The old saw about technology says it destroys jobs in some sectors and creates new ones in others.
But the adage probably couldn't have predicted the case of electronic health records and the growing number of medical scribes who work with them. Even as EHR use increases, so do the number of scribes manually recording their information.
The scribes sector, apparently, expects to see its numbers grow to 100,000 by 2020, a viewpoint article published in the Journal of the American Medical Association notes. The top firms in the space have been cited as among the fastest-growing in the country. If the 2020 projection is correct, that translates to one medical scribe for every nine physicians nationwide.
The growth of what are essentially medical secretaries is puzzling, given that most sectors have disposed of those kinds of manual jobs.
Dr. George Gellert of CHRISTUS Health in San Antonio, the lead author of the article, worries that “by reducing market demand and pressure on industry for needed improvements, the medical scribe industry (and inadvertently its customers) may contribute to an unintended, undesirable outcome: a deceleration and possibly stagnation in EHR technological improvement.”
That seems possible, at the margins. On the other hand, presumably doctors want to reduce labor costs and would prefer technology that allows them to do so.
But the discussion is more than simply an economic puzzle. As the viewpoint notes, there are safety concerns, particularly with drug orders, and the risks of having scribes input those orders instead of providers. But there are additional scenarios to consider.
What about clinical decision support? Providers say there are mountains of alerts and reminders that they must deal with every day. Are scribes communicating each of those to doctors? It seems hard to believe. What's the effect on care? Hard to say. The EHR market continues to present many puzzling questions.
Follow Darius Tahir on Twitter: @dariustahir