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    Chris Harrop
    Chris Harrop

    The hot topics of using AI in healthcare, confronting physician burnout and easing EHR burdens in medical groups often converge on a single topic: using scribes, human or machine. 

    About a decade ago, the use of scribes mainly involved in-person staff members creating notes on a patient visit, while the physician was free to be face to face with the patient rather than staring at the EHR screen, clicking away. A 2014 survey noted that about 20% of physicians used this traditional scribe approach.1 

    December 5, 2023 MGMA Stat poll: 25% of medical groups added or updated/improved use of scribes in 2023.

    Recent improvements in natural language processing (NLP) and speech recognition in various AI tools now allow providers to click “Record” on an app for automatic transcription and clinical note generation, eliminating the need for manual note-taking.  

    However, many medical groups have yet to adopt or upgrade these tools. A Dec. 5, 2023, MGMA Stat poll found that in the past year, about one in four (25%) medical group leaders added or improved their use of scribes — human or machine — in their organizations. The poll had 415 applicable responses. 

    Earlier MGMA polls this year revealed that nearly three out of four (74%) of medical groups have not added or expanded use of AI tools, per a Sept. 5 MGMA Stat poll. Another MGMA poll in March 2023 — just a few months after the popularization of ChatGPT — found that only about one in 10 medical groups reported using generative AI tools on a regular basis

    That’s not to say that these healthcare leaders are dismissive of the impact that AI will have on the industry: An Oct. 24, 2023, MGMA Stat poll found that 80% of medical group leaders believe use of AI will become an essential skill, with another 3% who said it already is. 

    What’s driving decisions on using scribes? 

    Medical group leaders who responded to this week’s poll detailed a variety of approaches to using scribes or rationales for not adding or updating use of scribes. Some of the key findings from what respondents told MGMA include: 

    • There was no clear shift from those who use in-person staff as scribes to automated AI platforms. Many practice leaders who already have an on-site scribe continue to seek them, especially for their high-volume providers. 
    • The largest pushback against using scribes typically came from groups in which the providers were directly responsible for the cost of adding that staff member or service.  
    • Several medical group leaders said their reluctance to do more in this area was a matter of certain services being cost prohibitive for them, as other expenses rise, and reimbursements stagnate. 
    • Among those who did not add or update their use of scribes this year, many noted that their previous use of medical assistants (MAs) or other clinical team members as scribes had become too expensive, or that these workers had been shifted to other responsibilities. Similarly, many respondents, facing staff turnover and the associated time and costs of recruiting and training new scribes, have been influenced to explore other options like AI-enabled platforms. 
    • Several respondents noted they continue to enjoy success with scribes working off-site, especially as some medical groups have noted difficulty in hiring and retaining on-site scribes amid the tightened labor market of recent years. 
    • Multiple medical group leaders said they have initiated trials of virtual scribes to assess if the productivity gains justify the cost. 

    What will patients think about AI scribes? 

    While most patients might be accustomed to using voice-activated commands on mobile phones or smart home devices, they may not find the question of putting their health information into an AI tool as familiar or quickly acceptable. 

    Cristy Good, MPH, MBA, CPC, CMPE, senior industry advisor at MGMA, recently joined the Ask MGMA podcast to address questions from MGMA members about the use of AI scribes. 

    As with any platform handling protected health information, the implementation of AI-enabled scribes will need to comply with federal and other regulations. Beyond that, the question of educating patients about the use of these tools and obtaining consent is one that practice leaders should consider carefully. 

    “Having a patient’s consent, either verbal or written, could be important,” Good said. “Make sure that you clearly communicate to the patient that an AI scribe will be involved in their healthcare process, explain the benefits, the purpose of using it.” Good also emphasized the necessity of being prepared to answer how data is stored, used and protected if having these types of conversations with patients.  

    “It is important to educate the patients about the benefits of using AI and how it can enhance the quality of their care,” Good said. “Help them understand that the AI scribes are designed to assist healthcare professionals, not replace them.” As Good notes, your practice staff should be educated and prepared to effectively communicate on this topic with patients. 

    Listen to the entire episode above for even more insights. For a member-benefit AI patient consent form template, click here. 

    MGMA resources:  

    Other resources:  

    1. Martineau M, Brookstone A, Stringham T, Hodgkins M. Physicians use of EHR systems 2014. AmericanEHR. 
    Chris Harrop

    Written By

    Chris Harrop

    A veteran journalist, Chris Harrop serves as managing editor of MGMA Connection magazine, MGMA Insights newsletter, MGMA Stat and several other publications across MGMA. Email him.

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