Effect of a National VHA Medical Scribe Pilot on Provider Productivity, Wait Times, and Patient Satisfaction in Cardiology and Orthopedics

Background Section 507 of the VA MISSION Act of 2018 mandated a 2-year pilot study of medical scribes in the Veterans Health Administration (VHA), with 12 VA Medical Centers randomly selected to receive scribes in their emergency departments or high wait time specialty clinics (cardiology and orthopedics). The pilot began on June 30, 2020, and ended on July 1, 2022. Objective Our objective was to evaluate the impact of medical scribes on provider productivity, wait times, and patient satisfaction in cardiology and orthopedics, as mandated by the MISSION Act. Design Cluster randomized trial, with intent-to-treat analysis using difference-in-differences regression. Patients Veterans using 18 included VA Medical Centers (12 intervention and 6 comparison sites). Intervention Randomization into MISSION 507 medical scribe pilot. Main Measures Provider productivity, wait times, and patient satisfaction per clinic-pay period. Key Results Randomization into the scribe pilot was associated with increases of 25.2 relative value units (RVUs) per full-time equivalent (FTE) ( p