Evidence map›Paper›PMID 41269285›Full record

SynthesisFamily practice2025

Family physician perspectives on managing indirect patient care activities in the electronic inbox: a systematic mixed studies review.

Alison K Scholes, Asiana Elma, Alexandra Cernat, Russell Dawe, Lawrence Grierson, Deena M Hamza, Danielle O'Toole, Ian Scott, Katrina Shen, Jennifer Shuldiner and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Alison K ScholesDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada.
Asiana ElmaDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada.
Alexandra CernatFaculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta T6G 2H6, Canada.ORCID 0000-0001-6007-7825
Russell DaweDiscipline of Family Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador A1B 3V6, Canada.
Lawrence GriersonDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada.
Deena M HamzaOffice of Postgraduate Medical Education, University of Alberta, Edmonton, Alberta T6G 2M6, Canada.
Danielle O'TooleDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada.
Ian ScottDepartment of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
Katrina ShenDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada.
Jennifer ShuldinerInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada.
Alexander SingerDepartment of Family Medicine, University of Manitoba, Winnipeg, Manitoba R3E 0W2, Canada.
Meredith VanstoneDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada.ORCID 0000-0002-7347-6259

Funding

CIHR FRN 195814Ontario SPOR SUPPORT Unit
6 · The paper itself

Abstract

introductionFamily physicians spend approximately half their professional time on indirect patient care activities (IPCA). Essential to patient care, inbox IPCA includes renewing prescriptions, checking lab results, and reviewing messages. However, IPCA detracts time from direct patient care and has been linked to burnout, potentially contributing to the family medicine crisis in Canada. Our objective was to understand the range of family physicians' experiences and perspectives regarding electronic inbox management.

methodsWe conducted a systematic review of peer-reviewed articles, published in English between 1 January 2012, and 22 April 2024, that addressed family physicians' perspectives on tasks related to the electronic inbox and used any method of primary data collection and analysis. Data analysis used a constant comparative method.

resultsFifty-four articles were included. The combination of fragmented technical systems and an overwhelming volume of complex tasks has created a system where family physicians struggle to manage the administrative work of patient care. Selected impacts include excessive time spent on duplicated or unnecessary tasks, inadvertently making uninformed clinical decisions, and perceived tension between patient accessibility and workload. Strategies for management were described, including the re-design of electronic medical record systems, task delegation, and synchronizing prescription renewals with patient visits.

conclusionsThe intersection of inefficient systems and high workloads makes inbox management labour-intensive and frustrating, lowering job satisfaction and efficacy. Downloading administrative tasks to family physicians, combined with the growing complexity of patient management, has generated a tremendous burden. Solutions are needed to improve the sustainability and appeal of family medicine.

Indexed as

Attitude of Health PersonnelElectronic Health RecordsPatient CarePhysicians, FamilyCanadaFamily PracticeHumansWorkload

Identifiers

PMID41269285
PMCPMC12636522

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.