Assessment of EHR Efficiency Tools and Resources Associated with Physician Time Spent on the Inbox

Richa Bundy; Adam Moses; Elisabeth Stambaugh; Paschal Stewart 3rd; Lauren Witek; Lindsey Carlasare; Gary Rosenthal; Christine Sinsky; Ajay Dharod

doi:10.1007/s11606-024-08761-3

Assessment of EHR Efficiency Tools and Resources Associated with Physician Time Spent on the Inbox

J Gen Intern Med. 2024 May 8. doi: 10.1007/s11606-024-08761-3. Online ahead of print.

Authors

Richa Bundy¹, Adam Moses², Elisabeth Stambaugh³, Paschal Stewart 3rd^{3

4}, Lauren Witek², Lindsey Carlasare⁵, Gary Rosenthal^{2

6}, Christine Sinsky⁵, Ajay Dharod^{2

4

6

7

8}

Affiliations

¹ Informatics and Analytics (I&A), Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, USA. rbundy@wakehealth.edu.
² Informatics and Analytics (I&A), Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, USA.
³ Wake Forest Health Network, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
⁴ Wake Forest Center for Biomedical Informatics (WFBMI), Wake Forest School of Medicine, Winston-Salem, USA.
⁵ Professional Satisfaction and Practice Sustainability, American Medical Association, Chicago, IL, USA.
⁶ General Internal Medicine (GIM), Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, USA.
⁷ Department of Implementation Science (IS), Wake Forest School of Medicine, Division of Public Health Sciences (PHS), Winston-Salem, USA.
⁸ Wake Forest Center for Healthcare Innovation (CHI), Wake Forest School of Medicine, Winston-Salem, USA.

PMID: 38717666
DOI: 10.1007/s11606-024-08761-3

Abstract

Background: Physicians are experiencing an increasing burden of messaging within the electronic health record (EHR) inbox. Studies have called for the implementation of tools and resources to mitigate this burden, but few studies have evaluated how these interventions impact time spent on inbox activities.

Objective: Explore the association between existing EHR efficiency tools and clinical resources on primary care physician (PCP) inbox time.

Design: Retrospective, cross-sectional study of inbox time among PCPs in network clinics affiliated with an academic health system.

Participants: One hundred fifteen community-based PCPs.

Main measures: Inbox time, in hours, normalized to eight physician scheduled hours (IB-Time₈).

Key results: Following adjustment for physician sex as well as panel size, age, and morbidity, we observed no significant differences in inbox time for physicians with and without message triage, custom inbox QuickActions, encounter specialists, and message pools. Moreover, IB-Time₈ increased by 0.01 inbox hours per eight scheduled hours for each additional staff member resource in a physician's practice (p = 0.03).

Conclusions: Physician inbox time was not associated with existing EHR efficiency tools evaluated in this study. Yet, there may be a slight increase in inbox time among physicians in practices with larger teams.

Keywords: EHR inbox efficiency; EHR use metrics; inbox time; primary care.