title: Impact of scribes on patient interaction, productivity, and revenue in a cardiology clinic: a prospective study.
abstract: OBJECTIVE
  Scribes have been used in the emergency department to improve physician productivity and patient interaction. There are no controlled, prospective studies of scribe use in the clinic setting.
  
  
  METHODS
  A prospective controlled study compared standard visits (20 minute follow-up and 40 minute new patient) to a scribe system (15 minute follow-up and 30 minute new patient) in a cardiology clinic. Physician productivity, patient satisfaction, physician-patient interaction, and revenue were measured.
  
  
  RESULTS
  Four physicians saw 129 patients using standard care and 210 patients with scribes during 65 clinic hours each. Patients seen per hour increased (P < 0.001) from 2.2 ± 0.3 to 3.5 ± 0.4 (59% increase) and work relative value units (wRVU) per hour increased (P < 0.001) from 3.5 ± 1.3 to 5.5 ± 1.3 (57% increase). Patient satisfaction was high at baseline and unchanged with scribes. In a substudy, direct patient contact time was lower (9.1 ± 2.0 versus 12.9 ± 3.4 minutes; P < 0.01) for scribe visits, but time of patient interaction (without computer) was greater (6.7 ± 2.1 versus 1.5 ± 1.9 minutes; P < 0.01). Subjective assessment of physician-patient interaction (1-10) was higher (P < 0.01) on scribe visits (9.1 ± 0.9 versus 7.9 ± 1.1). Direct and indirect (downstream) revenue per patient seen was $142 and $2,398, with $205,740 additional revenue generated from the 81 additional patients seen with scribes.
  
  
  CONCLUSIONS
  Using scribes in a cardiology clinic is feasible, produces improvements in physician-patient interaction, and results in large increases in physician productivity and system cardiovascular revenue.
authors: United heart and Vascular Clinic, St Paul, MN, USA.
authors: Alan J
authors: AJ
authors: Bank
authors: Christopher
authors: C
authors: Obetz
authors: Ann
authors: A
authors: Konrardy
authors: Akbar
authors: A
authors: Khan
authors: Kamalesh M
authors: KM
authors: Pillai
authors: Benjamin J
authors: BJ
authors: McKinley
authors: Ryan M
authors: RM
authors: Gage
authors: Mark A
authors: MA
authors: Turnbull
authors: William O
authors: WO
authors: Kenney
keywords: patient interaction, scribe; physician productivity, medical economics, patient satisfaction, physician
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