The idea we'd spend more money, add steps/inefficiencies and introduce new potential for errors (opposite of electronic health-record goals) via scribes or “audios to transcribers” sets the industry back almost 40 years when physicians first used computerized physician-order entry successfully and happily—and we're touting scribes and audio to “ease” the transition”? When will physicians take over from these scribes?
Using scribes sets industry 'back almost 40 years'
CPOE is not “back-end documentation” or a “clerical” process for requisition generation. CPOE is an upfront clinical transaction—part of human “interaction” with a patient—a tool enabling optimal decisions via access to EHR and medical knowledge bases. If stethoscopes were hard to use, would some suggest a second party listen and report sounds back to the physician?
Rather than navigate the system as intended, one envisions a physician asking a scribe in real time to “check laboratory result, check prior medications, check earlier blood pressure reading, etc., as the scribe navigates (with same clunky system physicians won't use) and barks back responses (HIPAA?) or points to a screen—reminiscent of a Marx Brothers' movie.
We need physicians to see computers as an invaluable tool and information source that can be woven into workflow, while remaining “human” and productive. EHR and device vendors clearly need to design solutions that work for clinicians—there are some out there! The use of scribes or transcribers of orders only delays getting to the real solution. As reported, once physicians use well-designed systems, they don't turn back.
Ann FarrellPrincipalFarrell AssociatesSan Francisco
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