Physicians are overwhelmed by administrative tasks that take the joy out of practicing medicine. We hear tips for streamlining clinical documentation, but what about the EHR inbox?

One recent study of EHR use found that primary care doctors in a Massachusetts hospital spent, on average, 36 minutes using the EHR per visit. About 6 of those minutes were after-hours “pajama time,” and physicians spent nearly 8 minutes in the EHR inbox for each patient visit. 

Institutions are essential in driving system-level changes that reduce physicians’ administrative burden and increase work satisfaction. For example, health systems, insurers, and government agencies should simplify quality-reporting requirements and reform payment models.

But in the meantime, providers can take practical steps to communicate more efficiently with staff and patients.

How to manage your EHR inbox more effectively

The average PCP sees 20 patients daily and spends 8 minutes in the inbox per visit. Based on these estimates, the average family doctor spends an incredible 13 hours in their EHR inbox weekly.

Whether you want to reduce EHR time or communicate more effectively with patients, here are eight helpful tips inspired by Jay Winner, MD.

1. Coordinate EHR inbox work with your team

Many EHR systems default to all messages going to the physician. Ask IT staff to help configure your inbox to route messages to other staff, like your nurse or medical assistant. The goal of delegating is for everyone on your team to work at the top of their license

2. Have your staff fill out forms

Are you filling out patient details and other basic information on forms? Train your staff to complete as much of a form as possible, then come to you for questions and approval. Taking this approach will save you time and provide staff training opportunities.

3. Set up protocols for urgent messages

You’ll feel less stressed about your inbox if you have a protocol for urgent messages. For example, whoever is checking the EHR inbox should know which messages are urgent and how to reach you if they need your input. If possible, forward appropriate messages to a triage nurse who can determine if the patient can wait for a visit, be sent to urgent care, or should go to the emergency room.

4. Use message templates

Create standardized templates for common responses to frequently asked questions or requests, such as prescription renewals or appointment confirmations. Using templates can save time and ensure consistency in communicating with patients and colleagues.

5. Review your EHR inbox before your staff leaves

If you often work later than your staff, schedule 30 minutes for a quick inbox review before your staff leave. If you see messages your staff can handle instead of you, forward them messages and results with instructions. Implementing this habit will lighten your end-of-day message load, even if you’re the last one in the office. 

6. Discuss test results at visits when possible

It’s sometimes vital to communicate test results quickly, but consider whether you can wait until the next visit and eliminate an extra back-and-forth. Implementing a pre-visit lab testing protocol can ensure patients have results before the next visit, and can discuss these with you in person. 

7. Streamline refills

Prescription refills can add substantial EHR inbox time if you’re not proactive. When possible, write prescriptions to last until the next visit or next physical (this may not be appropriate for certain patients or medications, such as controlled substances). A refill protocol can also help authorize staff to make appropriate refills that you can cosign. 

8. Limit repetitive tasks

Take note of keystrokes and EHR tasks you repeat many times throughout the day. How might you automate or eliminate these repetitive steps? For example, instead of typing in your ID and password each time you log into a computer, talk to IT about using badge readers to log in. Similarly, some EHRs let you set up one-click staff messages like “needs to do labs.” Take a few minutes to implement shortcuts that will save you hours over time.

Remember the bigger picture

As you work to streamline EHR inbox management, stay focused on the bigger picture. Productivity improvements are only valuable to a point.

If incremental changes aren’t making a difference, you may need to think bigger. Is your schedule too full? Does your department have staffing shortages? If you’re paid based on productivity, are you coding fully?

If you work for a health system, find a balance between making personal changes and asking your employer for adjustments to make your job more manageable.

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