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首页> 外文期刊>JMIR Medical Informatics >Influence of Scribes on Patient-Physician Communication in Primary Care Encounters: Mixed Methods Study
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Influence of Scribes on Patient-Physician Communication in Primary Care Encounters: Mixed Methods Study

机译：抄写员对基层医疗人员医患沟通的影响：混合方法研究

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Background With the increasing adoption of electronic health record (EHR) systems, documentation-related burdens have been increasing for health care providers. Recent estimates indicate that primary care providers spend about one-half of their workdays interacting with the EHR, of which about half is focused on clerical tasks. To reduce documentation burdens associated with the EHR, health care systems and physician practices are increasingly implementing medical scribes to assist providers with real-time documentation. Scribes are typically unlicensed paraprofessionals who assist health care providers by documenting notes electronically under the direction of a licensed practitioner or physician in real time. Despite the promise of scribes, few studies have investigated their effect on clinical encounters, particularly with regard to patient-provider communication. Objective The purpose of this quasi-experimental pilot study was to understand how scribes affect patient-physician communication in primary care clinical encounters. Methods We employed a convergent mixed methods design and included a sample of three physician-scribe pairs and 34 patients. Patients’ clinical encounters were randomly assigned to a scribe or nonscribe group. We conducted patient surveys focused on perceptions of patient-provider communication and satisfaction with encounters, video recorded clinical encounters, and conducted physician interviews about their experiences with scribes. Results Overall, the survey results revealed that patients across both arms reported very high satisfaction of communication with their physician, their physician’s use of the EHR, and their care, with very little variability. Video recording analysis supported patient survey data by demonstrating high measures of communication among physicians in both scribed and nonscribed encounters. Furthermore, video recordings revealed that the presence of scribes had very little effect on the clinical encounter. Conclusions From the patient’s perspective, scribes are an acceptable addition to clinical encounters. Although they do not have much impact on patients’ perceptions of satisfaction and their impact on the clinical encounter itself was minimal, their potential to reduce documentation-related burden on physicians is valuable. Physicians noted important issues related to scribes, including important considerations for implementing scribe programs, the role of scribes in patient interactions, how physicians work with scribes, characteristics of good scribes, and the role of scribes in physician workflow.
机译：背景技术随着电子病历（EHR）系统的采用越来越多，与文件有关的负担对于医疗保健提供者而言也在增加。最近的估计表明，初级保健提供者花费大约一半的工作日来与EHR进行交互，其中大约一半专注于文书工作。为了减轻与电子病历相关的文件负担，医疗保健系统和医生做法越来越多地采用医嘱来协助提供者提供实时文件。抄写员通常是无执照的准专业人士，他们通过在执业医师或医师的指导下实时以电子方式记录注释来协助医疗保健提供者。尽管有抄写员的希望，但很少有研究调查其对临床遭遇的影响，特别是在患者与提供者之间的交流方面。目的这项准实验性初步研究的目的是了解抄写员如何影响初级保健临床中的医患沟通。方法我们采用融合的混合方法设计，并包括三对医师-划线对和34例患者的样本。患者的临床遭遇被随机分配到一个抄写员或非抄写员组。我们进行了患者调查，重点是对患者与提供者之间的沟通和对相遇的满意度，视频记录的临床相遇的看法，并就他们与抄写员的经历进行了医生访谈。结果总体而言，调查结果表明，双臂交叉患者均表示与医师的沟通，医师对EHR的使用以及护理的满意度很高，并且变异很小。录像分析通过证明医生在有内遇和无内遇中的高水平沟通来支持患者调查数据。此外，视频记录表明抄写员的存在对临床遭遇的影响很小。结论从患者的角度来看，抄写员是临床遭遇中可接受的补充。尽管它们对患者满意度的影响不大，对临床遭遇的影响也很小，但它们减轻与医生有关的文件负担的潜力却是宝贵的。医师注意到与抄写员有关的重要问题，包括实施抄写员程序的重要考虑因素，抄写员在患者交互中的作用，医师如何与抄写员一起工作，好抄写员的特征以及抄写员在医师工作流程中的作用。

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