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Physicians Bear the Greatest Inpatient EHR Messaging Load
A study conducted at an academic medical center found that medicine practitioners had the largest daily EHR messaging burden across all healthcare providers.
Inpatient EHR messaging patterns differ by role, with medicine providers sending and receiving 2.8 and 3.1 times the average daily messaging volume compared to other groups, according to a study published in JAMA Network Open.
While previous research has reported that EHR messaging can improve patients' emergency department length of stay, other studies have signaled unintended patient safety consequences, such as increased interruptions for healthcare providers.
To characterize messaging patterns, researchers extracted Epic Secure Chat metadata associated with internal medicine inpatients at a large academic medical center. Epic Secure Chat can connect patients with conversations comprising two or more providers to support care coordination.
The researchers categorized roles as medicine and nonmedicine attendings, house staff, advanced practice professionals, nurses, technicians, social workers, care managers, or allied health professionals.
The study included 14,329 participants. There were 5.1 million messages sent about internal medicine inpatients to 2.5 users each during 22,900 encounters (35.9 daily messages/hospitalization). Providers sent approximately 69.1 percent of EHR messages between 8 am and 6 pm.
Nurses sent the largest share of messages (27.7 percent), followed by medicine house staff (13.5 percent) and social workers, care managers, and allied health professionals (12.6 percent). However, the study found that medical clinicians sent the most daytime messages.
Per user, medicine practitioners had the largest daily messaging burden. While most medicine house staff (77.0 percent) received over 45 daily messages, medicine attendings generally sent fewer messages and received up to 250 daily messages.
"Future studies should evaluate consequences of messaging on individual and team performance, identify harmful patterns, and analyze message content to contextualize important events," the study authors wrote.
They pointed out that institutional policies for message storage limited analysis of message content, which is necessary to understand inpatient communication patterns further.
"Characterizing messaging patterns in the inpatient setting represents a first step in facilitating benchmarking and, ultimately, strategic interventions to enhance the healthcare provider digital experience, preserving the technology's benefits while mitigating its disruptions," they concluded.