Characterization of Secure Message Use in a Children's Hospital.

Abstract

Objectives: Secure messaging is an increasingly common mode of communication among hospital-based clinicians. The use of these systems in pediatric settings is poorly understood. We sought to describe secure message volume, message response time, and emoji reaction use in a large children's hospital.

Methods: We extracted 6 months of secure message data from staff working on 3 inpatient units of an urban tertiary care children's hospital. Using assignment data, we isolated secure message activity during clinical shifts on these 3 units to report message volume, message response time, and emoji reaction use by unit and clinical role. We performed statistical analysis to compare message metrics within units and secondary analysis for key role comparisons.

Results: A total of 2493 clinicians sent and read 2 848 677 secure messages during the study period. Physicians and advanced practice providers (APPs) providing direct front-line care had the highest message use, a median of 13.4 (IQR 9.9, 17.3) combined sent and received messages per hour. We found significant differences in message volume and time to read, respond, and react to messages across clinical roles within units (all P<0.001). Front-line clinicians across units had significant differences in secure message volume and response times. (P<0.001).

Conclusions: Front-line physicians and APPs experienced the highest message burden per person across all clinical roles. We demonstrated nearly immediate message read and response times. Additional study is needed to understand the effects of secure messaging on clinician well-being and patient safety.