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

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.