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Impact of Scribes on Billed Relative Value Units in an Academic Emergency Department.

التفاصيل البيبلوغرافية
العنوان: Impact of Scribes on Billed Relative Value Units in an Academic Emergency Department.
المؤلفون: Heaton, Heather A.1, Nestler, David M.1, Jones, Derick D.1, Varghese, Rachelen S.1, Lohse, Christine M.2, Williamson, Eric S.3, Sadosty, Annie T.1
المصدر: Journal of Emergency Medicine (0736-4679). Mar2017, Vol. 52 Issue 3, p370-376. 7p.
مصطلحات موضوعية: *RELATIVE value scales (Medical care), *EMERGENCY medical services, *TERTIARY care, *PEDIATRIC diagnosis, *HEALTH programs, *DOCUMENTATION -- Economic aspects, *DOCUMENTATION standards, *MEDICAL care cost statistics, *ACADEMIC medical centers, *DOCUMENTATION, *HOSPITAL emergency services, *LONGITUDINAL method, *MEDICAL record personnel, *MANAGEMENT of medical records, *ECONOMICS
مصطلحات جغرافية: UNITED States
مستخلص: Background: Scribe use throughout health care is becoming more common. There is limited peer-reviewed literature supporting this emerging role in health care despite rapid uptake of the role.Objectives: Our study assesses impact of scribes on relative value units (RVUs) in adult and pediatric emergency departments (EDs).Methods: A prospective cohort study was developed in a tertiary academic ED. Charts were coded by an external billing and coding company, then returned and mapped by International Classification of Diseases, 9th revision diagnostic codes. After training by a staff member with significant experience in implementing scribe programs, scribes provided 1-to-1 support to a provider as staffing allowed. Comparisons were made between scribed and nonscribed visits.Results: There were 49,389 patient visits during the study period (39,926 adult [80.84%] and 9463 pediatric [19.16%] visits), of which 7865 (15.9%) were scribed. For adults, scribed visits produced 0.20 additional RVUs per patient (p < 0.001). Scribes generated additional RVUs in Emergency Severity Index (ESI) 2 (p < 0.001) and 3 (p < 0.001) patients. There were variable effects of scribes on RVUs by diagnostic codes. For pediatric patients, scribed encounters generated 0.08 fewer RVUs per patient (p = 0.007). ESI score had no effect on RVUs. The impact of scribes on pediatric diagnostic groupings was inconsistent.Conclusions: Scribes had a positive impact on RVUs in adult but not pediatric patients. Among adults, scribes led to higher RVUs in ESI 2 and 3 but not 4 and 5 patients, perhaps suggesting a limitation to improve revenue capture on lower-acuity patients. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
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