User:Diana Franklin/sandbox/Virtual Medical Scribe

Virtual Medical Scribe
A virtual medical scribe is a trained professional who listens to physician-patient interactions and charts in real-time. They remotely accompany the physician during patient visits via HIPAA-compliant technology, listen into patient encounters, take notes and document directly into the EHRs. They work from a fully remote location, usually a HIPAA-compliant company designated office. By handling EHR-related tasks and clinical charting, virtual scribes allow physicians to focus more on patient diagnosis and treatment. A virtual medical scribe is otherwise known as an online medical scribe, telescribe, off-site medical scribe or remote medical scribe. A virtual medical scribe is an indispensable part of the patient care team, and must comply with all information management standards, HIPAA and HITECH requirements, and laws governing confidentiality and patient rights.

History
Medical scribes were first introduced in the year 1970 to provide administrative support to an emergency room physician. With the HITECH financial incentives and punitive action to adopt electronic health records in 2009, the use of medical scribes gained traction. Though EHRs were intended to make patient record keeping easier, it was the other way around. Physicians found entering patient data into clunky, cumbersome and poorly designed EHRs extremely difficult and time-consuming. As a result, physicians experienced high levels of burnout and reduced work-life balance satisfaction. It is at this point physicians started to take the help of medical scribes to assist them with medical documentation and other administrative tasks. Medical scribes appeared to be a promising strategy to significantly improve physician satisfaction and reduce burnout. With the help of scribes physicians were able to spend less time on documentation and more time on direct patient care, thus enhancing the joy of practicing medicine and preventing burnout. Today, as experts anticipated, there are 100,000 medical scribes employed in the US healthcare industry, with one scribe for every nine physicians.

However, over time physicians started to realize the downside of medical scribes. The huge cost, risk of functional creep and scribe presence disruptive to patient interactions, physicians started to outsource their scribing needs. With virtual medical scribes being less intrusive, flexible, and costing half the price of an on-site scribe, they soon became a preferred option to the on-site scribes. Most importantly, after the Covid-19 global pandemic almost every business made a switch to remote working models. And virtual medical scribe services being Covid-friendly in nature, recorded a significant uptick.

Need for Virtual Medical Scribes
The role of a physician is to offer the best possible care for sick patients. The key to providing high-quality care lies in open communication with patients to assess needs and create an appropriate care plan. Paperwork and administrative tasks required substantial time and negatively impacted physicians’ ability to fully connect with patients and provide high quality care. This conundrum fueled the growth of medical scribes. Before the onset of the Covid-19 pandemic most of the scribes worked in the exam rooms in close proximity to physicians. Following the outbreak, with patients avoiding clinic visits and many in-person scribes being laid-off, the use of virtual medical scribes accelerated as they could work from any corner of the world. Moreover, the need to reduce paperwork burden, relieve physician burnout, and limit staff in exam rooms in response to the pandemic, has significantly increased the use of virtual medical scribing services.

Virtual Medical Scribe Workflow Model
The virtual scribe logs into the clinics’ EHR prior to the first patient visit to prep charts for the list of patients scheduled for the day.

Before Exam ·


 * The nurse or the medical assistant will take the patient into the exam room.
 * The patient is informed about the virtual medical scribe practices and ensured of their data privacy.
 * The nurse or the medical assistant enters the patient’s medical history and vitals into the electronic medical records.
 * The virtual medical scribe who is connected remotely to the exam room through a HIPAA-compliant VOIP connection, reviews the patient’s file.
 * The physician now enters the exam room.

During Exam


 * The virtual medical scribe listens to the patient encounters through a microphone attached to their computer and documents in real-time.
 * The scribe enters notes, ICD/CPT codes, eRx, orders, and other relevant data directly into the patient’s chart.
 * The physician focuses entirely on providing patient care, while the virtual scribe on documenting the encounter.

After Exam


 * After the patient visit is complete, the physician and the virtual scribe will review the charts together, via a secure VOIP connection.
 * The physician may instruct the scribe to make any changes, include any additional information or the scribe may seek clarifications, if any. Once these are taken care of, the physician signs off and the charts are complete.
 * The scribe may also prepare and fax referral letters to medical specialists for follow-up care, as directed by the physician.

Roles and Responsibilities
Virtual medical scribes join physicians virtually during patient visits, and provide accurate and thorough documentation in accordance with the guidelines established within the healthcare industry, all in real-time.

The following is the list of the roles and responsibilities assigned to a virtual medical scribe


 * The primary duty of the virtual medical scribe is to take accurate notes during patient visits and document them in real-time into the electronic medical records.
 * Document physician dictated medical history and physical examination findings
 * Document the procedures and treatments performed by the physician
 * Document the radiographic findings and laboratory test results as dictated by physicians
 * Chart the physician’s recommendations on diet and the physical activity behaviors
 * Maintain a meticulous record of patient's medical history, laboratory and radiology test results, and share such information as needed
 * Retrieve information for review i.e., nurses notes, prior records, and diagnostic results
 * Quickly research and locate any information that the physician may request
 * Record the correct time at which patient care activities were performed
 * Enter appropriate ICD/CPT codes to maximize reimbursements
 * Assist in filling out time-consuming forms, charts etc.,
 * Respond to messages or questions from patients or other physicians, as instructed by the physician
 * Place orders for medications and labs as directed by the physician
 * Attend information management, HIPAA, billing and coding and regulatory compliance training
 * Adhere to strict guidelines regarding the style and components of medical records
 * Abide to both ethical and legal responsibilities to safeguard the confidentiality of patient information

Types of Medical Scribe Services
In order to reduce the EHR documentation burden and improve efficiency, physicians across the country have started to take the help of medical scribe services. The following are the three types of scribe service models available.

On-site Scribe Model – Here the scribes work alongside the physician and chart patient encounters in real-time. They are direct employees of the clinic or hospital and work either full-time or part-time. They are also called in-house scribes.

Contracted Scribe Model – These scribes are not direct employees but work as a contracted service. Most commonly, they join the physician in the exam room. However, in some cases, the scribes may work from another room within the facility listening to appointments through a microphone and documenting in real-time. Medical scribe companies like ScribeAmerica, ProScribeMD, and ScribeKick manage scribes on a contract basis.

Virtual Scribe Model – These scribes provide real-time documentation assistance from an offsite HIPAA-compliant facility maintained by the virtual scribe company. Virtual medical scribe companies like Physicians Angels, Scribe4Me, ScribeEMR, AQuity Solutions and many others provide this type of remote or virtual scribing service.

Medical Scribe Training Programs
With virtual medical scribes being widely used in clinical practices, the need for training has also grown tremendously.

Medical scribe training can take various forms.


 * Online course
 * Books and manuals
 * Specialized company-assisted training programs
 * Courses at local colleges

There are many online courses available that give you the flexibility and convenience to study online and earn the scribe certification. These courses are conducted by current or former scribes or even health care providers. The Medical Scribe Training provided by the Medical Scribe Training Institute offers both general medical scribe training courses as well as specialty training courses.

There are several books available that serve as a powerful tool for training a virtual medical scribe. These books serve as an excellent source of information, not just for beginners but also for experienced scribes.

The Ophthalmic Scribe Manual: This is a perfect manual to develop the unique skill set required to become a successful ophthalmic scribe. It covers everything from retina and cornea to glaucoma and oculoplastics, and is regarded as a complete guide for learning to scribe in ophthalmology.

Medical Scribe Training Manual, Fifth Edition: This manual is a valuable resource that covers everything needed to train an individual for a successful scribing career.

The Ultimate Medical Scribe Handbook: Emergency Department 4th Edition: This is a comprehensive training manual designed exclusively for those seeking to work as emergency room scribes. It covers topics including medical terminology, HIPAA standards, common emergency room conditions, and the components of the medical note. This handbook can be used as a stand-alone training resource, but also ideally supplemented with additional, verified training materials.

Ultimate Medical Scribe Handbook: General Edition: This is an excellent training resource for scribes in a variety of settings. It gives medical scribes the knowledge and skills they need to get started in clinical training.

The Ultimate Medical Scribe Handbook: Primary Care 3rd Edition: This is a basic training manual focused entirely on training the scribes working in the primary care setting. It serves as a complete handbook for those intending to become a scribe or as a supplemental guide to other training materials.

Medical Scribe Training Courses offered by Independent Schools and Colleges

Scribe Academy at Grand Valley State University

The GVSU Scribe Academy program is specially designed to equip individuals with the knowledge and skills needed to help physicians with documentation and the electronic health records. Students get to learn in a variety of educational settings – in the classroom, online and in the clinic setting. Helix Scribe Solutions will hire the student on an hourly basis upon successful completion of the course.

Saginaw Valley State University

Saginaw Valley State University located in Michigan has partnered with Covenant HealthCare in Saginaw to provide medical scribe training courses to help aspiring students learn charting procedures, HIPAA law, medical terminology and pharmacology. Students will also get a better understanding of the clinical workflow and safe use of EHRs. They call the scribes “physician facilitators” as they help physicians with their documentation needs.

Online Scribe Certification Courses

These online courses are not affiliated to any college instead scribe certification courses offered by companies upon completion of an online course or exam.

Pacific Medical Training

Pacific Medical Training offers a three-week intensive medical scribe training program with flexible hours that allows individuals to focus on their coursework. Their training program consists of two components - The Medical Scribe Certification Course and the Clinical Documentation EHR Course. On successful completion of the courses, the students will receive two certificates of completion.

Healthcare Scribes

Healthcare Scribes is an online medical scribe training course designed by a team of experts in various fields. It covers everything from medical terminology, medical coding, pharmacology, HIPAA to health records. This is a self-paced course and consists of 11 modules, with quizzes at the end of each module and a final exam. Upon successful completion the candidate will receive a Certificate of Training from the Online Career Training, LLC.

Company-Assisted Medical Scribe Training Programs

Several medical scribing companies offer their own training programs. Training takes place after hiring to provide them with the knowledge, skills and tools needed to be a successful scribe. The job is contingent upon the successful completion of the training program. Trainees are entitled to receive a stipend during the training period.

ScribeAmerica Training Program

ScribeAmerica offers a rigorous training program to equip aspiring scribes for fast-paced clinical settings. Their three-step training module is divided into


 * Two-week instructor-led classroom training. This is the orientation phase where they are taught the  fundamental skills, including medical terminology, pharmacology, HIPAA  regulations, EHR workflow, clinical documentation standards and billing  and coding.
 * A supervisory period, during which they gain hands-on clinical experience as they get to work with experienced scribes, and
 * Regular assessment, review and continuing education to ensure that scribes are efficient and stay current with the latest developments, skills and new technologies.

Physicians Angels

Physicians Angels offers a comprehensive program designed to train individuals to meet the providers’ needs as well as the industry requirements. Their program covers a wide-range of topics such as basic human anatomy and physiology, common disease conditions, medications, specialty-specific terminology, HIPAA compliance, coding, clinical workflow, and best practices for successfully managing an EHR. Generally, the training period ranges from one to four months.

S10 Healthcare Solutions

S10 Scribe Academy’s Medical Scribe Training program is an intensive, self-paced program built by industry experts and veterans. It covers everything from human anatomy, physiology, medical terminology, clinical workflow, billing and coding, to ensuring compliance with HIPAA policies. It is a three-level certification program and upon successful completion, the individual will be awarded a certificate of completion.

Elite Medical Scribes Training

The Elite Academy is a medical scribe training program run by the Elite Medical Scribes, LLC, They offer online training courses geared towards various specialties. Their courses cover all important elements, including human anatomy and physiology, medical nomenclature, clinical workflow, safe use of EHRs, medical coding/billing and compliance policies. Medical scribe training managers provide one-on-one training for newly recruited scribes, and real-time feedback to help them improve their skills and knowledge.

Medical Scribe Training Course offered by the Healthcare Documentation Professionals Group

American Healthcare Documentation Professionals Group

The American Healthcare Documentation Professionals Group is yet another provider of medical scribe training and certifications. They launched the first Medical Scribe Training Program in the year 2011. The Medical Scribe Certification Exam was introduced in the year 2017. Individuals can earn their certification by taking a 100-question online exam that tests their knowledge and skills in all aspects of medical scribe practice.