Scribe Service Provider Addresses Clinical Documentation Challenge

Companies like IKS Health offer asynchronous virtual scribe services that integrate with various EHRs and population health management systems.

An asynchronous virtual scribe service that pairs physicians with a virtual physician partner is giving physicians an accurate, comprehensive clinical note for each patient visit, allowing them to return to the bedside interaction and clinical decision-making that inspired them to enter healthcare at the start.

IKS Health, which developed Scribble for healthcare, employs nearly 5,000 employees and focuses on business optimization supporting healthcare providers through every function of the patient visit. CEO and founder Sachin Gupta has been steering the company for 15 years.

In this Q&A, Gupta discusses the many changes and challenges for companies like his in an industry challenged to interoperate and prove its value during the ongoing pandemic.

HealthLeaders: From IKS’ perspective, what are the primary challenges physicians and clinical staff face today? What are your clients’ most prominent concerns? How does IKS address those concerns?

Sachin Gupta: The most immediate and concerning need is related to administrative burden and workforce shortages. Today, the industry is asking our clinical talent to do more than ever in less time, having piled administrative tasks onto our most discretionary workers (and) encumbering them when they should be connecting with and diagnosing patients. Additionally, new technologies that never accounted for how physicians naturally work and, worse, continue to layer on top of existing technology (are) adding more time to providers’ days to the detriment of the patients’ experience.

Therefore, it is no surprise that we face unprecedented levels of physician and clinical staff burnout. The gap between open jobs and the talent needed also continues to grow, with more open healthcare jobs in the US than there are workers to fill them by approximately half a million workers. We see this impacting our clients daily, where one organization operates understaffed by approximately 300 MAs every day.

When health providers can dedicate more time to their patients and less time on administrative chores, they are more likely to want to continue working and increase the number of patients they see, ultimately providing better clinical outcomes and improving their organizations’ bottom lines. (Companies like) IKS help organizations focus on the provider patient experience and identify tasks throughout their enterprise which can be streamlined, either with people, technology, or both. By standardizing, centralizing and, where possible, automating tasks to reduce administrative burden and enterprise waste, (companies like) IKS collect trends and analyze data that provide insights that improve everything from preventative care to collection rates. Not only does our work improve the physician experience, but it creates a smarter, scalable operating models, while enabling organizations to thrive.

HL: What do you think the answer is to improve the physician/patient relationship? How does improving back-end support drive better care?

Gupta: The simple answer is time and insight. We can declutter the in-office experience by determining which administrative tasks can be centralized and standardized.

(The goal is) localized and individualized care, where the patient-provider relationship is paramount and "human-in-the-loop" healthcare helps to unlock the value of technology, evaluated by a discerning expert, that ultimately takes insights and data and reinserts that into the physicians’ workflow for a more meaningful provider-patient relationship. Imagine the impact of an unencumbered physician, armed with meaningful information about the patient sitting in front of them.

HL: Has the pandemic impacted the services that IKS provides? Have your clients’ needs changed?

Gupta: The pandemic raised many questions about which business models work best in healthcare. Many have argued that shifting to value-based care sooner would have mitigated much of COVID-19’s impact on the industry, while others have realized that many fixed costs were negatively impacting their businesses. (Companies like IKS) help, shift healthcare organizations to variable cost models, which create flexibility during moments of significant change for businesses. During the height of the pandemic, as our clients’ number of visits significantly decreased, we were able to help clients rescale and ultimately grow their businesses in the months that followed.

The pandemic also forced organizations to operate outside of the four walls of their offices. Paired with the need for talent and stark competition for that talent, organizations are considering remote workers outside of their immediate geography. The result has been expansions of our scope within existing client organizations as well as an increase in new client conversations, because of our history of managing back-office and front-office services for our clients.

HL: The company is known first and foremost for scribe work. How important a service is scribe work these days?

Gupta: For us, scribe work is a meaningful component that addresses the much larger problem of physician documentation and coding. Virtual scribes, like Scribble, are important because they provide different value to different shareholders: patients gain intimacy, attention and quality of care; providers benefit from the "joy of practice" and increased compensation; for organizations it’s about access, revenue and engagement; for providers and self-ensured employers it’s about access, quality and cost of care.

With Scribble, we partner with clients to create accurate and comprehensive clinical notes for each patient visit, which enables a physician to interact with a patient anywhere, whether through telehealth, in the home or in the exam room. Digitizing this data has enabled digital health platforms to create pre-visit summaries for patients and further individualize the patient experience.

HL: Is this a difficult environment for provider systems to scale in? Can you share specific challenges that arise from scaling RCM and managing cost optimization?

Gupta: For a period of time, we may see fewer organizations with the ability to scale. However, we anticipate that organizations that have weathered the last 18 months well will want to scale and perhaps scale more aggressively than pre-COVID given that there will be many organizations looking to sell.

The biggest challenges for organizations looking to scale, outside of culture, come from standardizing technology, sharing data and standardizing processes. (Forward-thinking companies like IKS) are technology-agnostic, meaning our platform can scale as our clients improve operational and financial performance. Our technology seamlessly and securely integrates with existing platforms, and in many instances take the disparate systems within organizations and creates a standard data repository that serves as a single source for advanced analytics and insights. One of the many ways that we support our clients’ growth is through onboarding and inculcating new acquisitions into a standardized way of working.

By training and retaining back- and front-office teams, (we can help) to ensure that payment is collected at the time of service and that key data is captured correctly and timely. This important work relieves leadership from being burdened with identifying and rectifying these inefficiencies.

HL: Healthcare is experiencing unprecedented burnout. What is IKS’ answer to tackling burnout across physicians and staff?

Gupta: Pre-pandemic, burnout was already a looming threat in healthcare. Now, it’s more endemic than ever. Not only are staffs dealing with the most severe health crises of our time, but they are also navigating the looming pressures of day-to-day administrative work. Relieving healthcare workers’ administrative burdens and workflow bottlenecks offloads administrative work that leads to burnout and turnover, while also providing healthcare professionals with insight and expertise to enhance preventative care.

We believe the answer to burnout in healthcare is giving clinicians the time back in their day to care for patients, and the time back at night to be with their families, rather than writing their medical notes. Across our client organizations, rates of burnout are down, employee retention is up, patients are more satisfied, and clinical outcomes are improving.

HL: How does IKS work with clients to cut costs and improve quality of care?

Gupta: (Companies like) IKS enable provider enterprises to achieve clinical, financial, and operational excellence at scale by improving how our clients capture, collect, and protect revenue, while enabling optimal clinical and operational outcomes. (These companies help) clients grow revenue by accelerating patient collection and optimizing payer reimbursement; reducing operating expenses with virtual expertise and technology enabled workflows for greater efficiencies and patient access; and building enterprise value through an enablement platform that scales as our clients grow. By removing administrative bottlenecks, we can help restore the joy of practicing medicine – which improves patient satisfaction and enables value-based care.

HL: Interoperability, particularly in context of the 21st Century Cures Act, remains a big topic. How does IKS enable patient information to flow to and from the deliverers of healthcare?

Gupta: Unified data platforms can map to disparate EHRs, practice management systems, population health apps, clearinghouses, payer feeds and a host of other applications, allowing organizations to have a central place for clinical and financial data which can be used for reporting, analysis and other data-driven insights delivered via computational analysis or human BI experts. In addition, (these) platforms have features such as our Stacks solution, which converts unstructured data (e.g., consult notes, communications between practices) into structured data in the proper field of the EHR, allowing for more complete patient records and easier access for the practicing physician. Finally, for practices centralizing to a single EHR platform, the movement of existing clinical data is often an incomplete and time-consuming journey. Solutions like IKS combine field mapping technology with scalable, clinical, discernment, and expertise to safely migrate clinical data into the new EHR to make for a more complete medical record and safer healthcare.

HL: What is the health IT/health service industry not intensely focused on right now, that should get more attention?

Gupta: Right now, everyone is trying to develop technology that will help the industry take a giant leap forward. However, all these solutions rely on a healthcare environment that is standardized with consistent data quality and operating simplicity. That environment simply does not exist, and so unfortunately, what the industry is being sold is impossible to deliver. Resulting in being led back to the paradigm of healthcare tech that fails to deliver the promise on which it was sold, leading to further cynicism within the industry.

Additionally, much attention has been focused on advanced technology and AI promises, but the immediate wins that can be gained by eliminating inefficiencies and standardizing processes can bring immediate financial, clinical and emotional gains to our overburdened systems.

Where technology should focus is at the confluence of opportunity, practicality, and the connecting points within a patient's journey. So many health IT solutions are all clamoring for the same exam room space, or are otherwise so tied to a niche, that the responsibility for capturing value from those products relies strictly on the provider and their organization. Healthcare IT should take a less flashy, more holistic view of where to eliminate tasks within a provider’s workflow, decrease the tasks that the technology itself creates and increase the accountability that the solution assumes.