Remote Scribes and Informed Consent

In-office scribes have grown increasingly more rare as scribing alternatives become more advanced and affordable. Rather than hiring a fresh-out-of-college pre-med student eager to get experience in the field, hospitals and private practices have turned to entirely remote scribes to make life easier (and cheaper). In an effort to improve Covid-19 safety measures and decrease physical interaction, physicians have begun to search for alternative solutions. 

What is a Remote Scribe?

Doctors nationwide pivoted from staff scribes to entirely remote, third-party scribes. Remote scribes are real-life people who physically type treatment notes without assistance of artificial intelligence or the like. Instead of sitting in the exam room, the remote scribe is listening-in on the medical visit over video. How would you feel if a third party observer took notes on the most intimate health conversations between you and your doctor? This would understandably raise uneasiness in many patients. Even though there have always been scribes involved, having an unnamed, anonymous person — perhaps on the other side of the world — can feel violating for patients.  

Potentially violating the comfort and trust of the patient negates the point of a third party remote scribe. Although the intention was to focus the doctors’ attention on the patient instead of the note taking, the remote scribe may actually interrupt the doctor-patient interaction.  

Remote Scribes and Informed Consent 

Informed consent poses challenge and nuance to any healthcare practice. Disclosure about a remote scribe viewing the session by video is important to the integrity of the practice, but at what cost? Will it intimidate the patient and make them hold back information vital for their care?

According to Sarah Kwon, in her Kaiser Health News article, the Health Insurance Portability and Accountability Act of 1996 doesn’t require doctors to seek a patient’s consent before sharing their health information with a company that supports the practice’s work (like a scribe firm), as long as that company signed a contract agreeing to protect the patient’s data. This implies that often there are times when a remote scribe is listening to the interaction between doctor and patient, and the patient doesn’t even know. 

“Remote scribing is still a small part of the market. Craig Newman, chief strategy officer of HealthChannels, parent to ScribeAmerica, the largest scribing company in the U.S., said that the firm’s remote scribing business has increased threefold since the pandemic’s outset” added Kwon, “It’s a highly unregulated industry for which training and certification aren’t required.”

An Alternative Solution- AI Scribes

Artificial intelligence tools, such as AI scribes, eliminate the need for humans to document visits. In the short term, this would remove the awkwardness of an ominous third party scribe; in the long term, it would allow for immense time and money savings for your practice. 

AI scribes aim to improve the clinician-patient relationship, but also to free clinicians from the burden of documentation altogether. While many providers often feel that new technologies only further complicate their practice, developments like AI Scribes represent hope that one day every clinician will be able to solely focus on what they love; caring for patients. Why not make documentation easier and streamlined instead of onboarding yet another third party? 

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