care Survey.

TARGET POPULATION

Health care providers.

TIME HORIZON

1 year.

PERSPECTIVE

Office-based clinic.

OUTCOME MEASURES

The number of additional patient visits a physician must have to recover the costs of a scribe program at 1 year.

RESULTS OF BASE-CASE ANALYSIS: An average of 1.34 additional new patient visits per day (295 per year) were required to recover scribe costs (range, 0.89 [cardiology] to 1.80 [orthopedic surgery] new patient visits per day). For returning patients, an average of 2.15 additional visits per day (472 per year) were required (range, 1.65 [cardiology] to 2.78 [orthopedic surgery] returning visits per day). The addition of 2 new patient (or 3 returning) visits per day was profitable for all specialties.

RESULTS OF SENSITIVITY ANALYSIS

Results were not sensitive to most inputs, with the exception of hourly scribe cost and inclusion of CPT revenue.

LIMITATION

Use of Medicare data and failure to account for indirect costs, downstream revenue, or changes in documentation quality.

CONCLUSION

For all specialties, modest increases in productivity due to scribes may allow physicians to see more patients and offset scribe costs, making scribe programs revenue-neutral.

PRIMARY FUNDING SOURCE

University of Chicago Medicine's Center for Healthcare Delivery Science and Innovation and the Bucksbaum Institute.