Joint Commission issues guidance on use of scribes

The Joint Commission has issued guidance to clarify its position that hospitals may use unlicensed scribes to input patient information into a hospital's electronic health record or chart if certain requirements are met.

The guidance, in the form of answers to frequently asked questions to its accreditation manuals for hospitals and critical access hospitals, states that the Joint Commission "does not endorse nor prohibit" the use of scribes, but also states that hospitals can use them to document a physician's or practitioner's dictation or activities.

The Joint Commission, which accredits and certifies more than 19,000 healthcare organizations and programs in the U.S., acknowledged in the guidance that scribes accompany the physician or practitioner to record information in the medical record, and that they "also assist the practitioners listed above in navigating the EMR and in locating information such as test results and lab results. They can support work flow and documentation for medical record coding." 

If a hospital is going to use a scribe, the Joint Commission warned that its surveyors will expect to see compliance with several applicable standards, including human resources, information management, leadership, rights and responsibilities of the individual, record of care and provision of care.

The guidance specifies that the Joint Commission does not support the use of scribes to enter orders, and that hospitals must have a performance improvement process to ensure that this does not occur.

Scribes can improve EHR productivity and patient satisfaction. However, the Joint Commission is not the only entity concerned about the use of scribes for entering orders. Both the Healthcare Information and Management Systems Society (HIMSS) and the College of Healthcare Information Management Executives (CHIME) opposed the use of clerical support for computerized physician order entry in their comments on the Stage 2 Meaningful Use proposed rules.  

To learn more:
- here are the FAQs for critical access hospitals
- read the FAQs for hospitals