Take Control of Your EHR Messages
Lack of Control of EHR Messaging Contributes to Physician Burnout
According to an article in the Annals of Family Medicine, primary care physicians spend about 23 percent of their workday managing their EHR’s in-basket messages. Furthermore, Health Affairs reported that over 50 percent of their time is spent on desktop medicine tasks. That’s half the time seeing patients and the other half sending/answering staff and patient portal messages, dealing with prescription refills, ordering tests and reviewing test results.
The physician’s time, a finite resource, needs to be well-managed in order not only to increase patient access to care, but also to decrease physician burnout. From a financial perspective, in a fee-for-service environment, a decrease in the time allocated to face-to-face visits is time that is not compensated for and doesn’t generate revenue.
Another study from Health Affairs showed that primary care physicians receive twice as many messages as surgeons do. The study concluded that “perceived and realized loss of autonomy over their work schedules could leave physicians feeling defeated.”
Strategies to Tame Your EHR Inbox
To get your inbox under control and boost productivity you need to develop good messaging habits (these strategies also apply to all the paperwork on your desk):
- Don’t check your inbox first thing in the morning.
- Schedule time to process your messages.
- When checking your messages, if it takes you less than two minutes to respond or deal with the issue at hand, do it immediately.
- Avoid the urge to empty your inbox.
- Develop workflows to make your life easier.
- Use dot phrases and templates to communicate with staff and relay lab and test results to patients.
Don’t start your day dealing with the administrative burden of responding to messages. Mornings are usually when your mind is fresh and sharp, so take advantage of that to deal with more relevant cognitive work. You will get more return on your investment if you spend that time reviewing your schedule, checking who is coming today and anticipating the needs for the day. A brief huddle with your medical assistant might save you more time down the road than answering two or three messages in your inbox.
Still, scheduling time to process your EHR inbox is important. Ideally, spend 30-40 minutes on this task at the end of the morning and another block of time towards the end of the day. You could also take advantage of your downtime to answer a few messages — for example, if you have a “no-show,” assuming that you are all caught up with your documentation (if you are struggling with this, check out this article: “Tips for Efficient Documentation.”)
The Two-Minute Rule
The two-minute rule is perfect for shorter downtimes. Deal with every message you open or any paperwork you touch right away unless it will take you more than two minutes to complete. If you open a message, read it and then decide you will deal with it later, you just doubled the amount of time it will take to deal with the message. Next time you revisit this same message you will have forgotten the context and the intended response or action you had already determined. If you “touch it,” deal with it right away. If it is something more complex or lengthy (i.e., a long form a patient left for you to complete), then leave it for later. Or better yet, schedule an appointment with the patient so she can help you complete the form faster and get credit for it.
When you receive a new message, ask yourself: “Will this take less than two minutes to complete?” If the answer is “yes,” then complete the task right away so that it’s done and out of your message inbox.Click To Tweet
Rules and Workflows
Avoid the urge to keep an “inbox zero.” This rigorous approach aimed at keeping your inbox empty or almost empty will most likely leave you with the feeling that never-ending messages are taking over your life.
True inbox zero can be hard to achieve. A more workable version of inbox zero is to keep your urgent messages at zero and categorize and prioritize the rest.
You will be comfortable having a few dozen unread messages in your inbox if these messages have been prioritized. You don’t want an urgent message sitting in your computer for more than 48 hours. To achieve this, it helps to train your staff on appropriately labeling urgent and important messages. Never leave the office without dealing with these messages. Once your staff notices that you don’t respond to messages right away unless they are labeled as important or urgent, then they will get the gist of how your system works.
Here is another tip: Instead of sorting your messages by date, sort them by subject or sender (“From” column) instead. This will enable you, for example, to address all the billing and coding department messages first. You could filter out all the thank you replies or FYI messages. Or, maybe you want to delete all the useless auto-generated system messages and focus on patient med refill requests.
Remember this: You don’t always have to respond to a message. It is good electronic communication etiquette not to reply just to say thank you unless the message merits sincere thanks or the person who sent it needs acknowledgment that it was received. If your message is less than five words (“ok,” “got it,” “thanks for the info”), you will save your recipient and yourself time by not sending it.
Finally, take a moment before sending a message to be sure your recipient has all the information needed to complete a given task. Add “if this, then that” scenarios to your messages; this will cut down on back-and-forth messages with follow-up questions.
Developing workflows and strategies to deal with messages and paperwork enables physicians and their staff to thrive in this complex work environment, avoid burnout and improve practice efficiency. The American Medical Association suggests implementing the Getting Rid of Stupid Stuff (GROSS) initiative, a standardized organizational process to eliminate “stupid stuff” in your practice.
Don’t write the same message over and over again. Instead, create a template or dot phrase you can reuse to respond to staff messages or relay lab test and imaging results to patients. This powerful messaging productivity practice will skyrocket your efficiency.
If you need a head start, you can take advantage of StatNote dot phrases and templates. StatNote can help you manage your inbox by automating patient messages when you communicate lab and imaging results. It even includes templates in Spanish.
What do you think? What are your productivity hacks? How do you handle your inbox messages? Comment below.
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