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Medical Scribe Marketing Assessment Research Assignment (Research Paper Sample)

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MedicalscribeMarket Assessment 2014USMarket Overview (Size, Growth, Trends)Medical scribes have existed in the medical industry for decades. However, it was not until the advent of health information technology did scribes take center stage in the transition from a paper-based medical record system to an electronic medical record (EMR) system. As a result of its relative infancy as an occupation and subsequently its infancy as an industry, amalgamated data estimating the total market size and growth is not available. The American College of Medical Scribe Specialists (ACMSS) does not even report industry-level data. However, it is more accessible to find data on the leading companies in the industry that can assist in estimating the market size.The applicable NAICS code for this industry is 621999. Researching US Census data for this code results in data from 2007, which is before the true explosion in the industry. Therefore, the time for industry-wide economic data is due.left12065The Medical Scribe market is dominated by third-party companies training, sourcing and managing scribes for hospitals, physician groups, clinics, etc. Since the introduction of federal incentive funds of $15.5 billion through the 2008 American Recovery & Reinvestment Act to transition hospitals to EMR systems, scribe companies have exhibited exponential growth. Hospitals and physicians quickly realized the dramatic reduction in overall productivity as a result of having to learn an electronic system of documenting the patients’ visits. This need gave birth to new companies and raised the bottom-lines of existing scribe programs specializing in training individuals specifically in skill of accurately entering medical data into the EMR system while physicians focus on medical care.Major industry players include PhysAssist, the original scribe company; ScribeAmerica, the most commonly contracted company; Elite Medical Systems, and; Emergency Medicine Scribe Systems among others. These are the largest companies in the industry, all of which are privately-held and would subsequently lead the industry in sales and revenue. The private nature of these companies limit public reporting of annual reports and data and therefore up to the discretion of the executives to release data. As a result, some data reported is directly from information and reports released by the company and some have been estimated.To estimate industry size, to the left are the revenue reports/estimates of the top 5 companies in the industry.Total Industry Annual Revenue (Est.) = $112.2MTotal Industry Staff = 9,700+This estimate is supported by ScribeAmerica’s own estimates that there are approximately 10,000+ scribescurrently employed in the field where the vast majority is employed by the top 4 companies and the approximately 1,000+ employed by smaller companies according to the CEO of ScribeAmerica.Program CostsAlthough the costs to outsource to a scribe company varies by geographic location, payment arrangements, number of scribes needed among other variables, the average cost of outsourcing to a scribe company ranges from $20-$25 per hour all inclusive of all available services from the company. For facilities that choose to develop their own scribe programs, the costs are far cheaper averaging at $16/per hour. Some companies offer services with no up-front/setup fees with higher hourly rates and clients handle more administrative duties of the scribes. Other companies charge set-up or monthly fees with a lower hourly rate and administrative support to the client.There are also many payment arrangements for the program. Some programs have opted to deduct the entire cost of a scribe from the physicians’ pay when doctors are paid on a productivity basis. Other facilities choose to split the cost between the physician and the medical center. In general there is a 3:1 ratio of hospital revenue to emergency management (EM) group revenue, so a hospital would typically benefit 3 X $37.52, or $112.56/pt (less some incremental staffing cost) as a result of an EM group’s implementation of a scribe program.Program ServicesSome scribe programs contract with a hospital or group to provide administrative, benefits management, scheduling, training, etc. Other programs are more recruiting to assist hospitalsand medical groups in hiring scribes, who will then takes over all management of the scribe. The in the first case, the scribe is an employee of the scribe company. In the second case, the scribe is an employee of the hospital or medical group.[sources: /article/20130824/MAGAZINE/308249958; /documents/Essia%20Writes%20Up%20Prescription%20for%20Success_SFBJ.pdf]Largest Customers of Medical Scribing (Hospital Chains)Please see extended list in competitive analysisChildren’s Hospitals and Clinics of MinnesotaTenetMercyRush University Medical CenterEmCareVanguard Health SystemsSt. John Health SystemHospital Corporation of AmericaSouthwestern Medical CenterOconee Medical CenterWake Forest Baptist Medical CenterSt. Mary’s Medical CenterCatholic Medical CenterCookChildren’sLe Bonheur Children’s HospitalCommunity Health NetworkFranciscan St. Francis HealthWhat are the driving forces changing the Medical Scribe Industry? ICD 10: According to Healthcare IT News, a recent study on the ICD-10 implementation costs by the Nachimson Advisors revealed a predicted 10% drop in physician productivity during the conversion. Additionally, the ICD-10 is expected to increase documentation time by 15% for physicians. The industry transition to the ICD 10 will be a driving force in the need for scribe companies because, as a training company as well, they have the ability to quickly train staff in the new coding system within a couple of weeks as opposed to having to train the physicians, which may cost more time.[source: /blog/why-icd-10-implementation-expected-create-productivity-losses ]right17145EMR: Additionally, when hospitals transition to new EMR systems, the same training protocol applies where scribes can quickly be trained and certified in a new technology.Additionally, there is a growing number of physicians opting out of using EHRs. Of all the physicians surveyed 46% do not plan on purchasing an EHR system, which was up from 34% from the previous year.[source: http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/2013-salary-survey/primary-care-ehr-use-and-costs-charts ; /news/ama-presses-better-ehrs]Physician Retention: A 2013 Medical Economics survey revealed that 79% of primary care physicians use EHRs. The transition to electronic records was taxing on many physicians physically and mentally who spent extra hours learning the system and entering data. Establishing a scribe program allows physicians to focus on medical care while a scribe focuses on accurate data entry. In addition, the EMR system was also contributing to faster physician burnout whereas doctors often used extra hours at the end of their day to ‘catch-up’ on medical records. With a scribe program, doctors can have a shift of normal length.[source: http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/2013-salary-survey/ehr-holdouts-why-some-physicians-refuse-plug]Migration to Quality-based PaymentSystems: Scribe programs assist in increasing patient satisfaction and the overall quality of care delivered to patients. Therefore, physicians can reap benefits in the quality-based payment system as a result of using a scribe. However, some facilities that compensate based on quality may deduct the entire cost of the scribe from the physicians pay.Joint Commission Scribe Regulations: According to the Joint Commission, there is no endorsement or prohibition on using scribes. However, if scribes are used, they must comply with all of the Human Resources, Information Management, Leadership and Rights/Responsibilities of the individual standards as well as the Record of Care and Provision of Care standards. These requirements are best managed by both the scribe company from a training perspective as well as the medical facility.[Source:/mobile/standards_information/jcfaqdetails.aspx?StandardsFAQId=426&StandardsFAQChapterId=66]Establishment of Official Certifications and Standards: The establishment of certification programs and standards for scribes by the American College of Medical Scribe Specialists raises the quality and perception of scribes as a valued occupation.Patient Satisfaction& Productivity: As long as there is a loss of productivity among the facilities using EHR, there will be an effect on patient satisfaction and patient care. Studies 4476750by the American Medical Association and the RAND Corporation, reported by Healthcare IT News in 2014, show that EHRs have failed to improve efficiency and interferes with providing medical care. Physicians report that the EHR systems are too time consuming and takes away time from patients. Supporting this result, a recent study by the International Data Corporation showed that 58% of ambulatory physicians were not satisfied with their EMR technology.[Source:/content/dam/rand/pubs/research_reports/RR400/RR439/RAND_RR439.pdfWhat is the market look like in 5 years? Un-tapped MarketsMarket potential can be estimated by assessing the current usage of medical scribes and number of hospitals and medical facilities who have received these incentives funds to implement EMR systems. The American Recovery & Reinvestment Act allowed more than 4,000 hospitals and 300,000 physicians to use EMRs.Currently, among the approximate 10 medical scribe companies, there may only be 500-800 facilities, at the most, that use scribes. According to the CEO of ScribeAmerica, there were approximately 500 facilities in the nation that used scribes as of 2013. Considering the exp...
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