MedicalResearch.com Interview with:
Daniel R. Murphy MD MBA
Assistant Professor – Interim Director of GIM at Baylor Clinic
Department of Medicine
Health Svc Research & General Internal Medicine
Baylor College of Medicine
Houston, TX, US
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Murphy: Electronic health records (EHRs) have enabled a large number of messages to be transmitted to physicians each day, including new types of messages that were not present in the pre-EHR era. Lack of support and policies to assist physicians with this workload creates opportunities for important information, such as abnormal tests results, to be missed among the vast amount of other information. We found that primary care physicians (PCPs) at three clinics using commercial EHRs received an average of 77 messages per day, of which only about 20% were test results. Specialists received an average of 29 total messages per day. Extrapolating time needed to process these messages from prior work suggests that PCPs would require an average of 67 minutes per day to process these messages.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Murphy: Physicians, and especially PCPs, receive a large number of messages each day, and consequently spend a large amount of non-face-to-face time managing this information. This creates opportunities for important information to be missed and potentially leads to patient safety issues from delayed follow-up.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Murphy: Research into strategies to help filter messages relevant to high-quality care, EHR designs and workflows that support team-based care, and staffing models that assist clinicians in managing the influx of information are needed.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Murphy: While improved EHR designs, workflows, and team structures will help, reviewing and processing messages remains an uncompensated activity for physicians. This incentivizes clinics to focus more on filling physician schedules with patient visits, likely at the expense of leaving sufficient time for them to effectively manage EHR-delivered messages.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Murphy DR, Meyer AD, Russo E, Sittig DF, Wei L, Singh H. The Burden of Inbox Notifications in Commercial Electronic Health Records. JAMA Intern Med. Published online March 14, 2016. doi:10.1001/jamainternmed.2016.0209.
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Dr. Daniel Murphy (2016). Electronic Records Overwhelm Primary Care Physicians With Messages MedicalResearch.com