Gender Differences in Electronic Health Record Inbox Message Volumes Among Pediatric Surgeon Specialists

Prior studies examined the relationship between physician sex and electronic health records (EHR) utilization patterns to assess for provider gender equity, although this has not been explored among pediatric surgical subspecialists. We hypothesized that female surgeons received more inbox messages and had longer message lengths compared to male surgeons.

Surgeons who performed at least five surgical procedures at a free-standing children's hospital between January 2021 and December 2022 were stratified based on sex. EHR utilization data were retrospectively extracted. Message types were restricted to those from patients, health care team members, or results, opting to omit other automated messages from the EHR that were not initiated by a person. Primary outcomes were number of inbox messages received adjusting for the volume of surgical cases performed and message length. Univariate and multivariate analyses were performed to identify outcome predictors.

41 female and 79 male surgeons were included in the final analysis. There was a median of 693 messages received by surgeons over the study period (median of 1.8 messages per surgeon per case). Male surgeons tended to be further out from training but there were no significant differences in terms of surgical case count or characteristics. Surgeon sex was a significant predictor of inbox message count in univariate analysis (incidence rate ratio 1.58 favoring female surgeons, p = 0.03), but not in multivariate analysis, after correcting for case complexity. Surgeon sex was not a significant predictor of message length in either univariate or multivariate analysis.

Surgeon sex was not a significant predictor of inbox message count or message length among a cohort of pediatric surgical subspecialists. Ensuring gender equity with respect to EHR activities reaffirms our commitment to avoiding bias.

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