{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T02:38:17Z","timestamp":1782873497160,"version":"3.54.5"},"reference-count":57,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/100000092","name":"United States National Library of Medicine","doi-asserted-by":"crossref","award":["4T15LM007450"],"award-info":[{"award-number":["4T15LM007450"]}],"id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Asynchronous messaging is an integral aspect of communication in clinical settings, but imposes additional work and potentially leads to inefficiency. The goal of this study was to describe the time spent using the electronic health record (EHR) to manage asynchronous communication to support breast cancer care coordination.<\/jats:p><jats:p>\n          Methods\u2003We analyzed 3 years of audit logs and secure messaging logs from the EHR for care team members involved in breast cancer care at Vanderbilt University Medical Center. To evaluate trends in EHR use, we combined log data into sequences of events that occurred within 15\u2009minutes of any other event by the same employee about the same patient.<\/jats:p><jats:p>\n          Results\u2003Our cohort of 9,761 patients were the subject of 430,857 message threads by 7,194 employees over a 3-year period. Breast cancer care team members performed messaging actions in 37.5% of all EHR sessions, averaging 29.8 (standard deviation [SD]\u2009=\u200923.5) messaging sessions per day. Messaging sessions lasted an average of 1.1 (95% confidence interval: 0.99\u20131.24) minutes longer than nonmessaging sessions. On days when the cancer providers did not otherwise have clinical responsibilities, they still performed messaging actions in an average of 15 (SD\u2009=\u200911.9) sessions per day.<\/jats:p><jats:p>\n          Conclusion\u2003At our institution, clinical messaging occurred in 35% of all EHR sessions. Clinical messaging, sometimes viewed as a supporting task of clinical work, is important to delivering and coordinating care across roles. Measuring the electronic work of asynchronous communication among care team members affords the opportunity to systematically identify opportunities to improve employee workload.<\/jats:p>","DOI":"10.1055\/s-0041-1735257","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:16:44Z","timestamp":1631751404000},"page":"877-887","source":"Crossref","is-referenced-by-count":10,"title":["An Analysis of Electronic Health Record Work to Manage Asynchronous Clinical Messages among Breast Cancer Care Teams"],"prefix":"10.1055","volume":"12","author":[{"given":"Bryan D.","family":"Steitz","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M.","family":"Unertl","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia A.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States"},{"name":"Division Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University School of Medicine, Chicago, Illinois, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,9,15]]},"reference":[{"key":"ref1","first-page":"1718","article-title":"The EHR's roles in collaboration between providers: a qualitative study","volume":"2014","author":"D A Chase","year":"2014","journal-title":"AMIA Annu Symp Proc"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.acap.2017.04.005","article-title":"Care coordination and comprehensive electronic health records are associated with increased transition planning activities","volume":"18","author":"N Sharma","year":"2018","journal-title":"Acad Pediatr"},{"key":"ref3","first-page":"1","article-title":"How much collaboration? 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