Impact of Scribes on Billed Relative Value Units in an Academic Emergency Department

Abstract Background Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role. Objectives Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatri...

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Bibliographic Details
Published in:The Journal of emergency medicine 2017-03, Vol.52 (3), p.370-376
Main Authors: Heaton, Heather A., MD, Nestler, David M., MD, MS, Jones, Derick D., MD, MBA, Varghese, Rachelen S., MHA, Lohse, Christine M, Williamson, Eric S, Sadosty, Annie T., MD
Format: Article
Language:English
Subjects:
Academic Medical Centers - organization & administration
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cohort Studies
documentation
Documentation - economics
Documentation - methods
Documentation - standards
Electronic Health Records - trends
Emergency
emergency department
Emergency Service, Hospital - economics
Emergency Service, Hospital - manpower
Emergency Service, Hospital - organization & administration
Female
Health Care Costs - statistics & numerical data
Humans
Infant
Male
Medical Record Administrators - economics
Medical Record Administrators - standards
Middle Aged
Prospective Studies
relative value units
revenue
RVUs
scribe
United States
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Summary:Abstract Background Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role. Objectives Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs). Methods A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes. After training by a staff member with significant experience in implementing scribe programs, scribes provided 1-to-1 support to a provider as staffing allowed. Comparisons were made between scribed and nonscribed visits. Results There were 49,389 patient visits during the study period (39,926 adult [80.84%] and 9463 pediatric [19.16%] visits), of which 7865 (15.9%) were scribed. For adults, scribed visits produced 0.20 additional RVUs per patient ( p  
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2016.11.017