Can scribes enter orders for physicians and practitioners? The Joint Commission does not support scribes being utilized to enter orders for physicians or practitioners due to the additional risk added to the process.
Is it acceptable for physicians and licensed independent practitioners (and other practitioners allowed to write orders) to text orders for patients to the hospital or other healthcare setting? No it is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other healthcare setting. A telemedicine link does not fulfill the in-person requirement for the evaluation by an LIP of the individual in restraint or seclusion. A scribe is an unlicensed person hired to enter information into the electronic medical record (EMR) or chart at the direction of a physician or practitioner (Licensed Independent Practitioner, Advanced Practice Registered Nurse or Physician Assistant).
This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record. Is the use of a telemedicine link allowed for use by the LIP who conducts the in-person evaluations of an individual in restraint or seclusion? The Joint Commission has updated its FAQ regarding the use of unlicensed persons acting as scribes under the Human Resources (HR) chapter for Hospitals and Critical Access Hospitals (CAHs). It is the Joint Commission’s stand that the scribe does not and may not act independently but can document the previously determined physician’s or practitioner’s dictation and/or activities.
Two recent publications issued by CMS clearly indicate that the organization is tightening its requirements for the documentation required to support medical necessity and mandated signatures on prescriptions and orders for services.
The first publication is the "Improper Medicare Fee for Service Payments Report of November 2009." This report details the type and percentage of errors found in claims as determined by reviews performed under the CERT (Comprehensive Error Rate Testing) program.
The updated FAQ is also available on The Joint Commission website at this link.
The Joint Commission, similar to organization’s themselves, has expectations regarding anyone entering a health care organization.The scheduled regulation change was published in the Federal Register, Vol. 1, Tuesday January 3, 2012/Rules and Regulations 7, which is available at this link.The Joint Commission continues to clarify that when frozen plasma is thawed, the product is still considered to be fresh frozen plasma for up to the 24 hours.For more information on product modifications, The Joint Commission recommends utilizing the on the AABB website at this link.[Note: Free registration on the AABB website is required to access the resource guide.] The update Joint Commission FAQ on thawed plasma expiration is available here.They can be employed by the healthcare organization, the physician or practitioner or be a contracted service. Do the Joint Commission standards allow organizations to utilize scribes? The Joint Commission does not endorse nor prohibit the use of scribes.