The Use of Scribes at the Veterinary Emergency Group

Most veterinary staff members are likely familiar with the heavy burden of medical documentation.¹ Some might also be familiar with medical scribes, the staff members who document details at human healthcare appointments. Medical scribes have existed for years in human medicine, being utilized to ease the burden of the increased documentation demands that accompanied the adoption of the electronic medical records in human health care.² Similarly, electronic medical record integration in the veterinary industry left providers feeling overwhelmed with hours of documentation at the end of shifts.

While witnessing the negative impacts that documentation has on veterinarians’ work–life balance, the Veterinary Emergency Group (VEG) identified an opportunity to innovate in the field: Utilize scribes, particularly in the emergency setting where the fast-paced nature and case volume leave hours of daily documentation for providers.

In the era of ever-growing knowledge and access to advanced technology such as artificial intelligence (AI) tools, why were additional paid human scribe employees VEG’s solution? Despite what many may think, human scribes remain the driving force behind many of the recent innovative technologies in medical documentation.³ Additionally, though these purely technological solutions can be impactful on burnout rates of providers and continue to show increasing promise, scribes have the added advantage of providing a career pathway opportunity that builds a funnel of future veterinary professionals.

As these AI technologies continue to learn, develop, and advance, which is needed for their effective clinical implementation,⁴ VEG asked: Why not get to the root of this solution and master the baseline so that we can develop the innovations and people that will move the veterinary field into the next era?

Understanding the Scribe Role

The scribe program VEG developed has evolved to be highly adaptable, tailored to meet the specific needs of the providers on each shift. Scribes are capable of adjusting to individual preferences and addressing any pain points in workflows. Throughout the program, 1 of the main priorities includes fostering effective communication between the providers and scribes, recognizing it as a fundamental principle that underpins positive outcomes.

The scribe’s role involves closely shadowing the veterinarian throughout the care process and actively documenting the medical record as the veterinary team gathers the patient’s history and presenting complaint, conducts the physical examination, suggests a treatment plan, and begins care based on client feedback. Additionally, the scribe assists in creating estimates, inputting charges on the invoice for provider review, submitting reports, and keeping the doctor informed of any available results or reminding them to review new information.

The scribe alleviates the doctor of administrative tasks, enabling them to be more present on the floor, spend more time delivering care to patients, and be more accessible for other members of the care team. This streamlined workflow enhances the efficiency of the hospital floor, boosting job satisfaction for all care team members while improving outcomes and experiences for patients and clients alike.

Integration and Contributions to the Hospital Environment

The benefits this program brings to the hospital fall into 2 overarching categories: improving work–life balance for doctors and elevating patient care.

It is no secret that veterinarians across the country are experiencing burnout, moral distress, and overtime at an unprecedented rate. Due to the nature of shift work, emergency medicine has become widely more appealing; however, long hours spent documenting after each shift detract from that appeal. Doctors once reported spending up to 4 hours after their shifts documenting medical records. In VEG’s experience with scribes, this is down to about 30 minutes to finalize, approve, and sign records, helping to provide the long sought-after work–life balance that once seemed unachievable in the veterinary profession.

Proficiency in documentation benefits both the practice and the patient. The practice can benefit by ensuring legal coverage and accurate billing for the care provided. In developing VEG’s scribe program, there was collaboration with lawyers and regulatory experts to ensure that the medical records written by scribes include all the relevant information to mitigate doctor and practice liability. At the same time, patients benefit from more effective future encounters when doctors have a comprehensive understanding of a patient’s medical history. Additionally, by freeing doctors of time spent on administrative tasks, they are able to spend more time focusing on the clinical care of individual patients.

Scribes can also play a crucial role in ensuring consistency in documentation. Consistent documentation is important, particularly in emergency medicine, where high-acuity patients are frequently encountered and collaboration with referring veterinarians and specialists is essential. Clear and consistent documentation emphasizes the value of relationships, as it allows clients, referring veterinarians, and referrals to understand the actions taken.

Importantly, while scribes contribute to the hospital environment in a variety of ways, they are also a relatively affordable position for the hospital to hire. Given the typical background of a scribe, hourly wages tend to be less than that of a traditional hospital assistant or credentialed technician. Wage rates will vary by market, but the position is a very high-value role relative to the associated cost.

Looking Forward

In addition to benefiting frontline teams by improving work–life balance and enhancing patient care, human scribes have the potential to make a significant impact on the veterinary healthcare industry. This impact begins with individual practices, as the additional support from scribes enhances overall workflow efficiency throughout the hospital. This is particularly important with growing concerns about shortages in various positions within the field. Increasing job satisfaction serves as a strategy for addressing these shortages, helping to attract and retain talented veterinary healthcare professionals. Additionally, with doctors freed from administrative burdens, they can provide support, relief, leadership, and a stronger presence on the floor, enhancing the overall functioning of the healthcare environment.

Another way to combat shortages within the field is to open the door to a previously minimally tapped but highly ambitious population of preveterinary students. By documenting the entire patient care process from initial evaluation to disposition decision, the scribe gains insight into medical decision making. During this process, the scribe observes the doctor carrying out financial conversations and team management, essential duties of the job that are often overlooked. By observing these duties firsthand alongside a doctor, students are able to develop a more well-rounded picture of the role of the doctor, are able to gain recommendations to apply to veterinary school, and are better prepared to enter the clinic following graduation.

Historically, veterinary medicine has suffered from a lack of diversity, influenced by various factors such as high tuition costs, the demands of participating in unpaid experiences like shadowing and volunteering, and the exclusivity of professional networks. However, by offering paid scribe positions, passionate individuals from all backgrounds can gain a competitive advantage in entering the field through practical experience, professional recommendations, networking opportunities, and more. This inclusive approach not only promotes greater diversity within the industry but also contributes to the support of the growing population of animal patients across the country.

The growing demand of the industry is occurring concurrently with the rise of computing power, data, and informatics. Standardization is an important element that enables data sharing and research efforts that will continue to move the field forward.⁵ Encouraging concise data entry, a focus as VEG grows the scribe program, will improve data collection and enable informatics efforts. In human medicine, data sharing introduces privacy concerns, a considerable obstacle when it comes to research efforts. Veterinary medicine does not share the same severity of consequences around privacy and is therefore less regulated. This should empower the industry to set the standard for breakthroughs—demonstrating how you can harness data to promote a higher quality of medicine.

Summary

Building and implementing a scribe program in a veterinary emergency medicine setting have demonstrated a way to encourage veterinary career sustainability. Relieving doctors from hours spent on medical records allows them to get back to why they are there: Creating positive outcomes for patients. A more streamlined workflow, happier clients, and improved staff morale lead to an overall better hospital environment, translating to improved job satisfaction for all members of the veterinary healthcare team.