EHR Inbox @UCSF Kaiser Permanente approach

3 premises. Inbox work is stress. Quantity drives workload. System leaders are needed to do this work.

Stomping grapes from the EHR audit log data to get wine. This is really hard work.

Measures stress with smartwatch use to measure heart rate variability during work day with EHR.

1. Inbox workload causes stress.

2. Volume of messages affect workload

3. System work needed to address this.

Using a smartwatch to measure stress.

Some astounding quotes of physician work life about inbox.

Components of stress: inbox work duration. Percent of work outside of work outs. And rate of window switching. !!

Arrghh. Task switching is HUGE. Physicans/APPs have no control over the volume and switching necessary to do this work.

A related analysis showed that variability between medical centers have big difference in inbox workload for involved physicians. So there are system effects here that are not technology based. (Same EHR different outcome).

Author: CT Lin

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

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