Medical Scribe Uses On-the-Job Experience to Develop App

Posted on Wed, Sep 28, 2016
Medical Scribe Uses On-the-Job Experience to Develop App

By Affan Farooq, M.D.

Many times I’m asked, “What do you do in the E.D. exactly?” To the layman, I say that I’m a medical scribe, which is usually followed by a blank stare followed by an extensive Q & A session. For those familiar with the world of medicine, I simplify it by saying “I work as a scribe,” which usually means that I document history, physical exams, medical orders and patient encounters at the dictation of a practitioner.

As an EmCare scribe, also known as a clinical information manager, I expedite and enhance patient care in the emergency department by accurately documenting detailed electronic medical records for patients at the direction of the physician or physician assistant. This allows providers to spend more time with patients, increases overall productivity and ensures thorough documentation. But there is more.

In addition to taking dictations from multiple providers, I shadow providers to actively take history at the bedside and ask pertinent questions related to physical exams, management and plans to ensure information is complete, properly documented and compliant with most recent established billing guidelines. Essentially, I have a very important position; acting as a liaison between the medical world, the billing world and the medico-legal world.

From Medical School to Medical Scribe

After completing medical school and intern year at a medical school in Karachi, the 7th most populous urban city in the world and the most populous city in Pakistan, I felt unsafe in a turbulent country. Practicing medicine in a third-world country on the forefront of the war against terror comes with its own experiences, which one cannot begin to explain. From terrorist attacks, gang wars, humanitarian crises, kidnappings, natural disasters as well as manmade disasters, the list only goes on.  I had had enough and was looking for a way to transition my life, my career and my passion for helping humanity by making a move back to the United States.

While studying for various advanced licensing privileges to practice medicine both internationally and in the pursuit of residency here in the United States as a scribe, I believe I was placed at a pivotal point in my life with the opportunity to see the medical field through a more objective view. Instead of being the one participating hands-on in a given acute situation, discussing diagnostics, management and future course of action, I was able to take a step back and observe. This opportunity granted me the ability to see things that I would want to implement in the way I practice medicine with a finer focus, changes that I would make to myself and learn from those around me with more experience.

By working as a scribe at Newark Beth Israel Medical Center, the medical control site for two-thirds of New Jersey, I had the opportunity to be at the bedside during numerous codes, many of them cardiac arrests. Instead of actively participating as I had been trained to as a physician, I now was standing bedside documenting, observing and thinking what I would do in this situation if I were the attending physician. I was able to learn and discuss with various physicians the importance of intra-thoracic pressure regulation as well as the importance of high-performance CPR and feedback. Being a physician in a scribe position allowed me to know what was going on and see what could be done to improve patient care in acute settings.

Turning Training into Technology

It was this experience that lead me to begin thinking about a mobile app that would help improve the delivery of CPR in the field. The idea came to me after I learned about a metronome device used as a separate add-on to transport monitors. With a background in basic programming and a keen interest in technology, I embarked on developing one of the world’s first wearable CPR feedback devices – PerfectCPR – an app exclusively for the Apple Watch.

Using the transport monitor’s accelerometer, haptic feedback and gyro-meter, PerfectCPR provides a “tap” on your wrist to indicate when a compression should be performed while simultaneously keeping count of compressions and the total time elapsed since initiation. This can be used in emergencies by anyone to provide emergent compressions during any condition in which resuscitation may be indicated.

Working as a scribe gave me a diverse perspective and exposure to emergency medicine that enabled me to meet professionals who not only encouraged and supported me, but inspired me to grow my passion for serving humanity and validated my reason for pursing medicine.  These experiences, discussions and responsibilities are something that I believe have shaped me as an individual.
Ultimately, as is everything in life, opportunities are what you make of them, and being a scribe has been an invaluable experience.

Affan Faroog

Affan Farooq, M.D., graduated from Baqai Medical University in Karachi, Pakistan. He received a gold medal in general surgery and has worked at various hospitals in Karachi. In 2015, he traveled with Red Crescent to the Hindu Kush region to provide medical relief after it was hit with an earthquake. Dr. Farooq has been a scribe with EmCare for nearly two years, working at Newton Medical Center and Newark Beth Israel Medical Center. He is currently pursuing residency.

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