Atrius Health, a practice of 700 primary care and specialty physicians, reduced its inbox volume by 25 percent and eliminated 1,500 clicks a day per physician using an updated workflow strategy.
During the pandemic, inbox messages increased by 57 percent, and each message resulted in an additional 2.32 minutes of EHR active-use time, according to an article published April 4 on the American Medical Association's website.
It's part of the reason Newton, Mass.-based Atrius Health prioritized reducing in-basket volume. They collaborated with internal stakeholders to implement new systems to reduce EHR inbox volume by 25 percent, which reduced clicks by up to 50 million annually.
The team started by evaluating emails to determine which were wasteful, duplicative or had little clinical value. Then they worked with the EHR professionals to stop those emails from hitting the in-basket. This eliminated 98 percent of their media-manager messages, which contain attached forms like patient-screening forms, which don't need to be accepted by a physician.
Here are four other changes they made:
- The team eliminated 35 percent of carbon copy charts from other physicians and 100 percent of emergency department and hospital messages. These messages moved to a dashboard where nurses and physicians could pull the information needed about hospital stays.
- Routine and repetitive tasks were moved through automated pathways, cutting 50 percent of prescription-renewal messages and 30 percent of normal lab results.
- Atrius shared accountability for tasks between two or more team members.
- The team cut in-basket volume by 40 percent for patients seeking medical advice through the team accountability method.
"The messages that wind up coming back into your inbox, those were really important. Those were safety matters," Steven Strongwater, MD, the former president and CEO of Atrius Health, said in the article. "Those were drug interaction matters. You weren't just getting barraged and missing those things by the barrage."