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你知道你的医疗记录员去年春天做了什么吗?COVID-19 对医疗记录员工作流程的影响。

Do You Know What Your Scribe Did Last Spring? The Impact of COVID-19 on Medical Scribe Workflow.

机构信息

Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, United States.

Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, United States.

出版信息

Appl Clin Inform. 2020 Oct;11(5):807-811. doi: 10.1055/s-0040-1721396. Epub 2020 Dec 2.

DOI:10.1055/s-0040-1721396
PMID:33264803
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7725591/
Abstract

OBJECTIVE

To understand the impact of the shift to virtual medicine induced by coronavirus disease 2019 (COVID-19) has had on the workflow of medical scribes.

DESIGN

This is a prospective observational survey-based study.

SETTING

This study was conducted at academic medical center in the United States.

PARTICIPANTS

Seventy-four scribes working in ambulatory practices within an academic medical center.

INTERVENTIONS

All medical scribes received a survey assessing their workflow since beginning of COVID-19 restrictions.

PRIMARY AND SECONDARY OUTCOMES

To assess the current workflow of medical scribes since transition to virtual care. Secondary outcomes are to assess the equipment used and location of their new workflow.

RESULTS

Fifty-seven scribes completed the survey. Overall 42% of scribes have transitioned to remote scribing with 97% serving as remote scribes for remote visits. This workflow is conducted at home and with personal equipment. Of those not working as scribes, 46% serve in preclinic support, with a wide range of EHR-related activities being reported. The remaining scribes have been either redeployed or furloughed.

CONCLUSION

The rapid transition to virtual care brought about by COVID-19 has resulted in a dramatic shift in scribe workflow with the adoption of a previously unreported workflow of remote scribing for virtual care. Additional work is now needed to ensure these new workflows are safe and effective and that scribes are trained to work in this new paradigm.

摘要

目的

了解 2019 年冠状病毒病(COVID-19)引发的虚拟医疗转变对医疗记录员工作流程的影响。

设计

这是一项基于前瞻性观察调查的研究。

地点

这项研究在美国的学术医疗中心进行。

参与者

在学术医疗中心的门诊实践中工作的 74 名记录员。

干预措施

所有记录员都收到了一份评估自 COVID-19 限制开始以来其工作流程的调查。

主要和次要结果

评估自过渡到虚拟护理以来医疗记录员的当前工作流程。次要结果是评估他们新工作流程所使用的设备和位置。

结果

57 名记录员完成了调查。总体而言,42%的记录员已经过渡到远程记录,97%的记录员为远程就诊提供远程记录服务。这项工作流程是在家中使用个人设备完成的。那些不担任记录员的人中有 46%从事临床前支持工作,报告了广泛的与电子健康记录相关的活动。其余的记录员已被重新部署或停职。

结论

COVID-19 引发的快速向虚拟护理的转变导致记录员工作流程发生了巨大变化,采用了以前未报道的远程记录员为虚拟护理工作的新流程。现在需要做更多的工作来确保这些新的工作流程是安全有效的,并且记录员已经接受过在这种新范式下工作的培训。

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本文引用的文献

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Safe use of the EHR by medical scribes: a qualitative study.医疗转录员安全使用电子健康记录:一项定性研究。
J Am Med Inform Assoc. 2021 Feb 15;28(2):294-302. doi: 10.1093/jamia/ocaa199.
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Virtual Scribe Services Decrease Documentation Burden Without Affecting Patient Satisfaction: A Randomized Controlled Trial.虚拟抄写员服务在不影响患者满意度的情况下减轻了文书工作负担:一项随机对照试验。
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Int J Med Inform. 2019 Mar;123:76-83. doi: 10.1016/j.ijmedinf.2019.01.001. Epub 2019 Jan 3.
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Use of Simulation Based on an Electronic Health Records Environment to Evaluate the Structure and Accuracy of Notes Generated by Medical Scribes: Proof-of-Concept Study.基于电子健康记录环境的模拟用于评估医学抄写员生成的记录的结构和准确性:概念验证研究。
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