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

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.