*Purpose: Transplantation is the most regulated surgical specialty in the US today. Transplant Centers (TC) are an increasingly pivotal component contributing to the fiscal viability of major health care systems- with careful scrutiny of TC performance and ratings by patients, insurance companies as well as the regulatory agencies. The accurate collection of patient-level data is necessary to build the risk-adjustment models which contribute to ranking and assessment of TC performance. We describe an innovative model in which the use of scribes in a transplant practice in a busy academic center to streamline collection of necessary patient-level data to help achieve quality outcomes and program development.

*Methods: In March 2018, scribes were hired across all organ programs of the Transplant Institute for both the inpatient and outpatient settings. None of the physicians in the Institute had previously worked with scribes. In order to streamline the necessary data collection required by the regulatory agencies, scribe and physician training with specific template creation was rolled out.

*Results: Over the next 18 months, use of the scribes in every aspect of the clinical practice (inpatient and outpatient) was instrumental in the discrete collection of specific data points that are required by regulatory agencies (for eg, accuracy of TIEDI data). This greatly aided development of quality outcomes amid sustained program growth across all organs (abdominal and thoracic). Additional benefits reported included increased physician satisfaction as the use of scribes allowed enhanced physician-patient interaction.

*Conclusions: The use of scribes in both the inpatient and outpatient setting in a busy academic transplant center was transformative in streamlining necessary data collection across a large group of clinicians. The accurate collection of data (pre-, peri- and post-transplant) was crucial in the building of risk-adjustment models as well as required data components for submission to regulatory agencies. Additional benefits included enhanced physician satisfaction with improved engagement with patients. This was achieved across all organ programs and aided in program development. The use of scribes in a busy academic transplant practice to achieve both required data collection that aided in development of quality outcomes as well as enhanced physician-patient interaction, is a model that is fiscally responsible and qualitatively feasible.

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