One of the chief complaints of physicians has been the sub-professional work of data entry required by so-called modern electronic medical record (EMR), electronic health record (EHR), or even the simpler e-prescribing technologies. Having the examining physician do data entry also poses issues with cognitive load and distraction.
In many paper-based systems, other clinicians transcribe physician orders onto the appropriate paper form. Such transcription also provides checks and balances with respect to e-iatrogenesis errors introduced by single user order entry. There are of course tradeoffs between transcription errors and technology-generated errors.
While software designers intention is to have the physician do so (think user logon), what about scribes? Seems like the hi-tech way to resolve ... Surrogate prescribers are used in most e-prescribing implementations to date. Scribes just formalize the informal use of surrogates.
See the recent LA Times article. This isn't a new concept - see American Medical News article in July 2008 and even further back to 2004 in a note titled "The Perfect Combination: Professional Scribe + Electronic Medical Record".
Also Emergency Medicine News with sub-title "Scribes push emergency medicine closer to adoption of electronic medical records"
References
[Scribes almost a prequisite to effective EMR use]
Alexander, I 2007, 'Electronic Medical Records for the Orthopaedic Practice', Clinical Orthopaedics and Related Research, Vol. 457, pp. 114-9
Mintz, M, Narvarte, HJ, O'Brien, KE, Papp, KK, Thomas, M & Durning, SJ 2009, 'Use of Electronic Medical Records by Physicians and Students in Academic Internal Medicine Settings', Academic Medicine, Vol. 84, no. 12, pp. 1698-704
Prywes, AS 2004, 'Electronic Medical Records: Should Your Practice Get Them Now? Personal Experiences in a Private Group Practice-the Good, the Bad and the Ugly', Techniques in Ophthalmology, Vol. 2, no. 4, pp. 166-70.
Simonian, M 2007, 'The Electronic Medical Record', Pediatrics in Review, Vol. 28, no. 10, pp. e69-76.
[Not scribes per se but addresses logon issues and nursing performance with COWS]
University of California San Francisco Medical Center 2007, Improving Quality of Care and Nursing Workflow: A Clinician Usability Pilot of the Motion C5 Mobile Clinical Assistant, UCSF Medical Center, San Francisco, California.