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Virtual ‘scribes’ help doctors focus on patients, not note-taking

Nilesh Chandra, healthcare expert at PA Consulting, discusses data privacy concerns with software programs and virtual scribes that help doctors with patient documentation. Hospitals and physician groups are testing new strategies to free up harried doctors for other tasks, including seeing more patients.

Read the full Boston Globe article here

Dr. Amy Wheeler set a small tablet computer on the table as she turned to face her patient. Then she did something that’s become increasingly rare for doctors in the digital age: She talked to him without typing or clicking anything. Wheeler didn’t have to take notes, because the microphone on her tablet recorded everything. While she slept that night, a trained doctor working in an office building across the world in Mumbai listened to the recording and typed up a summary.

Patient documentation is a critical but tedious task for physicians, part of the mounting administrative burden that is driving many to exhaustion and burnout.

Massachusetts General Hospital, where Wheeler practices, expanded the use of voice-recognition software, which allows doctors to speak instead of type their notes. It hired nearly 200 scribes to work in clinics, typing notes in the exam room as doctors see patients. And now: virtual scribes based in India.

Doctors’ notes serve many purposes. They remind care providers about a patient’s diagnoses and treatments. They’re used to support insurance company billing. And now, as more patients access their medical records online, notes also can help them manage their health.

More than 130 Mass. General physicians in 12 specialties are using virtual scribes, and the hospital has plans to roll out the service to hundreds of additional doctors. At Brigham and Women’s Hospital — which along with Mass. General is part of the Partners HealthCare system — a handful of doctors started working with virtual scribes this summer. The Brigham plans to sign up at least 100 physicians within the next 12 months.

Doctors at Mass. General and the Brigham are using a virtual scribe service called Scribble, from the Mumbai-based company IKS Health. About 1,000 US clinicians use Scribble, and the company is adding about 100 users a month. All of the Indian scribes have medical degrees and are trained to take notes like US doctors.

IKS Health says its service can save physicians 90 minutes to two hours per day. The time savings can vary widely by doctor, specialty, and setting.

And while they’re trying to relieve burnout, hospitals that hire virtual scribes are also seeking a return on their investment. When doctors spend less time at the computer, they can fit in more appointments — and generate more revenue.

The program is designed to comply with US data privacy laws. The audio recordings are stripped of personal details like names and dates of births, and they’re stored on US-based servers. Scribes working in India access the recordings through “dumb terminals” designed just for that purpose.

Patients must give consent before their appointments are recorded. And most patients don’t seem to mind: The consent rate is 99 percent, according to IKS Health.

Nilesh says that it’s now common for US health care data to be shared globally.

He adds: “Any time you introduce a new entity into the equation, the risk multiplies. There are privacy issues to be mindful of, but I think it’s fairly well managed.”

Many companies market products aimed at reducing the administrative workload for doctors. More than 500,000 physicians and other providers around the world use Dragon Medical One, a speech-recognition program for documentation from Burlington-based Nuance Communications.

A growing number of physicians also have scribes with them in the clinic, drafting notes in real time. ScribeAmerica, a Fort Lauderdale, Fla., company that provides scribes to hospitals and physician groups across the country, including in Massachusetts, employs about 25,000 people — more than double its head count five years ago.

These solutions could be temporary. Many health care industry watchers expect that within several years, note-taking will become the responsibility of sophisticated artificial intelligence programs.

A global movement towards increased data privacy is changing the way companies do business. Are you ready for the new era of data privacy?

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