In March 2019, I accepted a scribing position with AQuity and have not looked back! When I came on board with this company, I completed the training that is required by all scribes and felt it was geniunely beneficial. The Scribe Academy is the first stop of many in virtual scribing, and it gives you a foundation of what to expect.
Immediately following the Scribe Academy, I was placed in Team Training and watched a fellow veteran scribe and his provider. Intitally when I sat with them and watched their work flow, I was intimidated. However, I quickly learned that AQuity is a team/family. Everyone is willing and able to help new scribes succeed. I also learned that, much like healthcare, scribing is not one-size-fits-all!
I have been very fortunate to be assigned three amazing, supportive, caring, and dedicated doctors. I currently work with Dr. Golden (Infectious Disease), Dr. Masoud (Digestive Diseases) and Dr. Navaratnam (Neurology). The amount of information I’ve gained from working with these amazing providers is not something that can be simplified into words. They have allowed me to learn about specialties that I previously had no knowledge of but was very interested in. In addition, I have covered for their peers when they are out of the office.
Daily duties remain relatively the same for each provider. In the morning, before my provider signs on to Fluency for Scribes (FFS), I start my daily precharting. I know some scribes do not do this, but I believe it is more time efficient and allows the scribe to become more familiar with their work flow and their patients prior to their arrival. My providers are very thorough with information that they like to have in each of their notes, including imaging, labs, and discharge summaries from hospital encounters. Precharting allows me to capture the pertinent information and include it chronologically in my note.
After precharting is completed, my provider is usually ready to begin their day. We start that day with normal greetings and specific information that they may have regarding each patient that I may not be privy to or pertinent information that may be critical to their visit that we ordinarily would not put into the note. Example: Another doctor calls and gives them a verbal report on a patient.
My doctors then take their Heart Phones (Yale issued phones) into the room with them and introduce me and the patient. The majority of the time, patients are blown away that there is actually someone on the phone and it’s not just a recording!
The doctors start with the HPI and ROS. My providers like for me to pull the HPI from their previous encounter and copy it into the current HPI while making encounter-specific adjustments. At this point, the doctor will also discuss lab/imaging results. After completing the HPI and ROS, they will review medications/surgical history/new diagnosis with the patients. This gives me a moment to do some fine tuning on the HPI. Once the medication list has been completed, the doctor will start the PE. The PE results are called out to me (or in one provider’s case given to me directly after the exam is complete). We utulize smart phrases and macros (don’t worry…Epic training shows you how to make and use these!) which are great time savers!!
Finally, we wrap up the appointment with the A/P. My assessments are limited to the first phrase entered into the HPI. The plan is then detailed out. Each of my providers are different in their plans. One doctor likes the plan in paragraph form and the other two like it in bullet format.
As always, I put the scribe attestation into place and VOILA! The encounter is complete.
Are there days where you don’t catch information? Or you don’t understand what happened during the visit? Yes. Of course! But the fantastic thing is you are a real person working real time with a provider! You have the oppurtunity and responsibilty to clarify any information. The best part is all the providers I have worked for WELCOME QUESTIONS.
Some providers are more specific or require you to input more information. However, you can rest assured that you will be given a “preference sheet” that is like your work Bible. Everything you need to know about your provider is laid out on this sheet and your support team is always available (performance coaches, team leads, supervisors, and peers.)
Holli lives in the Midwest and scribes for 3 doctors in the Yale New Haven Health system.
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