SIOUX CITY | Renita Goetz was sitting in a dictation room in UnityPoint Health - St. Luke's emergency department on a Friday morning when Dr. Denise Hanisch received word that paramedics were en route with a man suffering from a rapid heart beat.
Goetz, who had already created a medical history for the patient on her laptop, quickly followed Hanisch to the entrance to meet the ambulance.
"She just types along when I'm talking. She documents everything," Hanisch said of Goetz, one of 14 medical scribes working at the hospital.
The demand for scribes, who enter data for physicians, is booming as hospitals and clinics nationwide convert to electronic health records -- a computerized version of a paper chart that is more legible and accessible.
Scribe America, the company that supplies St. Luke's scribes, employs more than 4,100 scribes at health care facilities in 41 states.
Wendy Lindley, St. Luke's emergency department director, said scribes have been working in the emergency department 24/7 since December to reduce the time physicians spend entering data. Most scribes, according to Lindley, are pursuing careers in nursing or radiology or as physicians.
The Affordable Care Act, commonly called Obamacare, requires health care providers to move to electronic medical records this year or face a penalty in 2015.
St. Luke's entered the era of electronic medical records in 2013 when it implemented the multimillion-dollar Epic system that provides a variety of applications including physician order entry, bar coding for medication ordering and management and access to patient medical records at all Iowa Health System affiliate clinics and hospitals.
"Having the scribes allows the physician to concentrate more wholly on the patient," Lindley said. "They're able to voice their medical exam to the patient while the scribe is documenting it in the chart. It allows them to concentrate fully on patient care."
Scribes stand in the corner of the exam room. They don't interact with patients or wear scrubs -- the standard hospital garb of doctors and nurses.
Hanisch said she never worked with a scribe before coming to St. Luke's in February. She said scribes allow her to interact with patients on a more personal level, because her eyes aren't glued to a computer screen.
"I think it helps a ton in my ability to communicate with the patient," she said. "I actually can concentrate on what the patient is saying and not worrying about the paperwork I'll have to do later."
Goetz, a University of South Dakota student who will begin medical school in a month, said she's trained in medical terminology and feels comfortable talking with physicians about the lab tests they order and their findings.
"I think we help them a lot," she said. "I'd be very unhappy if the doctor wasn't talking to me."
Having an extra person in the room, Hanisch said, doesn't seem to bother patients, either.
"I've never had a patient have a negative comment about it," she said. "Some are actually nervous at first, but our scribes are very quiet in the corner. I think once we start the process with the interview with the patient it all becomes very comfortable."
If patients feel uncomfortable having scribes present, Lindley said physicians will ask them to step outside. She said patients often thank scribes when they leave the exam room with physicians.
"We haven't had any complaints or issues," she said.