Clinical trial NCT03854955: Device-Based Scribe Service (iScribes) on Patient Satisfaction
Official title: Randomized Controlled Trial of a Device-Based Scribe Service (iScribes) on Patient Satisfaction
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Foot & Ankle
Keywords: iScribes
patient satisfaction
device based scribe
Lead sponsor: Rush University Medical Center
Sponsor class: OTHER
First posted: 2019-02-26
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This project involves the implementation of a device-based scribe service (iScribes) for patient encounters. The objective of the proposed study is to track and compare the allocation of physician time and associated quality metrics with and without the use of iScribes. We anticipate that the use of iScribes will reduce the amount of physician time spent away from the patient (e.g., charting, dictating).

Detailed description: This project involves the implementation of a device-based scribe service (iScribes) for patient encounters. Device based scribing services record the patient-physician encounter and securely transmit data to an off-site facility where trained professionals transcribe the dictations. The information is then sent back to the physician and stored in the providing institutions electronic medical records. The objective of the proposed study is to track and compare the allocation of physician time and associated quality metrics with and without the use of iScribes. We anticipate that the use of iScribes will reduce the amount of physician time spent away from the patient (e.g., charting, dictating).

Eligibility criteria: Inclusion Criteria:

* ≥ 18 years of age
* Written informed consent is obtained
* New patient visit

Exclusion Criteria:

* Patient refuses
* Patient is lacking decisional capability

Primary outcomes:
measure: Total physician time spent on the encounter but not with the patient.
timeFrame: Duration of patient visit (up to 1 day).
Secondary outcomes:
measure: Patient satisfaction.
timeFrame: Duration of patient visit (up to 1 day).
Other outcomes:
Locations:
city: Chicago
country: United States
facility: Rush University Medical Center
state: Illinois
Study officials:
affiliation: Rush University Medical Center
name: Kamran Hamid, MD,MPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: Waters S, Edmondston SJ, Yates PJ, Gucciardi DF. Identification of factors influencing patient satisfaction with orthopaedic outpatient clinic consultation: A qualitative study. Man Ther. 2016 Sep;25:48-55. doi: 10.1016/j.math.2016.05.334. Epub 2016 Jun 4.
citation: Teunis T, Thornton ER, Jayakumar P, Ring D. Time Seeing a Hand Surgeon Is Not Associated With Patient Satisfaction. Clin Orthop Relat Res. 2015 Jul;473(7):2362-8. doi: 10.1007/s11999-014-4090-z. Epub 2014 Dec 5.
citation: Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US); 2001. Available from http://www.ncbi.nlm.nih.gov/books/NBK222274/
citation: Patterson BM, Eskildsen SM, Clement RC, Lin FC, Olcott CW, Del Gaizo DJ, Tennant JN. Patient Satisfaction Is Associated With Time With Provider But Not Clinic Wait Time Among Orthopedic Patients. Orthopedics. 2017 Jan 1;40(1):43-48. doi: 10.3928/01477447-20161013-05. Epub 2016 Oct 18.
citation: Sinsky C, Colligan L, Li L, Prgomet M, Reynolds S, Goeders L, Westbrook J, Tutty M, Blike G. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Intern Med. 2016 Dec 6;165(11):753-760. doi: 10.7326/M16-0961. Epub 2016 Sep 6.
citation: Wenger N, Mean M, Castioni J, Marques-Vidal P, Waeber G, Garnier A. Allocation of Internal Medicine Resident Time in a Swiss Hospital: A Time and Motion Study of Day and Evening Shifts. Ann Intern Med. 2017 Apr 18;166(8):579-586. doi: 10.7326/M16-2238. Epub 2017 Jan 31.
citation: Bank AJ, Gage RM. Annual impact of scribes on physician productivity and revenue in a cardiology clinic. Clinicoecon Outcomes Res. 2015 Sep 30;7:489-95. doi: 10.2147/CEOR.S89329. eCollection 2015.
citation: Koshy S, Feustel PJ, Hong M, Kogan BA. Scribes in an ambulatory urology practice: patient and physician satisfaction. J Urol. 2010 Jul;184(1):258-62. doi: 10.1016/j.juro.2010.03.040. Epub 2010 May 16.
citation: Bastani A, Shaqiri B, Palomba K, Bananno D, Anderson W. An ED scribe program is able to improve throughput time and patient satisfaction. Am J Emerg Med. 2014 May;32(5):399-402. doi: 10.1016/j.ajem.2013.03.040. Epub 2014 Mar 15.
citation: Misra-Hebert AD, Rabovsky A, Yan C, Hu B, Rothberg MB. A Team-based Model of Primary Care Delivery and Physician-patient Interaction. Am J Med. 2015 Sep;128(9):1025-8. doi: 10.1016/j.amjmed.2015.03.035. Epub 2015 Apr 23.
citation: Heaton HA, Nestler DM, Jones DD, Varghese RS, Lohse CM, Williamson ES, Sadosty AT. Impact of Scribes on Billed Relative Value Units in an Academic Emergency Department. J Emerg Med. 2017 Mar;52(3):370-376. doi: 10.1016/j.jemermed.2016.11.017. Epub 2016 Dec 14.
citation: Heaton HA, Castaneda-Guarderas A, Trotter ER, Erwin PJ, Bellolio MF. Effect of scribes on patient throughput, revenue, and patient and provider satisfaction: a systematic review and meta-analysis. Am J Emerg Med. 2016 Oct;34(10):2018-2028. doi: 10.1016/j.ajem.2016.07.056. Epub 2016 Jul 28.
citation: Shultz CG, Holmstrom HL. Response: Re: The Use of Medical Scribes in Health Care Settings: A Systematic Review and Future Directions. J Am Board Fam Med. 2016 May-Jun;29(3):423-4. doi: 10.3122/jabfm.2016.03.160043. No abstract available.
citation: Reuben DB, Knudsen J, Senelick W, Glazier E, Koretz BK. The effect of a physician partner program on physician efficiency and patient satisfaction. JAMA Intern Med. 2014 Jul;174(7):1190-3. doi: 10.1001/jamainternmed.2014.1315. No abstract available.