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Secure Messaging Use and Wrong-Patient Ordering Errors Among Inpatient Clinicians.

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Higher secure messaging volume among clinicians was linked to increased wrong-patient ordering errors. This association was particularly noted in attending physicians and advanced practice practitioners (APPs), suggesting potential impacts on patient safety.

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Area of Science:

  • Medical Informatics
  • Patient Safety
  • Healthcare Communication

Background:

  • Clinician-to-clinician secure messaging has rapidly increased.
  • The impact of this communication method on clinical work and patient safety remains unclear.

Purpose of the Study:

  • To examine the relationship between secure messaging use and wrong-patient ordering errors.
  • To identify if this association differs across clinician roles.

Main Methods:

  • A cohort study analyzed secure messaging volume and retract-and-reorder events (as a proxy for wrong-patient errors) over three months.
  • Data included 3239 clinicians from 14 hospitals.
  • Multilevel logistic regression adjusted for various confounding factors.

Main Results:

  • Higher secure messaging volume was associated with a 10% increased odds of wrong-patient ordering errors.
  • This association was significant for attending physicians and advanced practice practitioners (APPs).
  • Wrong-patient ordering errors occurred in 0.4% of clinician-days.

Conclusions:

  • Increased daily secure messaging correlates with higher odds of wrong-patient ordering errors in inpatient settings.
  • While the findings suggest a potential risk, further research is needed to establish causality.
  • Other factors like care coordination may influence this association.