EHR inbox @ucsf Jane Fogg MD

Use data to redesign inbox work at Atrius. What did they figure out?! Out of box ideas as well as executing on standard work.

Directing messages to the right person right away.

Eliminate automated messages. 98% reduction in media manager by directing them to the right person (specialist who ordered) and not PCP.

Care everywhere notifications. 100% reduction in unnecessary notifications.

Rx renewals. 50% reduction. With embedded automated protocols. Run by non licensed staff. Centralized. Eliminated physician sign off.

Automation lab results. 19% of volume. Removed ‘normal normal’ (normal in all clinical situations)

and send ONLY to patient and not to PCP.

It works. Removes 30% of lab volume today.

Another possibility: nursing directed messages for vitamin D protocol management.

PMAR: allow team members to touch messag first and reconcile a significant volume before it ever gets to physician/APP.

Another idea! Clinical coverage department. Retired clinician who can cover some visits and inbasket to help physicians in distress or extended leave. Wow. Also PCP and APP (advanced practice provider) partnerships.

Author: CT Lin

CMIO, UCHealth (Colorado); Professor, University of Colorado School of Medicine

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