Primary Care Staff Members’ Experiences with Managing Electronic Health Record Inbox Messages

Presentation Time: 09:45 AM - 09:57 AM

Abstract Keywords: Workflow, Human-computer Interaction, Qualitative Methods, Documentation Burden
Primary Track: Applications
Programmatic Theme: Clinical Informatics

Many primary care staff review inbox messages from patients but little is known about their experience with inbox work. In this qualitative study with twelve primary care staff we characterize their experience with inbox work as fragmented, feeling like and assembly line, involving frequent communication with other team member to manage tasks, and requiring the navigation of various expectations for inbox work. These results highlight the tension between standardization and customization in staff inbox workflows.

Speaker:
Adam Rule, PhD
University of Wisconsin - Madison

Authors:
Phillip Vang, BS - University of Wisconsin - Madison; Mark Micek, MD - University of Wisconsin - Madison; Brian Arndt, MD - University of Wisconsin - Madison;

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Impact of Releasing Test Results with Accompanying Education Materials on Patient-Initiated Messaging

Presentation Time: 09:57 AM - 10:09 AM

Abstract Keywords: Patient Engagement and Preferences, Delivering Health Information and Knowledge to the Public, Policy
Primary Track: Policy
Programmatic Theme: Consumer Health Informatics

In August 2024, Vanderbilt University Medical Center implemented curated education materials at the point of result review for common tests associated with the highest message volumes. This study evaluated the effect of these education details on the volume of patient-initiated messages. We found that these education materials did not lead to a clinically meaningful reduction in patient messaging behavior. However, messaging increased for viral load and PCR tests, suggesting opportunity for more tailored educational resources.

Speaker:
Bryan Steitz, PhD
Vanderbilt University Medical Center

Authors:
Andrew Guide, MS - Vanderbilt University Medical Center; Kelsey Rodriguez, MPH - Vanderbilt University Medical Center; Sunil Kripalani, MD, MSc - Vanderbilt University Medical Center; Amanda Mixon, MD - Vanderbilt University Medical Center; Christianne Roumie, MD, MPH - Vanderbilt University Medical Center; S. Trent Rosenbloom, MD, MPH, FACMI, FAMIA - Vanderbilt University Medical Center Dept of Biomedical Informatics;

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Evaluating the Adoption of Billing Patient Messages as ‘E-Visits’ and Impact on Physician Burnout

Presentation Time: 10:09 AM - 10:21 AM

Abstract Keywords: Documentation Burden, Policy, Usability
Primary Track: Policy

This mixed-methods study assessed how physician-initiated billing for patient messages (“e-visits”) impacted physician well-being. Physicians that adopted e-visit billing had a significant reduction in self-reported callousness towards others, a key symptom of burnout. Semi-structured interviews provided insight into the frictions that resulted in low adoption and emphasized the importance of valuing inbox care to improve well-being. Future efforts should focus on aligning incentives to balance patient access and physician well-being, including streamlining the billing process.

Speaker:
Sarah Rosenthal, BA
Harvard University

Authors:
Sarah Rosenthal, BA - University of California San Francisco; Julia Adler-Milstein, PhD, FACMI - UCSF School of Medicine; Maria Byron, MD - University of California, San Francisco; A J Holmgren, PhD - University of California, San Francisco;

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Building a Consumer Health Informatics Introductory Course Consensus Curriculum: An eDelphi Study

Presentation Time: 10:21 AM - 10:33 AM

Abstract Keywords: Delivering Health Information and Knowledge to the Public, Curriculum Development, User-centered Design Methods, Personal Health Informatics, Usability, User-centered Design Methods, Delivering Health Information and Knowledge to the Public, Mobile Health
Working Group: Consumer Health Informatics Working Group
Primary Track: Foundations
Programmatic Theme: Consumer Health Informatics

Digital health technology is becoming increasingly sophisticated and prevalent in modern healthcare. Consumer health informatics (CHI) introductory courses provide a baseline proficiency on this important topic, yet there are no standardized competencies for graduates. In the rapidly evolving digital technology landscape, clear competencies are particularly crucial, as content may shift rapidly. We developed core competencies for introductory graduate level CHI courses utilizing the eDelphi method. To conduct this study, we explored literature and current teaching methods to identify themes among CHI, created of a panel of experts to serve on our advisory panel, then systematically solicited expert feedback using an iterative process. Our preliminary results have identified several areas experts deem as integral to any consumer health informatics curriculum – defining CHI and its applications, understanding how health literacy and numeracy influence design, and analyzing how information platforms can influence consumer outcomes and decision making.

Speaker:
Olivia Krol, BS
Oregon Health & Science University

Authors:
Julie Doberne, MD, PhD - Oregon Health & Science University; Sriram Iyengar, PhD - University of Arizona College of Medicine, Phoenix; Katherine Blondon, MD, PhD - Hopitaux Universitaires Geneve; Vishala Mishra, MBBS - Duke; Christie Martin, PhD, MPH, RN-BC, LHIT-HP - University of Minnesota School of Nursing; Khaya Clark, PhD - VA Portland Health Care System; Ruchi Thanawala, MD, MS - Oregon Health and Science University;

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A Self-reflection Rewriting Method for Readability of Answers to Question about Spinal Cord Injury

Presentation Time: 10:33 AM - 10:45 AM

Abstract Keywords: Large Language Models (LLMs), Delivering Health Information and Knowledge to the Public, Evaluation
Working Group: Natural Language Processing Working Group
Primary Track: Applications
Programmatic Theme: Consumer Health Informatics

Retrieval Augmented Generation (RAG) often produces overly complex answers in biomedical Q&A. We evaluated three rewriting methods: (1) target grade-level prompt, (2) basic rewrite prompt, and (3) self-reflection with GPT-4o and Llama 3.3 70B-Instruct models. All lowered Flesch–Kincaid scores, but (1) and (2) still exceeded 8th grade level, while (3) hit the target for GPT-4o but not Llama. Despite lower semantic similarity, self-reflection retained over 93% similarity, indicating effective rewrites with minimal information loss.

Speaker:
Bayu Aryoyudanta, Master
University of Pittsburgh

Authors:
Bayu Aryoyudanta, Master - University of Pittsburgh; Maria Yuliana, Bachelor - University of Pittsburgh; I Made Agus Setiawan, PhD - University of Pittsburgh; Andi Saptono, PhD - University of Pittsburgh School of Health and Rehabilitation Services; Brad E. Dicianno, MD - University of Pittsburgh; Yong Kyung Choi, PhD, MPH - University of Pittsburgh; Bambang Parmanto, PhD - University of Pittsburgh;

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Improving Pediatric Lead Screening through Automated Electronic Health Record-Driven Patient Outreach

Presentation Time: 10:45 AM - 10:57 AM

Abstract Keywords: Population Health, Patient Engagement and Preferences, Clinical Guidelines
Primary Track: Applications
Programmatic Theme: Clinical Informatics

This study explores the feasibility of automated outreach for pediatric lead screening (LS), and the effectiveness of SMS texting vs Patient Portal (PP) vs Telephone Outreach modalities. A total of 805 outreaches were sent for 602 patients and 152 (25.25%) patients obtained LS. SMS (26.3%) resulted in the highest conversions followed by Telephone (24.0%) and PP (18.4%), p < 0.05. EHR automated patient messaging is an effective tool to increase LS rates.

Speaker:
Eman Jammali, MD
MetroHealth System

Authors:
Katherine Liang, MD - MetroHealth System; David Kaelber, MD, PhD, MPH - Case Western Reserve University/The MetroHealth System;

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