Navigating Communication: Crafting Guidelines for Epic Secure Chat in an Academic Medical Center

Effective communication among health care providers constitutes a critical cornerstone for delivering optimal patient care. However, the achievement of efficient communication within patient care remains a challenge in modern medicine. While traditional paging systems have served as the primary means of communication in health care, they are limited to unidirectional communication. To address these shortcomings, bidirectional models emerged, seeking to enhance communication among health care partners. To foster improved communication, our institution implemented a 2-way secure messaging system, Epic Secure Chat. This introduction, however, occurred without tailored guidance on appropriate use, leading to confusion among health care staff regarding optimal, safe utilization of the new platform.

Employing a system-wide survey to gather data from various in- and outpatient departments, we sought to comprehend the present state of affairs concerning the usage of this platform. The survey was distributed using a hierarchical email approach, beginning with Tier III Safety Huddle participants and cascading through departmental leadership at our institution. Department leaders further disseminated the survey to a wide range of clinical and administrative staff, including providers, nurses, pharmacists, technicians, and ancillary personnel, to ensure diverse role representation. Open-ended responses were analyzed using thematic analysis. The research team systematically coded and categorized responses to identify key themes, areas of consensus, and divergent viewpoints, enabling the extraction of meaningful insights into the use and perception of Epic Secure Chat.

The majority of survey respondents were physicians or advanced practice providers (56.54%) and nurses (31.78%), reflecting a predominantly clinical user base. Epic Secure Chat was widely used for interdisciplinary care coordination (34.07%) and 2-way communication (23.33%), though over 10% reported minimal use. While many valued its efficiency and ease of use, significant concerns emerged. Safety issues, including inappropriate use for urgent communication and lack of closed-loop messaging, accounted for 46.21% of feedback. Workflow challenges (34.70%) and compliance concerns (6.57%) were also noted. Despite these issues, 12.12% of responses highlighted positive impacts on team communication and workflow efficiency.

These findings may serve as a model for other health care organizations seeking to implement or refine secure messaging systems. As communication technologies continue to evolve, it is essential to balance efficiency with safety, ensuring that tools like Secure Chat enhance rather than hinder clinical care. Continued evaluation and adaptation will be critical to achieving this balance and supporting both provider well-being and patient outcomes.