Annual impact of scribes on physician productivity and revenue in a cardiology clinic

Figures & data

Table 1 Scribe training

	Training task	Number of Hours
General medicine	Review of medical terminology	4
	Classroom lecture on major diagnoses	4
	On-floor training	64
	Supervised scribing	80
	Review of notes with supervisor	2
	Quarterly meeting with supervisor	2
	Annual review of work	2
Cardiology specific	Review of terminology	2
	Review of cardiology template with physician	1
	Review of clinic processes	1
	Shadowing scribe	20
	Review guide of common cardiology diagnoses	2
Total		184

Figure 1 Physician productivity.

Note: Individual productivity (patients seen/hour) of physicians with and without scribes.

Table 2 Physician patient volumes and productivity in 2014

	Physicians with scribes (10)	Physicians without scribes (15)
New patients (n)	955	1,318
Follow-up patients (n)	4,830	7,150
Total patients (n)	5,785	8,468
Patients per hour	2.50±0.27*	2.28±0.15

Note:

* P=0.01. Data are presented as mean ± standard deviation.

Table 3 Average cardiovascular revenue generated per clinic patient

	Direct Clinic visit	Downstream			Total
		Professional services	Outpatient technical	Hospital
New patient	$209	$380	$3,418	$932	$4,939
Follow-up patient	$117	$172	$942	$976	$2,207

Table 4 Coding level for patient visits with and without scribes

		Level 2	Level 3	Level 4	Level 5
New patient	No scribe	0.9%	11.5%	62.2%	25.4%
	Scribe*	0.6%	3.4%	50.7%	45.3%
Follow-up patient	No scribe	0.6%	18.8%	72.6%	8.0%
	Scribe**	0.7%	16.3%	71.0%	12.0%

Notes:

* P<0.001, comparing distribution between scribe and no scribe usage within new patients.

** P=0.017, comparing distribution between scribe and no scribe usage within follow-up patients.