Association Between Conversational Multitasking and Clinician Work Behaviors at a Large US Health Care System: Cohort...

Area of Science:

• Medical Informatics
• Clinical Communication Systems
• Healthcare Workflow Optimization

Background:

• Secure messaging is vital for efficient, safe patient care.
• Its use has surged, potentially impacting clinician workload and cognitive load.
• Understanding these impacts is crucial for optimizing clinical workflows.

Purpose of the Study:

• To examine the link between conversational multitasking in secure messaging and clinician workload.
• To assess the relationship between concurrent secure message conversations and electronic health record (EHR) time and patient chart switching.

Main Methods:

• An observational cohort study of physicians and advanced practice providers in inpatient settings.
• Measured maximum concurrent secure messaging conversations as the primary exposure.
• Assessed EHR time and patient chart switches as co-primary outcomes using linear mixed-effect models.

Main Results:

• Increased concurrent secure messaging conversations correlated with higher EHR time and more patient chart switches.
• Clinicians engaging in 4+ concurrent conversations spent 54.8 minutes longer on EHRs and made 41.6 additional patient switches.
• Trainees experienced the most significant increases in EHR time and patient switches.

Conclusions:

• Conversational multitasking in secure messaging is dose-dependently associated with increased EHR time and patient switching.
• Findings suggest a link between multitasking and elevated clinician workload and cognitive burden.
• Development of guidelines and interventions is needed to manage secure messaging use effectively.