Compliance

Meaningful Use impacts scribes

New CMS requirements will require certification.

By C. Jolynn Dobson Cook, RN

With the significant growth of EHR, the focus on the role of a scribe is more important than ever. Most physicians want to avoid physically turning away from the patient and focusing on typing on a computer. A scribe, working alongside the ophthalmologist in a busy practice, is a necessity in this new electronic environment.

As part of Stage 2 Meaningful Use, scribes will require certain certification requirement.

According to the Meaningful Use Stage 2 core measure 1, any licensed healthcare professional can enter orders into the medical record for purposes of including the order in the numerator for the objective of CPOE (Computerized Physician Order Entry) if they can enter the order per state, local and professional guidelines.

The order must be entered by a scribe able to exercise clinical judgment in the case that the entry generates any alerts about possible interactions or other clinical decision support aides. This necessitates that the CPOE occurs when the order first becomes part of the patient’s medical record and before any action can be taken on the order.

Credentialing agencies

Although CMS did not specify any particular credentialing agency for scribes, the change requires that the credentialing would have to be obtained from an “outside” organization other than the practice employing the scribe. Certification would provide the documentation that the scribe has the skill to exercise clinical judgment.

Our practice has been recommending certification through the American College of Medical Scribe Specialists or ACMSS in order to comply with the Meaningful Use requirement.

Recently, the ASCRS and ASOA released an update:

“We have received conflicting information from CMS whether scribes certified by the American College of Medical Scribe Specialists (ACMSS) will be able to enter CPOE information for EHR Meaningful Use. At the time the 2012 Stage II final rule was published, there was no certification program for scribes and subsequent guidance documents and communications from CMS indicated that as long as the professional was certified by an outside accrediting body—they would be able to enter CPOE for the purposes of complying with Meaningful Use. Despite the communication received by the AAO, ASCRS/ASOA and the ACMSS are continuing to discuss the issue with CMS with a particular focus on the ability of certified scribes to qualify and the accreditation program offered by ACMSS.”

Eligibility

Because scribes often have not graduated from an accredited program, they are ineligible to sit for a certification examination offered by some agencies. The American Association of Medical Assistants (AAMA), the certifying agency for medical assistants, says these individuals are not eligible for certification by the AAMA, but they may be eligible for certification through other agencies, such as ACMSS, or perhaps others in the future. OP

Ms. Cook is the Administrator of the Laurel Eye Clinic and the Laurel Laser & Surgery Centers. A Certified Ophthalmic Executive and Certified Administrator Surgery Center, she is a registered nurse and also has a degree in Health Care Administration.