7 strategies for EHR inbox improvements to reduce physician burnout
2.3 minutes is the average time it takes physicians to answer a question in the patient portal. That might not sound like a long time, but when you multiply that number by dozens of messages per day or hundreds per week (which is not uncommon especially in primary care), you’ve got a recipe for physician burnout. As physicians continue to field more and more portal inbox messages from patients, they need clear strategies to manage those messages effectively to maximize productivity and reduce uncompensated time. Here are seven strategies for patient portal optimization.
1. Temper patient expectations. Set clear boundaries in terms of what your patients can expect from using the portal, so you don’t feel pressured to respond immediately or provide a highly detailed answer. Here’s some advice from the American Medical Association (AMA). For example, give patients a printed handout that outlines guidelines for portal use such as character limits for portal messages, potential charges associated with these messages, expected response times, and other restrictions. Educating patients on proper portal use can greatly reduce physician burnout.
2. Leverage non-physician care team members. Introducing a team-based inbox management system to triage and address messages in certain instances can expedite responses to patients and decrease EHR burnout. Grouping messages into buckets and identifying who within the medical practice (e.g., nurses or medical assistants) will respond to each type of message is ideal. Many patient portals allows patients to check a box indicating whether their message pertains to medical advice, test results, prescription refills, making or canceling an appointment, or other common requests. These EHR inbox improvements can help you delegate tasks accordingly.
3. Plan for when physicians are out of the office. Ensure EHR inbox coverage during your time off to stay on top of messages and promote timely responses.
4. Automate, automate, automate. For example, consider automating the release of normal lab and imaging results straight to the patient portal and bypassing the physician inbox. Only route abnormal results or those with a high dependency on clinical context to the ordering care team. In addition, there may be opportunities to leverage generative artificial intelligence to generate draft responses to patient messages. Automation is one of the greatest antidotes to EHR burnout.
5. Reduce portal messages proactively. For example, consider prescribing a 12- or 15- month supply of medications used to treat chronic conditions to reduce the number of refill requests coming through the portal. Or provide every patient with an after-visit summary to minimize the likelihood of follow-up questions. Another idea? Provide lab orders to patients before they present for their appointment so you can review and discuss lab results with the patient during the visit rather than via the patient portal. This gives the patient opportunities to ask questions and voice concerns in real time and reduces the likelihood of post-visits messages.
6. Bill for portal messages. In some cases, you may be able to bill for responding to complex messages or giving medical advice. These visits—known as e-visits—became billable for established patients to Medicare in January 2020, currently paying about $15 for responses that require 5-10 minutes of your time.
7. Chunk your time. Rather than responding to each portal message as it comes in or even in between patients, consider dedicating 10 or 20 minutes to inbox responses every 2-3 hours. Sometimes it’s more efficient to stick with one task for a limited period without distractions.
Additional resources for patient portal optimization
Want more resources? Here’s a patient portal optimization toolkit and systemic approach to reducing EHR inbox toolkit, both from the AMA, that provide actionable steps to make EHR inbox improvements that reduce physician burnout. Looking for a more condensed resource? Check out AMA’s EHR inbox reduction checklist.
Looking ahead
As patients become more engaged in their clinical care—and technology becomes more embedded in our daily lives—patient portal messages will likely continue to increase in volume. Make it a priority in 2025 and beyond to evaluate and improve inbox management to reduce EHR burnout and help you focus on providing high-quality patient care. Learn how edgeMED’s patient portal can help.
