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Appl Clin Inform 2024; 15(03): 612-619
DOI: 10.1055/s-0044-1787756
Research Article

Contributors to Electronic Health Record-Integrated Secure Messaging Use: A Study of Over 33,000 Health Care Professionals

Authors

  • Laura R. Baratta

    1   Division of Biology and Biomedical Sciences, Washington University School of Medicine, St Louis, Missouri, United States

  • Daphne Lew

    2   Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States

  • Thomas Kannampallil

    1   Division of Biology and Biomedical Sciences, Washington University School of Medicine, St Louis, Missouri, United States
    2   Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States
    3   Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, United States

  • Sunny S. Lou

    2   Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States
    3   Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, United States

Funding This study was supported by a grant from the American Medical Association's Practice Transformation Initiative.
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Abstract

Objectives Electronic health record (EHR)-integrated secure messaging is extensively used for communication between clinicians. We investigated the factors contributing to secure messaging use in a large health care system.

Methods This was a cross-sectional study that included 14 hospitals and 263 outpatient clinic locations. Data on EHR-integrated secure messaging use over a 1-month period (February 1, 2023, through February 28, 2023) were collected. A multilevel mixed effects model was used to assess the contribution of clinical role, clinical unit (i.e., specific inpatient ward or outpatient clinic), hospital or clinic location (i.e., Hospital X or Outpatient Clinic Building Y), and inpatient versus outpatient setting toward secure messaging use.

Results Of the 33,195 health care professionals who worked during the study period, 20,576 (62%) were secure messaging users. In total, 25.3% of the variability in messaging use was attributable to the clinical unit and 30.5% was attributable to the hospital or clinic location. Compared with nurses, advanced practice providers, pharmacists, and physicians were more likely to use secure messaging, whereas medical assistants, social workers, and therapists were less likely (p < 0.001). After adjusting for other factors, inpatient versus outpatient setting was not associated with secure messaging use.

Conclusion Secure messaging was widely used; however, there was substantial variation by clinical role, clinical unit, and hospital or clinic location. Our results suggest that interventions and policies for managing secure messaging behaviors are likely to be most effective if they are not only set at the organizational level but also communicated and tailored toward individual clinical units and clinician workflows.

Keywords

communication - electronic health records - adoption of new technology - secure messaging - interprofessional communication

Protection of Human and Animal Subjects

This study was approved by the Washington University institutional review board with a waiver of informed consent (IRB no.: 202205084).




Publication History

Received: 15 January 2024

Accepted: 22 May 2024

Article published online:
24 July 2024

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