Scribe Project FAQ

As many are aware, the Department initiated a pilot project testing the use of Scribes with providers in clinic. Heidi Hansen has been facilitating this project and we connected with Heidi asking her more about the Scribe project.

What are Scribes?

Scribes are documentation assistants who follow faculty into their appointments to help document the visits so that the faculty can focus more on the patient’s needs instead of worrying about writing what is going on in the visit.

Which providers are using them?

Currently we are piloting this model with four providers. The providers who were selected and agreed to trial this are Drs. Leyser and Tewar in Developmental and Behavioral Pediatrics; and Drs. Kanner and Pesce in Endocrinology.

Will their presence impact patient or clinic flow?

No, the workflow of the clinic should not change at all. The patient however, could be impacted. They could see more face-to-face interaction with their doctor and more attention to their needs during the visit among other potential positive impacts.

What is the benefit of using Scribes, and what is the goal of the program?

There are numerous benefits to using scribes. Just a couple include the increase of provider job satisfaction by reducing the amount of time that they have to do documentation outside of the work day; also, patient satisfaction is a benefit and a goal of this project. Patients should see an increase of provider engagement during their visits.

Specifically, the program is tracking the following metrics to determine if the goals are being met:

  • Provider’s daily time in Epic
  • Physician Burnout Survey
  • Epic Status Board usage to measure:
    • provider in room time
    • patient time in waiting area
  • Patient survey/feedback for Scribes in the room
  • Chart completion time
  • RVUs/Productivity

Do the physicians still sign off on the clinic notes themselves?

Yes, the physician is still 100% responsible for the documentation; the scribe fills in the information then sends it to the provider for review, additions, and signature.

How long does the pilot project last, and is the goal to expand the program or make it permanent in the future?

The plan is to pilot this for six months and then step back and evaluate the results. If it is successful we may look at expanding the program where it is appropriate and would be a benefit to all involved.

Where do the Scribes come from, internal source or external?

Who do they report to? Currently our scribes are contracted through ScribeAmerica. They technically report to the manager at Scribe America but Heidi Hansen is the UIHC contact within pediatrics.

Do the Scribes have access to Epic?

Yes, the scribes go through LIP training at HSSB so they can gain access to EPIC and be trained in the basics of EPIC documentation. They then have modified access so they can access the different pieces of EPIC to assist the providers with note documentation, patient histories, instructions, and orders.

Anything else you would like to add about the program?

There has been some learning curve to this project and the providers involved have been very supportive and flexible with this venture. Here are some of the positive comments which we have received from providers using scribes recently.

  • “Significant increase in the quality of interactions with patients and their families now that I don’t have to share my time between the screen and them. Real face-to-face interaction!”
  • “I feel much less burred out than previously without the current need of typing.”
  • “From a teaching standpoint, I can allow students to see more of my patients if we decide they don’t need to focus on note writing with me but instead history taking or presentations.”
  • “Today I closed all of my encounters at the end of the clinic. I am modifying the way I work in order to find a better balance in my life.”

Dr. Modi Featured in JMML Patient Story

Dr. Arun Modi from Hematology/Oncology was featured in a patient story about treating a toddler with a rare form of cancer – juvenile myelomonocytic leukemia, or JMML. JMML is a serious chronic leukemia that affects mostly boys 2 years old or younger. It accounts for about 2 percent of pediatric cancers and affects one or two children out of 1 million each year.

“This is the kind of cancer where your bone marrow produces an erratic type of blood cell, generally due to some kind of genetic defect in the cells, not in the body,” Modi says. “Carter had a very specific genetic defect in his blood cells that made it very resistant to normal treatments, like chemotherapy.”

Well done, Dr. Modi!

Family Testimonials for Several Pediatric Specialties

Two recent family testimonials attest to the quality multidisciplinary care provided by our specialty teams in the NICU.

The first highlights our neonatology, nephrology and urology teams. “Colt was born on October 19, 2018. He was two weeks early, only had one functioning kidney, and what they thought was a ureterocele in the bladder. He had a one-week stay in the NICU to watch his bladder/kidney and to get his sugars under control.”

The second highliths our neonatology and cardiology teams. “I was transferred to University of Iowa Hospitals & Clinics for preterm labor. Libby was delivered by emergency C-section at 26 weeks and had a blood transfusion on her first day of life. Libby participated in the drawer vent study and had a PDA – a patent ductus arteriosus, a condition that occurs when the ductus arteriosus (blood vessel) doesn’t close after birth.”

Pediatric Cardiology Team Featured in Patient Story

Members of our pediatric cardiology care team were featured in a patient story on the SFCH website. Drs. Aldoss and Reinking, with Trudy Pierick, ARNP and Brenda Haag, RN were prominently featured in the story of the Knapke family.

“When Shalan and Kyle Knapke found out that their daughter Adira would be born without a fully developed right ventricle, they turned to UI Stead Family Children’s Hospital. “We are so blessed to have such an amazing hospital nearby!”

Dr. Mathews and Pediatric Neurology Team Featured in UI SFCH Patient Story

Once a week, 12-year-old Ben Schussler boards a 9 a.m. plane near his hometown of Eagan, Minnesota, and flies – usually with either a parent or a “Ben’s Team” member – to the Eastern Iowa Airport in Cedar Rapids, Iowa. From there, he and his escort drive 25 minutes to the clinical research unit located within University of Iowa Hospitals & Clinics.

Clinic staff all know Ben, and he enters the clinic and heads to his infusion bay, where for an hour he’ll receive an experimental treatment for Duchenne muscular dystrophy (DMD). After the infusion, staff will monitor Ben for side effects, and on some days he has to have a blood draw to test progress. He’s usually back home by 7 or8 p.m. that same day.

Ben is part of a clinical trial testing to see whether a new therapy will change the progression of Duchenne muscular dystrophy, says Katherine Mathews, MD, pediatric neurologist at University of Iowa Stead Family Children’s Hospital and the UI’s principal investigator for the study in which Ben is participating. DMD is a genetic disorder marked by progressive degeneration of the muscles and increasing weakness.

Continue reading…

Dr. Sato and Dr. Pesce Featured in Patient Story

Dr. Mariko Sato (Hem/Onc) and Liuska Pesce (Endo) were featured in a touching patient story on the UI SFCH website about a child in the pediatric brain tumor clinic. The story highlights the multidisciplinary care provided here at the hospital, and includes pediatric subspecialists from other Departments as well, such as ophthalmology and radiation oncology.

Brady’s story: Finding help, balance, and hope

Calhoun and Marcellus Featured in STATNews

Amy Calhoun
Samantha Marcellus

“A decade earlier, her happy, easygoing little boy had died just after his second birthday. And now here she was, pregnant with twin boys, hoping against hope that they wouldn’t have the same mutated gene that killed their older brother. So when Alyssa Martin found out 21 weeks into her pregnancy that they, too, had inherited the faulty DNA, “it just felt like the end of the world,” she said.

This time, though, Martin knew what she was up against. While she was still pregnant, she and a team of doctors devised a plan to try to save the twins. The boys’ best hope was an experimental drug — a form of copper injected under the skin twice a day — designed to counteract the effects of that mutated gene, which wreaks such havoc on the body’s copper levels that it often kills boys before age 3. If the medication was to have a chance of working, doctors believed, it was crucial that the twins get it within weeks after birth — so time was of the essence.

But getting that drug to Charlie and Kolton Martin proved to be harder than anyone imagined.”

Read more about Dr. Amy Calhoun and Samantha Marcellus and their amazing story on the Martin twins.

New Clinic – Genetics Cancer Predisposition Clinic

The new Genetics Cancer Predisposition Clinic was started in April 2018. This is staffed by Dr. Alpa Sidhu in Genetics and Dr. William Terry in Hematology/Oncology, with genetic counselors- Kyle Dillahunt and Karin Panzer. Patients seen in the clinic include (a) Pediatric and adult presymptomatic/asymptomatic hereditary cancer predisposition evaluations, (b) Evaluation for genetic syndromes with an associated oncologic risk, and (c) Treatment and ongoing care of affected pediatric oncology patients with a suspected underlying cancer predisposition syndrome. Providers should contact Kyle Dillahunt or Karin Panzer to make referrals.

Clinic days:

Dr. Sidhu – fourth Wednesday of every month at IRL

Dr. Terry – Monday and Wednesday mornings at SFCH11

Karin Panzer – 2 half-days a month at SFCH11

NICU Featured in Waterloo-Cedar Falls Courier Article

The NICU was featured in an online article for the Waterloo-Cedar Falls Courier. The article, titled “Dysart ‘miracle’ twins, born 18 weeks premature, making history” is about a recent pair of twins in the NICU born at just 22 weeks and one day gestation, among the most premature surviving twins born at the University of Iowa Stead Family Children’s Hospital.

Dr. Jon Klein, NICU Medical Director, provided quotes for the article.