Medical scribe readiness checklist

A scribe who cannot access the EHR on their first day cannot help. A provider who has not thought through how the scribe will be integrated into the encounter workflow will spend the first week creating it under pressure. A practice that has not defined documentation standards has no basis for evaluating whether the scribe's work is meeting expectations. Readiness review addresses all of these predictable friction points before they become problems.

Before documentation support begins, the scribe must have the appropriate EHR access to perform their responsibilities. This typically includes access to the scheduling module, patient charts, note templates, and the documentation sections they will be supporting. Access should be set up in advance, tested, and confirmed, not provisioned on the first day and worked through as problems arise.

• EHR access is provisioned and confirmed before the first scheduled clinical day
• Access level matches the scribe's documentation responsibilities, not less, not more
• Login credentials and two-factor authentication are set up and tested
• Remote access is configured if the scribe will work virtually
• EHR vendor permissions for third-party or remote documentation support are confirmed

Providers who have not thought through how they will work with a scribe often struggle in the first week. Basic questions need to be answered in advance: Will the scribe be in the room during encounters, or will they work from an audio feed? How will the provider communicate assessment and plan elements to the scribe? What is the sign-off workflow? How does the scribe ask questions without interrupting the encounter? Defining these conventions before the first clinical day prevents confusion and allows the arrangement to start productively.

• Encounter model is defined, in-person, adjacent room, or virtual with audio access
• Provider communication conventions are defined for each documentation section
• Sign-off workflow is established, where notes appear, how provider reviews them
• Scribe question protocol is defined, how and when questions are asked
• A brief daily check-in time is scheduled for the first two weeks

EHR orientation is the most important training component before documentation support begins. Even a scribe with prior EHR experience needs orientation to the specific system, templates, and documentation conventions used in the practice. This orientation should cover the note templates for each appointment type, the specific fields the scribe is responsible for populating, the documentation standards that apply, and any practice-specific workflows that differ from standard EHR conventions.

• EHR orientation is scheduled and completed before the first clinical day
• Note templates for each appointment type are reviewed in the orientation
• Documentation standards and quality expectations are communicated clearly
• Practice-specific workflows and conventions are covered explicitly
• A shadow period, observing the provider's encounters before actively documenting, is included where possible

Documentation support implementations that are evaluated at 30 and 90 days against defined expectations perform better than those that run without defined success criteria. Before starting, the practice should agree on what success looks like: a target reduction in after-hours documentation time, a specific note completion timeline, or a provider satisfaction benchmark. These criteria make the evaluation honest and give the implementation a direction to optimize toward.

• Define 1-2 success metrics before documentation support begins
• Measure baseline documentation time and note backlog before the start date
• Schedule a formal review at 30 days to assess early outcomes
• Schedule a 90-day review to evaluate whether expectations are being met
• Adjust the workflow based on findings from each review rather than waiting for problems to surface