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Research Letter
April 2016

The Burden of Inbox Notifications in Commercial Electronic Health Records

Author Affiliations
  • 1Houston Veterans Affairs Center for Innovations in Quality, Effectiveness, and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas
  • 2Department of Medicine, Baylor College of Medicine, Houston, Texas
  • 3University of Texas Health Science Center at Houston’s School of Biomedical Informatics
  • 4University of Texas–Memorial Hermann Center for Healthcare Quality and Safety, Houston
JAMA Intern Med. 2016;176(4):559-560. doi:10.1001/jamainternmed.2016.0209

With wider use of electronic health records (EHRs), physicians increasingly receive notifications via EHR-based inboxes (eg, Epic’s In-Basket and General Electric Centricity’s Documents). Examples of types of notifications include test results, responses to referrals, requests for medication refills, and messages from physicians and other health care professionals.1,2 Previous work within the Department of Veterans Affairs found that health care professionals receive large quantities of EHR-based notifications, making it harder to discern important vs irrelevant information and increasing their risk of overlooking abnormal test results.36 Information overload is of emerging concern because new types of notifications and “FYI” (for your information) messages can be easily created in the EHR (vs in a paper-based system). Furthermore, the additional workload to read and process these messages remains uncompensated in an environment of reduced reimbursements for office-based care.1,2,4 Conversely, EHRs make it easier to measure the amount of information received. We quantified the notifications that physicians received via inboxes of commercial EHRs to estimate their burden.

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