The Problem
Recent analysis of Duke MyChart activity showed that over 800,000 Duke patients sent nearly 1.5 million MyChart messages to their healthcare providers in fiscal year 2018.(1) More than 140,000 patients sent 750,000 messages specifically requesting medical advice, with 90,000 additional messages related to medication renewal or refill. About 1% of patients or high-utilizers generated 10% of the MyChart message volume. Despite the high priority need (2) to ensure patients’ access to Duke and their providers, data processing in the current MyChart-based system cannot deliver efficient and timely information as it relies heavily on clinical providers tasked with responding to messages. According to a recent Duke survey, 25% of providers spend 60 minutes or more daily responding to messages, with over 50% doing so at night or on the weekends. 80% believe this contributes to provider burnout and 40% report MyChart messaging as their biggest pain point or source of friction in outpatient clinical care. Solutions such as limiting MyChart message length, charging per message, devoting more staff resources or improving MyChart messaging triaging cannot be the only solutions. Patients should be encouraged to get information and stay connected with their providers at Duke. Based on a national survey, 73% of those 65+ with more than 1 chronic condition and 75% of those with income < $25,000 or covered by Medicaid are searching online for health information.(3)
Our Solution
Therefore, there is a critical need to find a more efficient way to communicate with patients, while still considering provider resilience and burnout. Fortunately, new technologies such as online conversational agents or virtual assistants could allow Duke patients and visitors to obtain information they desire, while limiting time providers spend on responding to basic MyChart and other messages. The tool could help visitors get educational health information, understand their care options within Duke as well as be appropriately triaged to MyChart, clinic number, scheduler or even urgent care/emergency department – and thereby additionally increase patient satisfaction.
References
- Morgan B, McCulloch, S., Sharma, P., Keenan, R., Gupta, D., Blitzblau, R., Lipkin, M. Improving Provider Patient Communication and Provider Satisfaction by Optimizing Electronic Patient-Provider Messaging. Project Sponsor: Russell Hall, MD, Chair, Department of Dermatology. 2018.
- Griffin A, Skinner A, Thornhill J, Weinberger M. Patient Portals: Who uses them? What features do they use? And do they reduce hospital readmissions? Appl Clin Inform. 2016;7(2):489-501.
- Zweig M, Shen, J., Jug, L. Healthcare consumers in a digital transition. Rock Health. 2018;Special Report 2018.
