Virtual Medical Scribes: The Good, The Bad, And The Ugly

The advent of Electronic Health Records (EHRs) and their administrative demands on clinicians has given rise to a booming medical scribe industry. Currently medical scribes are the fastest-growing job segment in healthcare, with 1 out of every 9 clinicians employing a scribe in the US alone. However, scribes are expensive, costing as much as $50,000 per year per scribe, and are hard to scale across wider healthcare organizations, as each clinician requires their own. 

Virtual scribes are steadily gaining popularity as an alternative to traditional medical scribes. Rather than joining the clinician onsite, virtual scribes listen into patient encounters via video conferencing or phone from an offsite location. This comes with a number of advantages over traditional medical scribes, including a smaller price tag, greater sense of privacy, and increased flexibility of service. 

However virtual scribes are not without shortcomings. Below we dish it all - the good, the bad, and the ugly of virtual medical scribes.

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The Good

Increased Perception of Privacy 

Virtual scribes listen into the patient's encounter from an offsite location, which allows the patient and clinician to be alone in the exam room. This gives the patient a greater sense of privacy, which is especially beneficial for those that feel uncomfortable with a third pair of eyes and ears in the room. 

When a patient is more at ease, they are naturally more open and honest about their health concerns which increases the accuracy of diagnosis and ultimately, leads to better patient outcomes.


Reduced Functional Creep

Functional creep refers to the (often unintentional) process of increasing the responsibilities of an employee beyond the original scope of their job, and is one of the more serious concerns regarding onsite medical scribes. Scribes that have proven themselves as reliable and self-sufficient may be asked to complete increasingly complex EHR tasks while the provider focuses on patient care. If a clinician isn’t careful, functional creep could put them at risk for malpractice.

Fortunately, the degree of separation between virtual scribe and clinician greatly reduces the risk of functional creep. In fact, some virtual scribing agencies proactively limit their employees access to only information necessary for medical documentation, further removing opportunities for functional creep.


Reduced Training, Expedited Onboarding

Many providers have admitted that the burden of training and onboarding new scribes plays a big role in their hesitancy to offload their note taking and clerical work. One of the great elements of virtual scribes is that they are often employees of larger organizations and scribe networks, meaning they have a very solid foundation on which they can build.

While each clinician may need to familiarize virtual scribes with their individual tendencies and style of care, most of the heavy lifting is already covered. Virtual scribes know how to take clinical notes, know how to work with clinicians, and are comfortable using EHR’s and their accompanying workflows.

Flexibility of Service

Because virtual scribes can work from any remote location, they are a great option for medical practices in secluded or rural areas where access to onsite scribes is limited. 

Furthermore, many virtual scribing agencies provide on-demand service to cover vacancies due to illness or vacation – mitigating the scheduling nightmares that come with employing onsite medical scribes. 

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The Bad


While the cost of a virtual scribe is significantly lower than that of an on-site scribe, they will still run you about $1200/month per clinician. 

And it doesn’t stop there. Both onsite and virtual scribe positions are a popular choice for students entering medical school to get in-field experience before they hit the books. The scribing industry is plagued by high rates of turnover as a consequence, forcing practices to take on additional costs to recruit and onboard a replacement.

The effects of turnover may not be as pronounced when working with a scribe staffing agency, as they can quickly backfill. However, introducing a new scribe will likely interrupt workflow as it takes time to adjust to the provider's communication and exam style. 


Lack of Standardized Training

While the scribing industry is booming, standardized training has not caught up. Some third-party staffing companies have established internal training programs that their onsite and virtual scribes must complete, but these programs receive little to no regulation or guidelines from federal agencies. 

There is also a wide variation in experience level across scribes. One recent study found that 44% of scribes have no previous experience, while only 22% have received some form of certification. As a result, the study uncovered a significant inter-scribe discrepancy in notes taken for identical patient encounters. 

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The Ugly

Security Risks

One of the biggest downsides of virtual medical scribes is the risk that comes with offshore data transmission. It’s common for virtual scribing agencies to employ the majority of their scribes offshore, increasing the breach susceptibility of sensitive patient health information. 

It’s critical that you partner with a virtual scribe agency with proven security standards or find and vet an onshore virtual scribe yourself.

Telemedicine Trends and Increased Threats

As we know, the data trends over the last few years show the increasing (and impending) adoption of cloud-based, computer-driven solutions in healthcare. But in the wake of COVID-19, these trends were immediately thrust into the forefront of the industry.

The vast majority of healthcare consultations and regular visits over the past year were conducted via telehealth software due to patient and provider health safety reasons. But with all these new methods of providing care come increased cyber threats. 

In 2020 alone, reported security incidents rose by 42% and affected 31 million patients. While maybe we can expect a small decline as the pandemic eases up across the country, most experts believe telehealth practices are here to stay. This incredibly swift influx of patient information undoubtedly means that telehealth systems have an even bigger target on their back. Knowing these trends and protecting ourselves ahead of time is critical for success in this space, but in many instances may deter people from hiring virtual medical scribes.

In Conclusion

Bottom line, there are many pros and cons to weigh when considering a virtual scribe. For many practices, the overall cost, flexibility of service, and patient-centered encounters make virtual scribes a more suitable alternative to traditional medical scribes.

However, virtual and onsite medical scribes are not the only option. Watch our demo video to see why leading healthcare organizations are ditching scribes all together in favor of DeepScribe’s AI-powered scribe.

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