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Secure Provider-to-Provider Communication With Electronic Health Record Messaging

An Educational Outreach Study

Walsh, Kathleen E.; Secor, Jessica L.; Matsumura, Jon S.; Schwarze, Margaret L.; Potter, Beth E.; Newcomer, Peter; Kim, Michael K.; Bartels, Christie M.

doi: 10.1097/JHQ.0000000000000115
Original Article

Introduction: With increasing electronic health record (EHR) use, providers are talking less with one another. Now, many rely on EHRs, informal emails, or texts, introducing fragmentation and new data security challenges with new communication strategies. We aimed to examine the impact of a physician champion educational outreach intervention to promote electronic provider-to-provider communication in a large academic multispecialty group.

Methods: Physician champions provided educational outreach to 16 academic departments, using 10-minute case-based presentations. Online surveys assessed communication preferences and practices. Electronic health record queries counted EHR messaging use before and after intervention. Descriptive statistics compared responses by specialty (z-test). Paired responses with pre–post data were compared using chi-square tests. Time series analysis assessed EHR messaging rates before intervention versus after intervention.

Results: Five hundred seventeen providers responded to the postoutreach survey. Eighty-six percent were familiar with EHR messaging tool and 78% knew how to use it after intervention. Among practitioner groups, Family Medicine preferred EHR messaging the most (62%). Groups who declined outreach least preferred it (26%). Among 88 respondents with paired pre–post intervention surveys, familiarity rose (79–96%), and self-reported use increased (66–88%).

Conclusions: Physician champion educational outreach increased the use of the secure provider-to-provider EHR messaging tool.

For more information on this article, Christie M. Bartels, MD, MS at

This study was funded, in part by the Division of Vascular Surgery. Dr. M. L. Schwarze was funded by a Greenwall Faculty Scholars Award and a Training Award KL2TR000428 and by the Clinical and Translational Science Award program, through the National Institutes of Health National Center for Advancing Translational Sciences Grant UL1 TR000427. Additional statistical support was from NIH-NCATS 9U54TR000021 (the Health Innovation Program/Community-Academic Partnerships core of UW ICTR-CTSA).

C. M. Bartels received time support from the National Institutes of Health National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) (K23 #AR062381) and has a research grant through the University of Wisconsin from Independent Grants for Learning and Change (Pfizer). J. S. Matsumura has research grant support through the University of Wisconsin from Abbott, Cook, Covidien, Endologix, and Gore. The remaining authors declare no conflicts of interest.

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© 2018 National Association for Healthcare Quality
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