This guide covers what a virtual medical scribe does, the difference between a real-time and an asynchronous scribe, which parts of the note the scribe writes, where the line sits between a scribe and clinical care, how the scribe works inside the EHR, how the role differs from a virtual medical assistant, and what it costs.
A virtual medical scribe records the history, exam, and plan under the provider's review, never makes clinical decisions, and works inside the practice's own EHR from a remote location.
At a glance
- A virtual medical scribe documents the visit in the EHR so the provider stays focused on the patient.
- Real-time scribes write during the live visit; asynchronous scribes draft from a recording right after.
- A scribe records the history, review of systems, exam, and plan, and never gives medical advice.
- Every note stays under provider review, and the provider keeps the final assessment and signature.
- Rates at Honest Taskers run $10.00 to $12.65 per hour, with most placements starting within 1 to 3 weeks.
What Does a Virtual Medical Scribe Do?
A virtual medical scribe captures the patient encounter in the EHR as the provider works, building the clinical note so the provider doesn't have to type during or after the visit. The scribe listens, documents, and hands a drafted note back for review.
The work centers on the visit note. As the provider takes the history and runs the exam, the scribe records each part in the practice's EHR template. That covers the chief complaint, the history of present illness, the review of systems, the exam findings, and the assessment and plan the provider states out loud.
The scribe also handles the documentation tasks around the note. Preparing the chart before the visit, entering orders and referrals for the provider to approve, and prompting chart closure all fit the role. For more on the day-to-day responsibilities, the full task list sits in our guide on virtual medical scribe duties and responsibilities.
Sinsky and colleagues, in "Allocation of Physician Time in Ambulatory Practice", a 2016 time and motion study in Annals of Internal Medicine, observed physicians spending 49.2% of the office day on EHR and desk work against 27.0% on direct clinical face time.
What Is the Difference Between a Real-Time and an Asynchronous Scribe?
The difference is timing, because a real-time scribe documents during the live visit while an asynchronous scribe drafts the note from a recording shortly after the encounter. Both produce a complete chart for the provider to review and sign.
A real-time scribe joins the visit by a secure audio or video connection. As the provider speaks, the scribe types the note live, so the chart is nearly done when the patient leaves. This model suits providers who want the note closed before the next patient is roomed.
An asynchronous scribe works from a recording or the provider's dictation after the visit. The provider sees the patient first, then the scribe drafts the note within the practice's turnaround window and returns it for review. This model gives providers flexibility and works well across time zones. The benefits each model brings back in provider time are covered in our guide on the benefits of a virtual medical scribe.
| Factor | Real-time scribe | Asynchronous scribe |
|---|---|---|
| Timing | Documents during the live visit | Drafts from a recording after the visit |
| Connection | Secure audio or video link to the encounter | Recording or dictation reviewed afterward |
| Note readiness | Nearly complete when the patient leaves | Returned within the practice's turnaround window |
| Best fit | Providers who want notes closed between patients | Providers who want flexibility and time-zone coverage |
Which Parts of the Note Does a Virtual Medical Scribe Write?
A virtual medical scribe documents every part of the clinical note that the provider dictates, from the chief complaint through the assessment and plan, in the structure the practice's EHR expects. The scribe captures what's said and observed, not what should be decided.
- Chief complaint and the reason for the visit
- History of present illness as the patient describes it and the provider frames it
- Review of systems across the relevant body systems
- Past medical, surgical, family, and social history updates
- Physical exam findings as the provider states them
- Assessment and plan, including the provider's stated diagnoses and next steps
- Orders, referrals, and patient instructions prepared for provider approval
The scribe records all of this in the practice's EHR, using the templates and macros the practice already runs. The tools that support this work, from EHR access to dictation platforms, are covered in our guide on virtual medical scribe tools.
Where Is the Line Between a Scribe and Clinical Care?
The line is firm, because a virtual medical scribe documents only what the provider says and does, and never gives medical advice, makes a diagnosis, or decides on treatment. The scribe writes the record. The provider owns every clinical call in it.
A scribe doesn't interpret symptoms, choose a diagnosis, or pick a medication. Those decisions belong to the licensed provider, full stop. When a patient asks the scribe a clinical question, the scribe routes it to the provider rather than answering it. That boundary protects patients and keeps the role clearly defined.
Every note a scribe drafts goes back to the provider for review before it's signed. The provider reads the chart, corrects anything that needs it, confirms the clinical content, and applies the signature. Nothing enters the permanent record on the scribe's authority. This is the difference between documentation support and clinical work, and it never blurs.
How Does a Virtual Medical Scribe Work Inside the EHR?
A virtual medical scribe works inside the practice's own EHR through a secure, practice-controlled account, documenting in the same system the on-site team uses. The scribe doesn't bring outside software for the chart. The work happens where the practice already keeps its records.
The practice grants the scribe the access the role needs and nothing more. The scribe logs in, opens the patient's chart, and documents in the practice's templates. EHR experience varies by candidate, so Honest Taskers matches each scribe to the practice's technology stack rather than assuming a system fit.
On the safeguards side, every placed scribe completes documented HIPAA training before placement and signs a confidentiality agreement. The scribe then works under practice-specific access controls, so the practice decides what the scribe can reach and can revoke that access at any time. Business Associate Agreement support is available when the engagement requires one. Compliance itself lives in the practice's own policies, not with the staffing company.
How Is a Virtual Medical Scribe Different From a Virtual Medical Assistant?
A virtual medical scribe focuses on documenting the clinical encounter, while a virtual medical assistant handles broader administrative work like scheduling, insurance, and billing. The scribe is a documentation specialist. The assistant covers the wider front- and back-office load.
A scribe lives in the visit note. The role exists to keep the provider's hands off the keyboard during the encounter and to keep charting from following the provider home. A virtual medical assistant works a different queue, including phones, scheduling, prior authorization, and claims.
Some practices need both, and some hire one person who covers lighter documentation alongside admin. For more on this, our guide on what a virtual medical assistant is covers the broader role, and the two pages together map the full remote-staffing picture for a practice.
How Much Does a Virtual Medical Scribe Cost?
A virtual medical scribe at Honest Taskers costs $10.00 to $12.65 per hour, depending on experience, specialty knowledge, and expertise. At 20 hours per week, that lands between $800 and $1,012 per month. Full-time coverage at 40 hours runs between $1,600 and $2,024 per month.
An in-person scribe carries salary, payroll taxes, benefits, equipment, and a seat in the clinic. A two-week working trial on the first hire lets a practice test the role on live visits before committing.
Cost moves with specialty demands, hours, and how much documentation a provider runs. The full breakdown, including comparisons against in-house scribe salaries, sits in our virtual medical scribe cost guide.
Published by Honest Taskers, a healthcare staffing company headquartered in Fort Worth, Texas, founded by Roland Omene. Honest Taskers places healthcare-trained virtual medical scribes and assistants with US medical, dental, and mental health practices.
Talk to Honest Taskers about placing a medical scribe in your practice.