Monday, February 9, 2015

Emergence of the Electronic Scribe

The definition of a scribe is a person who writes books or documents by hand as a profession ad helps keep track of records.  This profession is found in all literate cultures and lost most of its importance with the invention of printing press. 

The modern medical scribe is more a data jockey than a hand writer.  With the advent and proliferation of the Electronic Health Record (EHR), providers are forced to add more people power to document their records.  Originally most records were handwritten and/or dictated.  The downsides of handwriting are illegibility, incoherence, and lack of completeness.  Dictated report are often incoherent and filled with mistakes.

The EHR solution where the provider would type organized, logical data collection giving the document a realistic reflection of a clinical interaction. 

This assumption unfortunately does not translate into the reality of time constraints, lack of computer skills and difficult user platforms.  Providers became data entry clerks and charts are written in "computereeze".

Administrators and providers needed solutions.  Thus was born the medical scribe- an ancient Egyptian worker to document the history of what was happening.  Scribes follow the provider and inputs data into the EHR.  In lieu of using a scribe, voice activated technology.  The provider can dictate key information directly in the EHR.  Both of these solutions still have down sides such as incoherence and providers lack of computer skills, but are better than the third option of overtime typing/clicking everything yourself.

The negatives of scribes are costs, potential lack of accuracy during the filtering process and fundamental distaste of hiring more people to function normally.  EHR technology was meant to simplify the process, not exponentially complicate it.  The creation of the EHR has also created an unfunded mandate to provide more information to the government with the goal of solving human interactions by computers.  Computers are tremendous assistants, but rarely solve interpersonal relationships with multiple variables like provider patient interactions.

Scribes have evolved into "clickers of data" and probably do not handwrite anymore.  There should be a better solution in the modern era.

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