In today’s US healthcare system, providers are spending more than 30% of their daily time on electronic documentation. That’s why medical scribe services have emerged as an effective way to streamline workflow and allow physicians to focus on delivering quality care.
Healthcare facilities can build an in-house team or look for remote medical scribe services to enhance their workflow efficiency.
When choosing between on-site medical scribes and virtual scribes, practices need to weigh workflow, cost, and impact on physician-patient relationships. Here is a detailed breakdown of the definitions, pros and cons, and guidance for modern healthcare facilities on which model may work best.
What is a medical scribe service?
Medical scribe services refer to trained professionals who accompany or assist a physician during patient encounters. They capture every detail of the encounter, like history, exam findings, physician’s assessment, and plans in real time or near-real time. They enter or assist with entering the information into the electronic health record (EHR), enabling the physician to focus on the patient. Studies show that employing scribes can lead to increased productivity, higher RVUs (relative value units), and improved provider satisfaction.
What Does a Medical Scribe Do?
Some of the common roles and responsibilities of a healthcare remote scribe include the following-
- Being present (offline/online ) during the patient-physician visit
- Capturing narrative, documentation of exam, orders, plans, etc
- Preparing clinical notes / SOAP notes / DAP notes
- Updating the EHR in real time or immediately after the encounter
- Potentially assisting with coding/billing capture, though that is supplemental
What are virtual scribe services?
Virtual scribe services involve trained professionals who work from a remote location and support physicians via video, audio, or real-time EHR integration. They listen in (live) or review a recording (asynchronous), document the encounter, and feed the note into the EHR for physician review.
For example, a recent study of many physicians found that the use of virtual scribes was associated with significant decreases in total EHR time per appointment and reductions in physician charting after hours.
Pros of Virtual Scribe Services
Here are some of the key benefits that remote medical scribes bring to a practice-
Reduced physician documentation time
Providers who have virtual scribes reduce overall EHR time, including after-hours work.
Cost efficiency
Remote scribes eliminate many overhead costs (office space, onsite supervision, local recruitment) and can scale according to demand.
Flexibility & scalability
Remote scribe services can adjust to varying patient volumes, multiple locations, telemedicine encounters, and off-hours support.
Improved physician and patient relationship
With the remote scribe services, there is less physical presence of a third person in the exam room. It preserves a more efficient and direct physician-patient connection. Some studies highlight increased privacy and improved patient comfort with remote scribes.
Access to a larger talent pool
A medical scribe agency hires professionals from diverse backgrounds and geographic regions, which overcomes local labor shortages.
Cons of Remote Scribes Services
With these significant benefits, virtual scribe services also present some challenges, if not connecting with experts.
Dependence on technology & connectivity
Because the medical scribe is remote, reliable internet, secure connections, and seamless EHR integration are essential. Connectivity interruptions can impact documentation quality or timing.
Integration & security concerns
Adhering to HIPAA compliance, secure remote access, and data privacy are essential. While many medical scribing companies have addressed this, providers just need to find the right partners.
What are On-Site Medical Scribes?
On-site medical scribes (also called physical or in-room scribes) are professionals physically present in the clinic or hospital environment. Commonly, they sit with the physician during patient visits. They document the encounter in real time or immediately thereafter. They are part of the care team physically.
Pros of On-Site Medical Scribes
Here are the major advantages of on-site scribes-
Immediate presence & interaction
The scribe can clarify details instantly, ask follow-up questions, observe non-verbal cues, and capture subtleties in the encounter.
Integrated with team dynamics
Being on-site allows the scribe to naturally integrate into the care team, understand local workflow, and build rapport with physicians, nurses, and patients.
Fewer technological dependencies
Less reliance on remote connectivity or tele-interface (though still requires EHR access).
Cons of On-Site Medical Scribes
Despite their advantages, on-site scribes come with drawbacks-
High cost
On-site scribes require salary, benefits, physical workspace, onboarding, and supervision.
Recruitment & turnover risks
Local staffing may suffer from turnover, absence, holidays, and rainy gaps, which can disrupt service.
Infrastructure needs
Workspace, computing, EHR access, supervision, and scheduling are needed. For remote sites or smaller practices, on-site presence may be inefficient.
Scalability challenges
Scaling up for multiple physicians, multiple locations, or telemedicine settings is more difficult when scribes must be physically present.
Potential impact on the physician-patient dynamic
Some patients may feel uneasy with another person in the exam room, and some physicians may feel crowded or constrained by a scribe physically sitting beside them.
Virtual vs. On-Site Medical Scribes – Select the Best for Your Healthcare Facility
When comparing virtual versus on-site scribes, many factors must be weighed. Based on current research and practical considerations, virtual scribe services increasingly offer a favorable cost-benefit profile. They offer strategic solutions for practices looking for flexibility, efficiency, and cost control.
Workflow & Efficiency
Research shows virtual scribes reduce EHR time per visit and help physicians avoid after-hours charting. Their flexibility allows documentation support across multiple locations and telehealth sessions. On-site scribes offer strong real-time support, but may be less scalable.
Consider Your Budget
Virtual scribes reduce overhead costs (no physical scribe space, lower local staffing costs) and scale more reasonably. On-site scribes have significant salary & infrastructure costs.
Physician-patient relationship
Virtual scribes enhance the physician-patient dynamic by removing the physical presence of a third person in the room. On-site scribes provide immediate team integration but add another person in the space.
Scalability and flexibility
Virtual scribes excel here. Practices with multiple sites, telemedicine workflows, or varying volume will find remote scribes easier to adjust to. On-site scribes are more rigid in scheduling and location.
Quality and accuracy
On-site scribes may capture subtle in-room context more easily; remote scribes depend on robust connectivity and training. However, evidence suggests that virtual scribes effectively reduce physician documentation burden and maintain accuracy when well-implemented.
Best Overall: For many U.S. healthcare facilities, like ambulatory clinics, multi-site practices, and physicians, virtual scribe services present a superior model. On-site scribes remain a strong option for specialty hospital settings, procedural environments, or where physical presence provides clear value.
Elevate your healthcare setup, budget, and workflow type to choose the best medical scribe model for your practice.
Conclusion
Selecting between virtual and on-site medical scribes is a strategic decision for any healthcare facility. Many real-world experiences suggest that virtual scribe services provide greater flexibility, lower cost, and strong results in improving workflow and physician experience.
By evaluating your setup, budget, workload type, and long-term goals, providers can choose a scribe model that enhances efficiency and supports physician well-being. If you’re looking for a partner to support remote scribe services in the USA, consider panaHEALTH to get strategic solutions. We help you tailor a solution that fits your workflow, patient volume, and care model.
