{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:00:07Z","timestamp":1781143207630,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>One legacy of the COVID\u201019 pandemic has been an increase in electronic health record (EHR) patient\u2010generated messages to providers, which has increased the amount of time providers spend on EHR tasks. We sought to evaluate clinical and demographic variables associated with high EHR patient message generation in a head and neck oncologic surgery (HNS) clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized 20% sample of unique outpatient visits to the HNS service at a tertiary academic medical center from July to December 2023 was retrospectively reviewed. Patient\u2010generated EHR messages to providers for 6\u2009months following the index visit date were categorized by quintiles, with high\u2010utilizers defined as the top quintile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High\u2010utilizers sent a greater number of messages (mean, 27.6 [range: 8\u2013110] vs. 3.2 [1\u20137],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). On multivariable regression analysis, high\u2010utilizers were less likely to be elderly (OR\u2009=\u20090.13 [95% CI 0.04\u20130.52]), single (OR\u2009=\u20090.44 [0.19\u20130.98]), and more likely to have malignancy (OR\u2009=\u20092.27 [1.27\u20134.04]), advanced comorbidity (OR\u2009=\u20095.33 [1.71\u201316.53]), surgical treatment (OR\u2009=\u20093.16 [1.78\u20135.58]), and a specific provider (OR\u2009=\u20094.20 [1.21\u201314.53]). Sex, payor status, location, and new vs. established patient status were not associated with high\u2010utilization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within an academic HNS practice, patients with malignant disease, comorbidity, surgical patients, and those who saw a specific provider were more likely to be high\u2010utilizers, while older patients were less likely to use EHR messaging. These data suggest that some patient populations require more personalized and frequent support to address communication needs and raise concern about the ability of elderly patients to use electronic communications, who may have unmet needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>NA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70465","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T04:58:46Z","timestamp":1773377926000},"page":"3013-3019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High Utilizers of\n                    <scp>MyChart<\/scp>\n                    Electronic Patient Portal Messaging in A Head and Neck Surgery Clinic"],"prefix":"10.1002","volume":"136","author":[{"given":"Syed Ameen","family":"Ahmad","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1157-3942","authenticated-orcid":false,"given":"Sarah","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefany","family":"Lazieh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Mady","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Fakhry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Eisele","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2902-4407","authenticated-orcid":false,"given":"Nyall R.","family":"London","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-9307","authenticated-orcid":false,"given":"Christine G.","family":"Gourin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medical Institutions  Baltimore Maryland 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