MEDICAL SCRIBING Medical scribing is a process in which a trained medical scribe assists a physician to document patient encounters in real-time. The medical scribe is responsible for accurately entering patient information into the medical record, such as patient histories, physical exam findings, procedures, medications, labs, and diagnostic imaging reports. The role of a medical scribe is to ensure accuracy in the medical record by capturing a complete and accurate patient charting and to provide assistance to the physician during a patient visit. The duties of a medical scribe include: • Listening to the physician and patient interaction to document a patient’s history, physical exam, and other pertinent information • Entering patient information into the electronic health record (EHR) in real-time •...
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