In a decade or so, Siri or Alexa might be smart enough to turn a doctor’s visit into an accurate input on an electronic medical record – but the startup MedScribes is meeting that need right now.
Abhi Mehrotra and Scott Quilty (both MBA ’15) employ aspiring medical students across the Triangle as scribes. These women and men sit in on patient visits to write charts, track down test results and complete administrative tasks while physicians care for patients.
Deliberately low-tech, MedScribes fills an important need for doctors under increasing pressure to ensure patients have better outcomes. It also helps hospitals, outpatient clinics and other practices provide more access to patients – doctors see anywhere from two to eight additional patients in a day when they employ a scribe.
MedScribes has become a profitable and growing business serving patients, medical practices and students eager to learn about their future field.
“Sometimes we have to pinch ourselves when we look at our budget for the year,” Quilty says. “We look at old pitch decks and it’s happening. We have awesome employees, happy clients and now we’re looking at cash flow and investments to scale.”
The founders met during the Weekend Executive MBA Program at UNC Kenan-Flagler Business School.
Mehrotra is an emergency room physician with director roles in the emergency departments of two hospitals. He is a professor in the UNC School of Medicine and vice chair for strategic initiatives and operations at UNC’s Department of Emergency Medicine.
Quilty is a U.S. Army veteran with a background in sales and marketing. He also co-founded the nonprofit TentED – which provides school supplies to children displaced by war living in the Kurdistan region of Iraq – while at UNC Kenan-Flagler.
The immersive nature of their MBA program helped the pair build a strong working relationship. They were assigned to the same six-person study group and roomed together during the Global Entrepreneurship Lab in Copenhagen. So when Mehrotra needed help turning his final class project into a startup and Quilty was looking for an entrepreneurial opportunity after graduation, partnering was an easy decision.
The idea for MedScribes came during Professor Ted Zoller’s Soft Launch class, where students are challenged to dream up solutions to a problem they feel passionate about, create a business model and pitch it to potential investors.
As Mehrotra spent time identifying gaps in his field of medicine, he wondered if expanding the use of medical scribes would alleviate challenges for doctors and their practices. He’d seen a positive impact when he started using scribes in his own emergency department.
“I was frustrated when I would work a shift and then spend three hours afterward just doing documentation. Staying late like that can negatively impact home life. And having my nose buried in a computer when I should be listening attentively to a patient really disrupts the sanctity of the physician-patient relationship,” Mehrotra says. “When I work with a scribe it’s a very different experience.”
A scribe service helps reduce burnout from monstrous workloads and improves the quality of charts and electronic health records, while bringing back the joy of practicing medicine for physicians. For administrators, scribes can make practices more efficient and, by seeing more patients, add to the bottom line. Most importantly, patients benefit from more focused attention by their doctors.
Quilty was drawn to Mehrotra’s passion for the idea, but he needed to understand the market for what seemed like an old-school practice – technology is taking over administrative tasks in many medical settings.
His research showed that doctors can waste up to 50 percent of their time doing paperwork. And existing automated technology lacked the knowledge and accuracy required for that work.
Though Mehrotra was only familiar with scribes in emergency room settings, there’s a growing market for the practice. The 20,000 scribes in the U.S. in 2017 were projected to grow to 100,000 by 2020 and a $1 billion industry.
MedScribes placed first in the Soft Launch class of 2015. By April 2016, Mehrotra and Quilty had launched the business – based in Durham, North Carolina – with their first customer. In the first year, they started supporting dozens of doctors from Clayton to Hillsborough, including in the UNC and WakeMed health systems.
A secret to the quick momentum has been taking every advantage of every opportunity UNC provides. They consider Zoller’s class their startup accelerator program – where client needs were considered, pain points met and investors validated the idea. They used free office space at 1789 Venture Lab to incubate the idea. And any time an issue has come up since they graduated, they’ve relied on UNC’s alumni and entrepreneur connections.
“If we had IP questions or trademark issues, we can turn to an alum or someone connected to the Business School for help. As first-time entrepreneurs, we have not met a Tar Heel who wouldn’t drop what they were doing to point us in the right direction,” Quilty says.
The Executive MBA program also helped them define leadership roles and recruit the right talent for the company. As CEO, Mehrotra gives strategic direction and lends credibility as a medical practitioner. Quilty handles the sales and marketing. Together they built out a management team to oversee human resources, finance and scribe operations.
Training remains their secret sauce. Students receive 75 to 100 hours of training before they start working as scribes. They spend time in a classroom learning nomenclature, medical terminology and chart structure, followed by on-site learning about a hospital’s electronic medical records, understanding the flow of the practice and the doctors’ styles.
And by employing students interested in medical careers, Mehrotra better prepares future doctors, nurses or physician’s assistants for school and their careers. Though most scribes move on after a year or two to attend school, some are promoted to chief scribes to oversee the training and quality control at their clinic or site. When a scribe gets into medical or PA school, everyone at MedScribes celebrates.
“After they are with us, a high percentage of the time, they get into school,” Mehrotra says. “More than in a classroom or research lab, this provides the training ground to really understand the day-to-day experience of a physician in a clinical setting.”
By 2019, MedScribes was employing more than 60 pre-professional students across the Triangle. And as their startup grows, the founders recognize the role their education played in MedScribes’ success. To give back, both are serve as coaches for the EMBA Soft Launch class, helping the next generation of entrepreneurs turn their projects into successful businesses.