Main image courtesy of Gensler.

As a clinician, you want to make sure you’re always fully present for your patient encounters. That means listening to their concerns and addressing any issues or questions that come up. Additionally you’re responsible for creating medical documentation to record what went on during the encounter, and how the patient has been progressing. One of the best ways to do that is by taking notes, either during the visit or filling in the information afterwards. This way, all the essential information is up to date and accurate.

Lots of providers want to limit distractions or limit how much they divert their attention away from patients, and turn to scribes to help them with transcription. Scribes can be human employees or they can be AI applications, and there are advantages and disadvantages to both. In this article we’ll be discussing a little more about:

• The major differences between human vs AI scribes
• The pros and cons of both types of scribes
• Whether or not human scribes will be replaced by AI

What is the difference between an AI scribe and a human scribe?

Both scribes offer important services to clinicians

Scribes have been around for thousands of years to help document important information, whether it’s medical, civic, religious, or something else entirely. They are still used today in medical settings to allow the clinician to spend more time focusing on the needs of the patient. A human scribe is trained to enter the essential information as the encounter progresses so the provider does not have to do it later. Because all patient data is in electronic record form now, this means having a tablet or a computer to document what transpires at the visit.

Human medical scribes can be trained and certified by places like the Medical Scribes Training Institute, but there is no law that states scribes must be certified. Scribes follow the provider as they visit patients and enter information into the record in real time. This can mean adding in new information, diagnoses, codes for insurance companies, or scheduling follow up tests and appointments. 

Scribes can work in clinics, family practices, outpatient centers, and even in emergency rooms. You can expect that working in an office you’ll see a variety of patients, and you may even be responsible for ordering tests under physician supervision, or ensuring that preventative tests are up to date. Working as a human scribe in an ER may be a bit more hectic, but you’ll get to see first hand how doctors assess the symptoms and order different tests, procedures, or medications. Scribes in both types of environments are there to take care of the clerical tasks so the provider can concentrate on taking care of the patient.

Scribes may have other administrative tasks that they’re responsible for, it all depends on the facility. But their main focus is to ensure the accurate transcription of information into the EHR so that patient files are up to date.

AI scribes have been making their presence known in a variety of healthcare fields and facilities over the course of the past few years. These ambient scribes are applications that you can download to a tablet or smartphone and they are designed to transcribe the doctor/patient encounter. Once you receive consent from the patient, the scribe will listen using natural language processing and advanced learning algorithms to pull out important health information. This transcription is then used to create a note that will go into the patient’s EHR with any new diagnosis, treatment plan, request for tests, or follow ups. 

Once the encounter is over, the clinician just needs to review the transcription to ensure it is accurate and they have nothing additional to add (which they can easily do with a voice note or by typing it in). Then the information is synced with the electronic records management software and across all devices. AI scribes do not record patient encounters, and the data they send is encrypted for patient security.

In addition to creating summaries of patient encounters that can be turned into progress notes, AI medical scribes can also automate the patient journey from registration to check out, allow the clinician to make voice recordings that can be added to the file, and can sync with all devices to ensure everyone has access to the most up to date information.

What is the difference between in person and virtual scribe?

An in person scribe is someone who accompanies the clinician to each patient encounter. They’re there to document medical histories, type notes, and pull records or tests among a variety of other things. A virtual scribe is someone doing all of those things, but instead of being in the room with the patient and doctor, they’re in their own home on the computer. Virtual scribes can be hooked up to the patient encounter either with audio and visual, or sometimes just audio. They’re responsible for listening to the patient and filling in the EHR just like they would in person. 

Both types of human scribes have their pros and cons—some people may find running around a hospital from patient to patient is exhausting, while others will find it difficult to sit all day and transcribe information with a poor wifi connection. 

Pros and cons of human vs AI scribes

What are some of the top advantages and disadvantages of human vs AI scribes?

Whether or not you choose to use a human or AI scribe depends on your preferences and the needs of your facility. Human scribes have been around for a lot longer, but AI scribes have been steadily increasing their presence in all kinds of healthcare fields. If you’re considering getting a scribe, it’s best to know the pros and cons of both.

Human scribe

Pros

• Well trained. Human scribes need to undergo training in order to be prepared for a variety of tasks. They must know medical terminology, have knowledge of billing codes, and can work independently when required. This means they are very adaptable and can help clinicians with all kinds of clerical tasks, not just medical record documentation.

• Can recognize errors. Humans also have the capacity to recognize an error, or to question the patient or the doctor if something is missing from the file or doesn’t seem accurate. They can use this clarification to identify any further mistakes to ensure the patient record is complete. 

• Communicate directly with staff. Human medical scribes can interact directly with the provider and other healthcare staff in order to provide better patient outcomes. During an encounter, they are also capable of picking up non-verbal clues that could be important for the record, or ask additional questions to ensure the information in the record is right. They can order additional tests as soon as the clinician requests them, or follow up with other departments for results. 

Cons

• Cost. One of the major drawbacks for healthcare facilities is the cost of human scribes. They will need to be paid a salary, and may need to undergo ongoing education or training. Depending on how large your facility is, you may require a few scribes, which can increase their cost even more

• Human error. Scribes are human, and there is the chance that they’ll make errors in their documentation. If they miss important information during an encounter, it won’t make it into the medical record, which can develop into a large problem. They could also mishear or not interpret what the provider was saying correctly due to a misunderstanding. 

• Availability. Human scribes may not be readily available in all areas, and the ones that are there can only work what their shift schedule is. Overworking scribes (and anyone in the healthcare field) can lead to quicker burnout, and increase the likelihood that the scribe may find another job. 

AI scribe 

Pros 

• Speed. An AI medical scribe is designed to transcribe conversations in real time, creating a document that can easily be formatted into a note or put into the medical record itself. It can instantly populate fields of the patient’s medical history, what their concern or problem is at the encounter, and what diagnosis and treatment the clinician prescribes. This can be done much quicker than a human scribe can type in.

• Accuracy. Even though the speed of AI scribes is faster than that of humans, they do not lose their accuracy. In fact, ambient scribes are typically more accurate than a human entering the information, and there is less chance of an error.

• 24/7 support. AI scribes can be used all the time—whether that’s during patient encounters, when a clinician needs to add a voice note for it to transcribe into the file, or sending follow up appointment requests to the patient after hours. 

• Lots of options to choose from. There are a variety of AI scribes available for providers to try. Most of them come with a free trial or a demo period, so you can get a better feel for if the AI will meet the needs of your facility. 

Cons

• Needs review. Every AI summary and note should be reviewed by the clinician for accuracy. Although they are more accurate than human scribes, they can still misinterpret what either the doctor or patient said during the encounter. Even though the transcription still needs to be reviewed and approved, it still saves the clinician valuable time and eliminates the time consuming task of creating the note from scratch.

• Lack of judgment. The AI scribe can only transcribe the conversation during an encounter, it cannot read non-verbal clues, nor can it detect errors or if there is missing information needed.

• Potential for bias. If the data the AI scribe is trained on is biased, the ambient medical scribe will also reflect that bias.

• Cost. In order to get all the features your facility may need, there is likely a cost. Whatever the cost, it will still be much less than hiring a human scribe. 

• How much does an AI medical scribe cost?

Most AI scribes are subscription models, which means you’ll need to find a plan with the features you need at a cost that meets your budget. Ambient scribes can run anywhere from $99-$150+ each month. There are some free versions of AI scribes, but they may have limited features.

Will scribes be replaced by AI? 

It doesn’t seem like AI scribes are ready to entirely replace human scribes just yet. One way to see a future for both types of scribes is to use them both! A healthcare facility could use the ambient medical scribe in the patient encounter, and then have the human scribe review it for accuracy. Which scribe you choose to use will depend greatly on your needs and what kind of budget you’re working with. 

Which will you choose, a human or AI scribe?

It’s important to weigh the pros and cons of both of these kinds of scribes, as what’s right for one facility might not work out for another. While there are lots of benefits to having human scribes in settings like an ER room, other providers may find that AI scribes serve them best. If you’re ready to learn more about an ambient medical scribe that can reduce your administrative workload so you can spend more time with patients, consider seeing what Playback Health has to offer!