Dataset Information

Effect of a National VHA Medical Scribe Pilot on Provider Productivity, Wait Times, and Patient Satisfaction in Cardiology and Orthopedics.

ABSTRACT:

Background

Section 507 of the VA MISSION Act of 2018 mandated a 2-year pilot study of medical scribes in the Veterans Health Administration (VHA), with 12 VA Medical Centers randomly selected to receive scribes in their emergency departments or high wait time specialty clinics (cardiology and orthopedics). The pilot began on June 30, 2020, and ended on July 1, 2022.

Objective

Our objective was to evaluate the impact of medical scribes on provider productivity, wait times, and patient satisfaction in cardiology and orthopedics, as mandated by the MISSION Act.

Design

Cluster randomized trial, with intent-to-treat analysis using difference-in-differences regression.

Patients

Veterans using 18 included VA Medical Centers (12 intervention and 6 comparison sites).

Intervention

Randomization into MISSION 507 medical scribe pilot.

Main measures

Provider productivity, wait times, and patient satisfaction per clinic-pay period.

Key results

Randomization into the scribe pilot was associated with increases of 25.2 relative value units (RVUs) per full-time equivalent (FTE) (p < 0.001) and 8.5 visits per FTE (p = 0.002) in cardiology and increases of 17.3 RVUs per FTE (p = 0.001) and 12.5 visits per FTE (p = 0.001) in orthopedics. We found that the scribe pilot was associated with a decrease of 8.5 days in request to appointment day wait times (p < 0.001) in orthopedics, driven by a 5.7-day decrease in appointment made to appointment day wait times (p < 0.001), and observed no change in wait times in cardiology. We also observed no declines in patient satisfaction with randomization into the scribe pilot.

Conclusions

Given the potential improvements in productivity and wait times with no change in patient satisfaction, our results suggest that scribes may be a useful tool to improve access to VHA care. However, participation in the pilot by sites and providers was voluntary, which could have implications for scalability and what effects could be expected if scribes were introduced to the care process without buy-in. Cost was not considered in this analysis but is an important factor for future implementation.

Trial registration

ClinicalTrials.gov Identifier: NCT04154462.

SUBMITTER: Palani S

PROVIDER: S-EPMC10356725 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effect of a National VHA Medical Scribe Pilot on Provider Productivity, Wait Times, and Patient Satisfaction in Cardiology and Orthopedics.

Palani Sivagaminathan S Saeed Iman I Legler Aaron A Sadej Izabela I MacDonald Carol C Kirsh Susan R SR Pizer Steven D SD Shafer Paul R PR

Journal of general internal medicine 20230620 Suppl 3

<h4>Background</h4>Section 507 of the VA MISSION Act of 2018 mandated a 2-year pilot study of medical scribes in the Veterans Health Administration (VHA), with 12 VA Medical Centers randomly selected to receive scribes in their emergency departments or high wait time specialty clinics (cardiology and orthopedics). The pilot began on June 30, 2020, and ended on July 1, 2022.<h4>Objective</h4>Our objective was to evaluate the impact of medical scribes on provider productivity, wait times, and pati ...[more]

PMID: 37340268

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Dataset Information

Effect of a National VHA Medical Scribe Pilot on Provider Productivity, Wait Times, and Patient Satisfaction in Cardiology and Orthopedics.

Background

Objective

Design

Patients

Intervention

Main measures

Key results

Conclusions

Trial registration

Publications

Effect of a National VHA Medical Scribe Pilot on Provider Productivity, Wait Times, and Patient Satisfaction in Cardiology and Orthopedics.

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