Written by: Center for Care Innovations

Petaluma Health Center is known for solving problems at its high-spirited daily huddles and regular brainstorming sessions.

But it discovered one persistent pain point needed some extra time and attention to remedy — the time-consuming process of writing up patient notes for the clinic’s electronic health record. Some providers, especially new ones, had difficulty keeping up with all the documentation, and the team was interested in trying out tools that might make a difference.

Clinic staff at the California clinic — located in Sonoma County’s riverside city of Petaluma — discussed what could make it easier to compile notes for the visits from the clinic’s 35,000 patients from the city and nearby vineyards, farms, ranches, and coastal hamlets.

The staff hardest hit were behavioral health providers, who had onerous documentation requirements and had reported note-writing as an area of frustration and dissatisfaction, according to Danielle Oryn, the chief medical informatics officer at Petaluma Health Center (PHC). In addition, she noted, a few providers had injuries that made typing lengthy progress notes difficult.

Among them was Annie Nichol, a family nurse practitioner for whom patient notes consumed many hours when she was supposed to be off work. Since she was slow at typing and suffered from wrist strain, she explained, “I often spend hours outside of clinic time finishing my notes. I would love to have some help to get my notes done more quickly.”

The clinic discussed hiring scribes to aid doctors with physical limitations, but it seemed cost-prohibitive. “Additionally, human scribes require a significant investment of time and training and you also have turnover” to contend with, according to Jessica Moore, PHC’s director of innovation. “We wanted to see if a mobile scribe app would improve the experience for these providers.”