This study investigates inpatient Electronic Health Record (EHR) messaging dynamics, revealing stark imbalances in daily burdens among healthcare providers. Medicine practitioners shoulder the heaviest load, engaging in substantially more messaging interactions compared to other roles. While EHR messaging offers benefits, concerns over patient safety and provider interruptions loom. The study, using Epic Secure Chat metadata, scrutinizes patterns among 14,329 participants, showcasing the significance of daytime messaging by medical clinicians. Future research aims to gauge messaging’s impact on performance and discern detrimental patterns. It underscores the need for comprehensive analysis and strategic interventions to optimize the digital healthcare experience while curbing disruptions.
The dynamics of Electronic Health Record (EHR) messaging within inpatient settings are a crucial aspect of modern healthcare delivery. This study delves into the nuanced landscape of messaging patterns among healthcare providers, highlighting a significant disparity in daily burdens across roles. Notably, medicine practitioners carry a disproportionate load, raising concerns about potential consequences for patient safety and provider interruptions. Leveraging data extracted from Epic Secure Chat metadata and involving 14,329 participants, this research explores the dominance of daytime messaging by medical clinicians. It underscores the imperative to evaluate messaging impacts and discern harmful patterns, necessitating strategic interventions for an enhanced healthcare digital experience.
Published in JAMA Network Open, this study delineated the distinct patterns of inpatient EHR messaging across various roles within healthcare provision. Notably, medicine providers were found to engage in 2.8 to 3.1 times more daily messaging interactions compared to their counterparts, marking a substantial deviation in messaging volume.
While earlier research has hailed EHR messaging for potential benefits, such as ameliorating emergency department length of stay for patients, this study sounded cautionary notes regarding unintended ramifications. Specifically, it highlighted potential patient safety concerns due to heightened interruptions experienced by healthcare providers, arising from the surge in messaging activities.
The study’s methodology involved the extraction and analysis of Epic Secure Chat metadata associated with internal medicine inpatients within a prominent academic medical center. This platform facilitates communication among two or more providers, fostering seamless coordination to bolster patient care.
Roles within the healthcare framework were categorized to discern messaging behaviors. The study encompassed 14,329 participants, navigating through a staggering 5.1 million messages exchanged about internal medicine inpatients among 2.5 users per message across 22,900 encounters, translating to an average of 35.9 daily messages per hospitalization. Notably, the majority of EHR messages, approximately 69.1 percent, were transmitted during standard working hours between 8 am and 6 pm.
Nurses emerged as the primary contributors to messaging, accounting for 27.7 percent of the messages, followed by medicine house staff at 13.5 percent, and a collective 12.6 percent from social workers, care managers, and allied health professionals. However, the study revealed that medical clinicians were the most active during daytime hours, indicating their profound involvement in inpatient EHR communication.
Delving deeper into individual burdens, medicine practitioners shouldered the heaviest daily messaging load. While a substantial majority of medicine house staff—77.0 percent—received over 45 daily messages, the attending physicians exhibited a different dynamic, sending fewer messages while fielding up to 250 incoming messages daily.
The study authors underscored the necessity for future investigations to scrutinize the impact of messaging on both individual and team performance. They emphasized the need to identify potentially detrimental patterns and analyze message content, recognizing it as pivotal for comprehending inpatient communication dynamics more thoroughly. However, they lamented that institutional policies restricting message content analysis constrained their ability to grasp these nuanced patterns effectively.
Highlighting the importance of understanding messaging patterns in the inpatient setting, the authors advocated for this analysis as a crucial initial step. They emphasized its role in facilitating benchmarking efforts and proposed strategic interventions aimed at enhancing the digital experience for healthcare providers. The overarching goal was to leverage the advantages of technology while mitigating disruptive influences on healthcare delivery.
This study unravels the unequal distribution of Electronic Health Record (EHR) messaging burdens among healthcare providers, particularly spotlighting the substantial load shouldered by medicine practitioners. While acknowledging the benefits, concerns over patient safety and provider interruptions warrant immediate attention. With insights gleaned from Epic Secure Chat metadata involving 14,329 participants, the imperative lies in evaluating messaging impacts on individual and team performance. It emphasizes the need to identify detrimental patterns and advocates for strategic interventions to optimize the digital healthcare experience. The goal is to harness technology’s advantages while mitigating disruptions, ensuring an optimal environment for effective healthcare delivery.
