Observational studyJournal of general internal medicine2024
Patient Portal Message Volume and Time Spent on the EHR: an Observational Study of Primary Care Clinicians.
Observational study in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed.
- Barriers and Enablers to Asynchronous Secure Messaging Use in Hospital-Based Ambulatory Specialty Clinics in Ontario, Canada: Convergent Mixed Methods Study.Journal of medical Internet research · 2026Article
- Natural language processing models for patient-centered summaries of prostatectomy pathology reports.Scientific reports · 2026Article
- A scoping review of studies on secure messaging through patient portals: persistent challenges and potential solutions.npj health systems · 2026Article
- Digital alert fatigue and escalation behaviours in nurse-led remote postoperative care: a cross-sectional study.BMC nursing · 2026Article
- A Dataset for Addressing Patient's Information Needs related to Clinical Course of Hospitalization.Scientific data · 2026Article
- Initiating and maintaining home-based exercise rehabilitation in the first year after lung transplantation: a multi-stakeholder qualitative study.BMC nursing · 2026Article
- High Users of Primary Care Secure Messaging in the Veterans Health Administration.Annals of family medicine · 2025Article
- Surprisingly Helpful: The Introduction of Portal Practice Slots to Address the Inbasket Explosion.Journal of general internal medicine · 2025Article
- The Gender Gap in EHR Workload: A Comparative Analysis of Primary Care Physician In Basket Usage.Journal of general internal medicine · 2025Observational
- Burden of administrative responsibilities in primary care: Qualitative study.Canadian family physician Medecin de famille canadien · 2025Article
- Opportunities and risks of artificial intelligence in patient portal messaging in primary care.NPJ digital medicine · 2025Article
- Users' perspectives on a demonstration to increase shared access to older adults' patient portals.BMC health services research · 2025Article
- Characterizing patient portal use of people with cognitive impairment and potentially inappropriate medications.Journal of the American Geriatrics Society · 2025Article
- Secure messaging telehealth billing in the digital age: moving beyond time-based metrics.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Appointments aren't Access: The Hidden Work of Getting Care.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs patient-initiated messaging rises, identifying variation in message volume and its relationship to clinician workload is essential.
objectiveTo describe the association between variation in message volume over time and time spent on the electronic health record (EHR) outside of scheduled hours.
designRetrospective cohort study.
participantsPrimary care clinicians at Cleveland Clinic Health System. MAIN MEASURES: We categorized clinicians according to their number of quarterly incoming medical advice messages (i.e., message volume) between January 2019 and December 2021 using group-based trajectory modeling. We assessed change in quarterly messages and outpatient visits between October-December 2019 (Q4) and October-December 2021 (Q12). The primary outcome was time outside of scheduled hours spent on the EHR. We used mixed effects logistic regression to describe the association between incoming portal messages and time spent on the EHR by clinician messaging group and at the clinician level. KEY
resultsAmong the 150 clinicians, 31% were in the low-volume group (206 messages per quarter per clinician), 47% were in the moderate-volume group (505 messages), and 22% were in the high-volume group (840 messages). Mean quarterly messages increased from 340 to 695 (p < 0.001) between Q4 and Q12; mean quarterly outpatient visits fell from 711 to 575 (p = 0.005). While time spent on the EHR outside of scheduled hours increased modestly for all clinicians, this did not significantly differ by message group. Across all clinicians, each additional 10 messages was associated with an average of 12 min per quarter of additional time spent on the EHR (p < 0.001).
conclusionsMessage volume increased substantially over the study period and varied by group. While messages were associated with additional time spent on the EHR outside of scheduled hours, there was no significant difference in time spent on the EHR between the high and low message volume groups.
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