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84 Highland Avenue
Salem, MA 01970

Phone: (978) 745-3050
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Ayres D'Souza Medical Building
30 Tozer Rd.
Beverly, MA 01915

Phone: (978) 745-3050
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PAGS Patient Care – Taking Two Steps Forward

In 2006, Pediatric Associates of Greater Salem (PAGS) took a huge step and transitioned from paper charts to an electronic medical record.  Bright -eyed and bushy tailed, we immersed ourselves to learn the system and improve efficiency and care and our patients overwhelmingly liked the changes.

The feedback from families indicated they liked the improved access to their children’s records and better communication with doctors, nurse practitioners, nurses and administrative staff.  Prescriptions could be faxed electronically, there was better continuity of care, and a host of other positives of transitioning to an electronic health record.

However, one of the down sides, nay the dark side some might say of the electronic record, is less engagement and eye contact with patients with health care providers looking at the computer. In 2015, a study published in JAMA, Internal Medicine showed that only 48% of patients with doctors with heavy computer use during a visit rated their care as excellent, while 83% of patients with doctors less engaged with their computers rated their care as excellent.

We do not want you to look at our backs, but undoubtedly that has happened more often than families would like, as we navigate the electronic record to accurately document your concerns, send prescriptions and review growth charts for instance. 

In our efforts to continually improve our service levels to our patients, PAGS has taken two big steps with our approach to your care:
 
1) Team Huddle:  All patients have a “medical team” (a core part of our being a Patient-Centered Medical Home) which they have come to trust and we believe it keeps the cozy feeling of a small practice within the larger practice.  One aspect of the patient-centered medical home is being prepared for our patients prior to the visit. We, your medical team, “huddle” prior to starting the day to review the patients we have on our schedule, review consults and urgent visits they have had, review vaccines and health maintenance items such as anemia and tuberculosis screening that may be recommended. Preparing for our patients visit ahead of time undoubtedly allows for more engagement with them and their families and less engagement with the computers.
 
2) Scribe Program:  In 2015, we began a pilot scribe program with Drs. McAuliffe and Morgan. The concept was new to us but we quickly realized the benefit and took the leap into adopting a scribe program. If you have never heard of a medical scribe you are not alone. It is by no means widespread.

So who is a scribe? A medical scribe is someone who prepares for the patients’ visits before they arrive, documents in the electronic record accurately, and thereby improves efficiency of care. At PAGS, all members of the team prepare for the visits ahead of time.  Our scribes may often make initial contact with families and take any vital signs that are needed, as most are cross-trained as medical assistants. They then document the details of the visit in real-time so your doctor can talk with you face to face with less time looking at a screen, and more eye contact. Thus far, our patients have embraced scribes as part of our medical team and have not felt the process to be an intrusion.  If we do not have a scribe on a given day, we continue to try to strike a balance of face time and timely documentation.

Our hope is that these changes will provide for a more relaxing visit and allow us to be more engaging with you, as we had been before computers became an irreplaceable feature of medicine, and intervened between doctor and patients.
 
We would love your feedback regarding our attempts to “look up” and bring face to face medicine back into the office visits.  Please let us know in person, through our new Athena portal or visit our Facebook page.
 
Computers are not going away.  Here’s to scribes and here’s looking at you!
 
 
Meet PAGS Scribes:
 
         
L-R: Stephanie & Logan    


 L-R: Soraniya, Yoselyn & Aida
 
 
Posted: 10/18/2017 8:39:14 AM by Kim Gendron | with 0 comments


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