Developing a Medical Scribe Program at an Academic Hospital: The Hennepin County Medical Center Experience

Published:April 23, 2018DOI:


      Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement.


      The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants). This paper describes a prospective quasi-experimental study conducted at an academic, inner-city, hospital-based clinic system,


      A pre-post analysis showed positive results; of the 51 providers, 44 responded to the survey pre and 41 responded post. Respondents in the post-scribe group felt that a scribe was valuable (90.2%), that documentation time at the office improved (75.0% poor or marginal pre-scribe, vs. 24% post; p <0.0001), and that time spent on the EHR at home declined (63.6% with excessive or moderately high home EHR time pre vs. 31.7% post; p = 0.003). More providers felt satisfied with their role in clinic with the use of scribes, and more providers felt that with scribes they could listen sufficiently to patients (p <0.05).


      Scribe support was well received across the institution in multiple clinical settings. Benefits for providers were seen in documentation time and ability to listen to patients. Scribes appear to be an effective intervention for improving clinician work life.
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      Marc L. Martel, MD, is Emergency Physician, Department of Emergency Medicine, and Co-Director, Medical Scribe Program, Hennepin County Medical Center (HCMC), Minneapolis.


      Brian H. Imdieke, MAN, ANP-BC, is Nurse Practitioner and Co-Director, Medical Scribe Program, Division of General Internal Medicine, HCMC.


      Kayla M. Holm, BS, formerly Medical Scribe, Department of Emergency Medicine, HCMC, is Lead Medical Scribe, Department of Emergency Medicine, Regions Hospital, St. Paul.


      Sara Poplau, BA, is Assistant Director, Office for Professional Worklife, Division of General Internal Medicine, HCMC, and Senior Research Project Manager, Minneapolis Medical Research Foundation.


      William G Heegaard, MD, MPH, MBA, is Emergency Physician, and Chief Medical Officer, Department of Emergency Medicine, HCMC, and Chief Medical Officer, Hennepin Healthcare, HCMC, Minneapolis.


      Jon L. Pryor, MD, MBA, is a Urologist and Chief Executive Officer, Hennepin Healthcare, HCMC.


      Mark Linzer, MD, is Physician, Division of General Internal Medicine, and Vice-Chair for Education, Mentorship and Scholarship in the Department of Medicine, HCMC.