Emergency consultants value medical scribes and most prefer to work with them, a few would rather not: a qualitative Australian study.

OBJECTIVE: The utilisation of medical scribes in the USA has enabled productivity gains for emergency consultants, though their personal experiences have not been widely documented. We aimed to evaluate the consultant experience of working with scribes in an Australian ED. METHODS: Emergency consultants working with scribes and those who declined to work with scribes were invited to participate in individual interviews (structured and semistructured questions) about scribes, scribe work and the scribe program in October 2016. RESULTS: Of 16 consultants, 13 participated in interviews, that is, 11 worked with scribes and 2 did not and 3 left Cabrini prior to the interviews. Consultants working with scribes found them most useful for capturing initial patient encounters, for finding information and completing discharge tasks. Scribes captured more details than consultants usually did. Editing was required for omissions, misunderstandings and rearranging information order, but this improved with increasing scribe experience. Consultants described changing their style to give more information to the patient in the room. Consultants felt more productive and able to meet demands. They also described enjoyment, less stress, less cognitive loading, improved ability to multitask, see complex patients and less fatigue.In interviews with the two consultants declining scribes, theme saturation was not achieved. Consultants declining scribes preferred to work independently. They did not like templated notes and felt that consultation nuances were lost. They valued their notes write-up time as time for cognitive processing of the presentation. They thought the scribe and computer impacted negatively on communication with the patient. CONCLUSION: Medical scribes were seen to improve physician productivity, enjoyment at work, ability to multitask and to lower stress levels. Those who declined scribes were concerned about losing important nuances and cognitive processing time for the case.

HIM jobs of tomorrow.

Tomorrow's HIM jobs are arriving today, as technology transforms how we capture, manage, and use information. Following are 11 jobs that represent evolving roles and emerging opportunities. Some are familiar roles with a new twist. Others are new roles, and some are possibilities. All are opportunities for HIM professionals to use their core competencies in new ways and move into positions that have not been thought of as career tracks for HIM.

Health information management in the computer era.

Medical record professionals are confronted with change at practically every front. Technologic advancements are changing the technical aspects of our job responsibilities. These advancements also have implications for the interpersonal aspects of our jobs. The effect of new technology on working relationships is exacerbated by the introduction of TQM, which also encourages a change in organizational relationships through a move away from traditional heirarchical management by fostering teamwork and staff empowerment. The changes that are transforming health care organizations can be viewed in two lights: (1) as unwanted hindrances to accomplishment or (2) as opportunities to enhance accomplishment. Medical record professionals are presented with unprecedented opportunities to enhance our accomplishments and maximize our position in health care facilities. We cannot long for the way things were or be satisfied with the status quo. Such action (or lack thereof) will only ensure that our role on the health care team will be taken over by someone else. To capitalize on the opportunities presented, medical record professionals must hone the knowledge and skills we already possess, gain other knowledge and skills necessary to function in the computerized environment, and, most of all, be proactive rather than reactive. Such action will ensure that we truly become health information managers.