the joint commission released guidelines for the use of medical scribes in july 2012. the joint commission's guidelines explained: "a scribe is an unlicensed person hired to enter information into the ehr or chart at the direction of a physician or practitioner (licensed independent practitioner, advanced practice registered nurse or physician assistant). it is the joint commission’s stand that the scribe does not and may not act independently but can document the previously determined physician’s or practitioner’s dictation and/or activities. scribes also assist the practitioners listed above in navigating the emr and in locating information such as test results and lab results. they can support work flow and documentation for medical record coding. scribes are used most frequently, but not exclusively, in emergency departments where they accompany the physician or practitioner and record information into the medical record, with the goal of allowing the physician or practitioner to spend more time with the patient and have accurate documentation. scribes are sometimes used in other areas of the hospital or ambulatory facility. they can be employed by the healthcare organization, the physician or practitioner or be a contracted service." the american health information management association also published guidance in its november 2012 edition of "journal of ahima" for physicians on the use of medical scribes, echoing and elaborating on the joint commission's guidance by explaining that "a scribe can be found in multiple settings including physician practices, hospitals, emergency departments, long-term care facilities, long-term acute care hospitals, public health clinics, and ambulatory care centers. they can be employed by a healthcare organization, physician, licensed independent practitioner, or work as a contracted service."