Pritzker School of Medicine, University of Chicago, Chicago, Illinois (T.J.M., W.W.L., V.G.P., N.L.).
Centre for Health Economics and Policy Innovation, Imperial College Business School, Imperial College London, London, United Kingdom (M.R.S.).
Ann Intern Med. 2021 Jan;174(1):1-7. doi: 10.7326/M20-0428. Epub 2020 Oct 6.
Economic analyses of medical scribes have been limited to individual, specialty-specific clinics.
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.
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.
2015 data from CMS and the National Ambulatory Medical Care Survey.
Health care providers.
1 year.
Office-based clinic.
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 were not sensitive to most inputs, with the exception of hourly scribe cost and inclusion of CPT revenue.
Use of Medicare data and failure to account for indirect costs, downstream revenue, or changes in documentation quality.
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.
University of Chicago Medicine's Center for Healthcare Delivery Science and Innovation and the Bucksbaum Institute.
对医疗抄写员的经济分析仅限于个别专科诊所。
确定各专业在 1 年内实施抄写员后需要增加多少患者就诊次数才能收回成本。
基于 2015 年医疗保险和医疗补助服务中心 (CMS) 和全国门诊医疗保健调查 (National Ambulatory Medical Care Survey) 的数据进行建模研究。抄写员成本基于文献综述和第三方承包商模式。收入来自直接就诊计费、CPT（当前程序术语）计费以及全国门诊医疗保健调查的数据。
CMS 和全国门诊医疗保健调查 2015 年的数据。
医疗保健提供者。
1 年。
门诊诊所。
医生必须增加多少额外的患者就诊次数才能在 1 年内收回抄写员计划的成本。
为了收回抄写员的成本，平均每天需要增加 1.34 次新患者就诊（每年 295 次）（范围，0.89 [心脏病学]至 1.80 [矫形外科]每天新患者就诊）。对于复诊患者，平均每天需要增加 2.15 次就诊（每年 472 次）（范围，1.65 [心脏病学]至 2.78 [矫形外科]复诊患者就诊）。每天增加 2 次新患者（或 3 次复诊）就诊对所有专业都有利可图。
除了每小时抄写员成本和包括 CPT 收入之外，大多数输入结果都不敏感。
使用医疗保险数据且未考虑间接成本、下游收入或文件质量变化。
对于所有专业，由于抄写员而导致的生产力适度提高可能使医生能够看到更多的患者，并抵消抄写员的成本，使抄写员计划收支平衡。
芝加哥大学医学中心的医疗保健交付科学与创新中心和 Bucksbaum 研究所。
