Reducing the Demands of Patient Portal Messages

New research published in JAMA Network Open examines strategies for primary care physicians (PCPs) to best manage the stressors associated with use of patient messaging portals. The volume of computer-related tasks is commonly associated with physician burnout, and a surge in electronic messages is requiring some PCPs, according to the study, to spend more than half their time in front of a screen.

The authors report that the high number of incoming messages from patients and pressure to respond quickly is “causing unintended effects on clinical practice and physician well-being.” They outline the following four key trends related to PCP management of electronic inboxes:

• Effects of Inbox Management on Primary Care Practice. Inbox management is sparking a cultural shift in medicine because computer tasks compete with other clinical responsibilities. Physicians say they experience anxiety trying to meet patient expectations for a quick and personalized response.

• Stressors Associated with Inbox Management. Inbox management is creating additional stress for physicians because it further erodes work-life boundaries. With no limit on the number of messages received, there’s pressure to respond outside of normal work hours.

• Diverse Individual Strategies for Inbox Management. Physicians are adopting a variety of techniques to ease the added stress of electronic inbox management. Strategies include multitasking, regulating pace to slow down the communication cycle, working on different inbox folders in a clustered fashion, attempting to clear their inbox completely once per day and using voice transcription software.

• Group-Level Strategies for Inbox Management. Team-based approaches, such as a coverage (or buddy) system, physician-to-physician training and delegation of tasks show promise as both effective and patient-focused solutions for alleviating stress resulting from inbox management.

The authors conclude by emphasizing that healthcare organizations “can support PCPs by facilitating knowledge transfer among physicians about inbox management strategies and developing team structures for inbox coverage.” Additionally, they note that “no single strategy emerged as the dominant solution” and any approach should be tailored to consider a provider’s unique circumstances.

Click here to access MLMIC’s risk management tip on proper use of patient portals.