Carnes Kevin M, de Riese Cornelia S, de Riese Werner T W
Department of Urology, Texas Tech University Health Sciences Center, Lubbock, Texas.
Urol Pract. 2015 May;2(3):101-105. doi: 10.1016/j.urpr.2014.10.006. Epub 2015 Feb 26.
Electronic medical records have introduced an additional level of complexity to the patient-provider encounter and medical scribes may offer a solution. We examined how a medical scribe system could support an academic urology clinic. To assess the financial feasibility of this model, we analyzed the additional costs associated with adding medical scribes and we discuss the potential benefits of this system.
We measured total patient wait and interaction times with staff, and estimated the additional staff required to maintain an increased patient load if medical scribes were introduced. We then calculated the average revenue per patient during the most recent 9 months of data to estimate the minimum increase in the number of patient visits needed to offset the additional staffing needs.
Mean ± SD total wait time was 23 minutes 28 seconds ± 13 minutes 4 seconds. Average monthly expenses would increase by $17,452.50 for 6 additional staff members, including 1 nursing assistant, 1 patient service specialist, 1 nurse and 3 scribes. There was an average of 666 monthly office visits and average net revenue to the department was $107.78 per patient visit. The increase in the number of patient visits required to break even would be 162 additional patients per month, representing a 24.3% increase. Additional downstream revenue was considered.
A medical scribe system in the example of an academic urology clinic setting could increase patient flow and decrease the burden on medical providers by reducing computer charting. This model is only financially prudent if the increased expenses are offset by additional revenue from increased patient visits.
电子病历给医患诊疗过程带来了额外的复杂性，而医疗文书员或许能提供一种解决方案。我们研究了医疗文书员系统如何支持一家学术性泌尿外科诊所。为评估该模式的财务可行性，我们分析了增加医疗文书员带来的额外成本，并讨论了该系统的潜在益处。
我们测量了患者的总等待时间以及与工作人员的互动时间，并估计了引入医疗文书员后为维持增加的患者量所需增加的工作人员数量。然后，我们计算了最近9个月数据中每位患者的平均收入，以估计抵消额外人员需求所需的患者就诊量的最小增幅。
平均总等待时间为23分28秒±13分4秒。增加6名额外工作人员（包括1名护理助理、1名患者服务专员、1名护士和3名文书员），每月平均费用将增加17452.50美元。每月平均门诊量为666次，该科室每位患者就诊的平均净收入为107.78美元。达到收支平衡所需增加的患者就诊量为每月额外增加162名患者，增幅为24.3%。还考虑了额外的下游收入。
以一家学术性泌尿外科诊所为例，医疗文书员系统可以通过减少电脑录入图表工作来增加患者流量，并减轻医疗服务提供者的负担。仅当增加的费用被因患者就诊量增加带来的额外收入抵消时，该模式在财务上才是审慎的。
