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Business of Medicine/Practice Management

Analysis of Inbox Burden in Otolaryngology

Tuesday, October 3, 2023
4:57 PM - 5:03 PM East Coast USA Time
Location: 106A

    Presenting Author(s)

  • JH

    Jacob E. Hoerter, MD

    Resident Physician
    Kaiser Permanente Med Group - Northern California
    Oakland, CA, United States

    • Co-Author(s)

  • Peter M. Debbaneh, MD

    Resident
    Kaiser Permanente Oakland Medical Center
    Oakland, California, USA

    • Senior Author(s)

  • Nancy Jiang, MD

    Chair, Department of Head & Neck Surgery
    Kaiser Permanente Med Group - Northern California
    Orinda, CA, United States

Disclosure(s):
Jacob E. Hoerter, MD: No relevant relationships to disclose.
Introduction: The rapid evolution of the electronic medical record (EMR) has enhanced healthcare but introduced new responsibilities for physicians. Inbox management of clinical results and patient messages presents a burgeoning challenge for all otolaryngologists. We sought to quantify inbox burden across demographics and subspecialties of otolaryngology to identify opportunities for improvement in practice.

Methods: Inbox data was queried from January 2019 until December 2022 at an integrated healthcare system. Providers were categorized based on subspecialty, self-reported gender, and graduation year. All inbox tasks, secure messages, and clinical encounters were gathered and compared to gender, practice type, and surgeon subspecialty. Means for demographic and clinical factors were compared using t-test.

Results: There were 378 providers across 12 clinical roles of which 152 were physicians; 38.16% were comprehensive otolaryngologists and 61.18% were male. On average all otolaryngologists had 137.68 tasks per month ( SD 80.78) of which 95.1 were secure messages (SD 56.3). There were no statistically significant differences in inbox tasks or secure messages per clinical encounter between gender, languages spoken, or years in practice. Oncology had significantly higher inbox tasks (1.72 vs 1.13, p< 0.001) and secure messages (1.10 vs 0.75, p< 0.001) per clinical encounter when compared to all clinicians. Facial plastics providers had the fewest inbox tasks per clinical encounter when compared to all physicians(0.94 vs 1.13, p=0.03). There was a weakly positive correlation between patient survey scores and physician average secure messages per clinical encounter (m=0.03, r2=0.12).

Conclusions: Inbox burden for otolaryngologist is largely secure messages which demonstrates considerable variation across specialties. Considerations should be made to the relative burden of inbox management for oncology subspecialists.