Increase in Cancer Center Staff Effort Related to Electronic Patient Portal Use

Abstract

SUMMARY ANSWER: Cancer center staff electronic patient portal activities have increased approximately 10-fold over a recent 3-year period. Nursing staff account for the majority of this effort. WHAT WE DID:We identified and characterized cancer center providers and clinic staff who performed electronic activities related to MyChart, our institution's personal health records portal, from 2009 to 2014. Total MyChart actions and messages received were quantified and characterized according to type, timing, and staff category. We applied descriptive statistics to nurses, who exhibited the greatest use of MyChart. Mean and median action/message counts for individual nurses were calculated for 2011 and 2014 and compared using t tests (assessing for a significant increase in actions and messages during this time frame). Mean and median action/message counts were also compared between clinical divisions (medical oncology, radiation oncology, and surgical oncology) using t tests. WHAT WE FOUND:In our analysis, 289 employees performed 740,613 MyChart actions and received 117,799 messages. Seventy-seven percent of actions were performed by nurses, 11% by ancillary staff, 6% by midlevel providers, 5% by physicians, and 1% by clerical/managerial staff. On average, 6.3 staff MyChart actions were performed per patient-initiated message. In 2014, nurses performed an average of 3,838 MyChart actions and received an average of 589 messages compared with 591 actions and 87 messages in 2011 (P , .001). Sixteen percent of all actions occurred outside clinic hours. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:Although we present a quantitative analysis of staff portal use, as defined by numbers of actions and messages, we are not able to determine the amount of time employees devoted to these tasks or the impact on clinic work flow. Due to inherent limitations within the available data tables, we were unable to capture messages initiated de novo by providers, only those received from patients. Finally, generalizability of our findings may be limited by the study cohort, as patients seeking care at NCI-designated comprehensive centers may differ from the broader population by race, geographic location, and socioeconomic status. REAL-LIFE IMPLICATIONS:Given the disease severity, longitudinal course, and data intensive practice of oncology, understanding how patients and providers use electronic portals is key to practice quality and safety. While this technology has been implemented widely in the last decade, few studies have directly examined the impact of electronic patient portals on cancer care providers. In the present analysis, we identified a dramatic and sustained increase in staff use of an electronic patient portal at an NCI-designated comprehensive cancer center. Most of this work falls to nurses, and a substantial proportion occurs outside clinic hours. Future research into the impact of this technology on staff and patient satisfaction, utilization of other healthcare resources, practice finances, and clinical outcomes will be e...

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