A
HANDBOOK
FOR
For Emergency Rooms, Private Practices and Hospitals.
INTRODUCTION
If you want to see more patients and make your practice
more profitable, medical scribes are a must. These
tech-savvy EMR specialists relieve the burden of
documentation to free up physicians and dedicate more
time to revenue-generating clinical work.
Too often, scribe programs fail to deliver expected results
simply because one critical step was overlooked. This
handbook will guide you through each of them as you
learn how to build a high-quality medical scribe program.
BUILDING A QUALITY
SCRIBE PROGRAM
While we have scribe staffing down to a science, it did take a while to
get here. eScribe's founder, former emergency physician Dr. Brian
Clare, has been using and managing scribes since the 1990s. Our
program managers have been training and overseeing scribes, day in
and day out, for years. And our chief medical officer launched her own
career by starting out as a scribe herself. The following handbook is
based on insights these and other members of the eScribe team have
gained while training thousands of medical scribe candidates and
collaborating with hundreds of physicians and healthcare administrators.
WHY USE SCRIBES
IMPROVE PRODUCTIVITY
by freeing up physicians’ time
INCREASE REVENUE
through better documentation
INCREASE PATIENT SATISFACTION
through better documentation
• More patients
• Better coding
• Shorter wait times
• Higher income
• More productivity
• Better work lifestyle
• More focused attention
• No EMR distractions
• Faster treatments
• Valuable clinical exposure
• Career-building experiences
• Excellent job training
WHERE TO
START
FIVE SIGNS IT’S TIME FOR A SCRIBE PROGRAM
1
Your health data’s not as accurate as it used to, or could, be.
2
Patient wait times are increasing.
3
Physician morale is low.
4
Patient ratings are slipping.
5
Physicians are regularly documenting visits after hours.
If your practice is relatively small, your current in-house staff may be
able to handle most of the scribe staffing process. For larger scribe
staffing programs, you will need full-time employees dedicated to
managing recruiting, training, evaluations and turnover.
QUICK TIP:
RECRUITING
HOW TO ENSURE
HIGH QUALITY SCRIBES:
Top graduates of elite universities have
many job options. To successfully recruit
and retain these candidates, think of creative
ways to promote the value of scribing at
below-market rates for student wages.
Snapshot of the Ideal Scribe Candidate
Alex Tremblay
The Standards Every
Candidate Should Meet
Scribe staffing is essentially talent
management. For a scribe program
to work well, you’ll need to find and
attract the right candidates—
medically-minded students who are
tech-savvy, enthusiastic and
hard-working—and give them a
reason to choose you over many
other employment opportunities.
As you evaluate students for scribe
positions, be sure you can answer “yes”
to every one of these questions:
Do they have advanced computer skills?
Can they type at a minimum rate of 80 WPM?
Are they passionate about healthcare?
Are they medically-minded?
Do they have relevant experience?
Are they top performers with high GPAs?
Do they have relevant job experience?
Are they eager to learn?
Are they ready to commit to their fair share
of nights, weekends and holidays?
Are they enthusiastic about the work?
Student at: College of William and Mary
Major: Biology
GPA: 3.87
Travis plans to become a practicing
physician, most likely in oncology
and orthopedic medicine. He also
hopes to teach and do medical
research—two areas he’s gained
valuable first-hand knowledge of
through his role as a medical scribe.
“Working in a clinical setting promotes active learning concerning medical
terminology and concepts.
This type of medical
knowledge is something
that cannot be taught in an
undergraduate classroom,
and is what makes the
scribe experience special.”
SCRIBE SALARIES
Once you’ve found a great pool of candidates, how much should you pay them?
This is a common question, often accompanied by another:
“Are scribes cost efficient?”
The answer depends not only on how thoroughly you vetted candidates during the
recruitment phase, but also how well your staff manages the newest members of the team.
Overhead Associated
with Managing Scribes
The true cost of managing a scribe
program goes beyond payroll.
Scribes are a workforce, and one
with a high turnover rate at that. If
you choose to manage a program
in-house, be sure you’re ready to
take on the following costs:
Ongoing training
Compliance monitoring
Performance evaluations
Human resources
IT support
Health insurance
The key is to go beyond calculating
overhead to see how scribes will
impact your entire revenue cycle.
Smart, fully-trained scribes tend to
correlate with shorter wait times, higher
patient volumes, increased revenues
and reimbursements, improved patient
care and happier doctors.
While the exact numbers will vary by
location and practice, today’s scribes
are all paid an hourly wage. The good
news is that wages tend to be
surprisingly affordable (typically under
$20 an hour), as the best scribe
candidates are more interested in the
experience than the salary.
(at larger practices)
“I hated the idea of scribes. Thought it was a ‘fools errand,’ would undermine
education…bankrupt us. I am also the first to admit I was dead wrong.”
- Emergency Physician in Virginia
TRAINING
Finding top talent is just the start. While the best candidates are fast
learners, they still arrive with no prior knowledge of your electronic
medical records software. You’ll need to develop training tools and
resources aimed at making employees proficient at advanced medical
terminology, documentation, billing and coding. Use the worksheet on
these pages to begin planning and budgeting for your scribe training
program.
COMPENSATION
Who will conduct the training?
Will trainers be compensated for their time?
Will scribes be compensated for training hours?
TRAINING MATERIALS
How will training materials be created?
How often will they be updated?
Where will the training and exams take place?
Classroom
Online
Exam rooms
All of the above
Tip: If you work in a setting where multiple EMRs are used, devise a
separate training program for each one.
Estimated hours:
Estimated budget:
SCHEDULING & PLANNING
How many hours do you anticipate it will take to get each scribe fully
trained?
How will you plan training around class schedules?
Estimated hours:
Estimated budget:
ASSESSMENT
How will you monitor and evaluate job performance?
What metrics will you use to measure ROI?
How often will the review process be performed?
Estimated hours:
Estimated budget:
Total anticipated hours:
Total budget:
MANAGING
INEVITABLE SCRIBE TURNOVER
CONGRATULATIONS! If you’ve gotten this far, you’re on your way to a
program of scribes who are fully trained on your EMR and ready to click through
it at jaw-dropping speed and accuracy. Soon you’ll get into a rhythm of ongoing
training and performance reviews, and your doctors will be happier than ever.
This can only mean one thing:
You’re already getting close to the next round of hiring.
If there’s one certainty in the scribe staffing industry, it’s predictably high turnover.
More than 90% of scribes are guaranteed to move on in less than two years.
Effective scribe candidates are young, smart, tech-savvy and ready to apply
these unique EMR experiences to physician assistant and medical school
applications. Unfortunately, this means managing turnover is a necessary evil for
all medical scribe programs.
Here are some steps you can take to prepare for this part of the process:
PLAN AHEAD
Nurture recruitment contacts at nearby universities, keep training materials fresh
and make an online job application accessible at all times.
START A WAITING LIST
You may be surprised at how quickly you can build up a pool of highly qualified
candidates who are ready and eager to join your team.
PARTNER WITH LOCAL UNIVERSITITES AND PRE-MED PROGRAMS
Creating a recruitment center at a local college or university will prove to be
invaluable for both your practice and the university.
EMBRACE IT
This is one industry where reducing employee turnover is not an option. Instead,
embrace it. The more willing you are to nurture current scribes, the more likely
they are to recommend the job to younger classmates and colleagues.
TIPS
TO MAKE YOUR
SCRIBE PROGRAM
EXCEL
CREATE SCRIBE TRAINING MATERIALS SPECIFIC TO YOUR EMR
If you plan to manage the scribe program in-house, hold mock “clinical cases” and have
new scribes practice using your EMR in a classroom setting before releasing them for
on-the-job training. If you contract the management of your program to a scribe staffing
company, make sure it has a training program that will cater to your specific EMR.
Introduce Scribes Gradually
Instead of inserting scribes wholesale into your practice, introduce them gradually. It takes
time for the rest of the healthcare team to understand and adjust to the role of scribes.
Teach Providers How to Properly Interact with Scribes
Providers will need to become versed in what scribes can and cannot, or are not
permitted, to do. Educate physicians on compliance standards associated with using
scribes.
Audit Scribe Charts Periodically
One of the principal goals of using scribes is to reduce the number of delinquent and
downcoded patient charts. Periodically auditing scribes’ charts for completeness,
accuracy and timeliness is an important quality control measure.
Measure Your Scribe Program’s Impact
Create a plan early on for measuring success. Establish a timeframe to see how well your
scribe program is impacting provider efficiency, chart accuracy, patient care and provider
satisfaction.
PARTING
THOUGHTS
Yes, it’s a lot to manage. But a high quality
scribe program that follows the steps above
WILL help your physicians see more
patients, increase revenue and, above all,
rediscover the joy of practicing medicine.
ABOUT eScribe
eScribe provides industry-leading scribe staffing
for hospitals and physician-owned groups across
the nation in a variety of emergency medicine and
outpatient settings. The firm has a proven track
record of creating full-service scribe programs that
are affordable and produce a sustainable, positive
return on investment for its partners.
QUESTIONS?
757.645.0938 www.md-scribes.com/contact