The Joint Commission clarifies documentation assistant guidelines — 4 insights

The Joint Commission provided updated guidance concerning personnel tasked with documentation assistance.

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Here’s what you should know:

1. The Joint Commission’s initial guidance prevented scribes from entering orders. However, as more models continued to emerge, including licensed and unlicensed personnel, the accrediting body felt the definition was no longer valid.

2. The Joint Commission’s new guideline neither supports nor prohibits documentation assistant use.

3. The Joint Commission did identify a number of issues including:

  • Unqualified staff providing documentation assistance
  • Unclear or undefined roles
  • Documentation assistants using a physician login rather than a separate login
  • A lack of provider verification of entered documents

4. The Joint Commission recommends assistants be trained on:

  • Medical terminology
  • HIPAA
  • Coding, billing and reimbursement principles
  • Electronic medical record navigation and functionality
  • Computerized order entry, clinical decision support and reminders

To read the entire breakdown, click here.

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