Impact of Secure Electronic Health Record Chat on Physician Communication in the Emergency Department.
- 1Oregon Health and Science University, Department of Emergency Medicine, Portland, Oregon.
- 2Oregon Health and Science University, Division of Informatics, Clinical Epidemiology and Translational Data Science, Portland, Oregon.
- 3King Abdulaziz University, Faculty of Medicine, Department of Emergency Medicine, Jeddah, Saudi Arabia.
Abstract
Introduction
Effective communication in the emergency department (ED) is essential for safe patient care. Electronic health record (EHR)-integrated secure messaging may improve communication workflows, but limited evidence exists comparing clinician satisfaction across modalities in the ED. This study evaluated physician satisfaction with an EHR-integrated secure messaging tool compared to existing communication methods for non-emergent communication.Methods
We conducted an electronic pre-post survey study at an urban academic ED following implementation of an EHR-integrated secure messaging tool in October 2024. The primary outcome was overall communication satisfaction pre-post implementation. We also compared nursing communication satisfaction and repeat consult order proportions. Survey domains (ease of use, efficiency, timeliness, clarity, overall satisfaction) were graded using a four-point forced-choice Likert scale.Results
Response rates were 35% (33/95) pre-implementation and 36% (34/95) post-implementation. Although face-to-face communication maintained superior clarity ratings, secure chat received significantly higher overall satisfaction than phone communication (median 3 [IQR 3-4] vs 2 [2-3], P < .001) and higher ratings than the existing consult workflow across all domains (all P ≤ .03). Overall nursing communication satisfaction shifted toward higher scores post-implementation (median 3 [3-4] vs 3 [2-3], P = .03). Repeat consult order proportion decreased from 22% to 18% (risk difference, -3.5%; 95% CI, -4.5% to -2.5%; P < .001).Conclusion
Electronic health record-integrated secure messaging demonstrated high user satisfaction among emergency physicians and may reduce repeat consultant communications. Secure chat provides a complementary communication channel in the ED setting.
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BibTeX
@article{go2026impact,
title = {{Impact of Secure Electronic Health Record Chat on Physician Communication in the Emergency Department.}},
author = {Michaela Go and Hasan Alshamrani and Obert Xu and Steven McGaughey},
journal = {The western journal of emergency medicine},
year = {2026},
month = sep,
doi = {10.5811/westjem.53220},
url = {https://europepmc.org/article/MED/42900948},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of Secure Electronic Health Record Chat on Physician Communication in the Emergency Department.
AU - Michaela Go
AU - Hasan Alshamrani
AU - Obert Xu
AU - Steven McGaughey
PY - 2026
DA - 2026/09/24
JO - The western journal of emergency medicine
DO - 10.5811/westjem.53220
UR - https://europepmc.org/article/MED/42900948
AB - Introduction Effective communication in the emergency department (ED) is essential for safe patient care. Electronic health record (EHR)-integrated secure messaging may improve communication workflows, but limited evidence exists comparing clinician satisfaction across modalities in the ED. This study evaluated physician satisfaction with an EHR-integrated secure messaging tool compared to existing communication methods for non-emergent communication.Methods We conducted an electronic pre-post survey study at an urban academic ED following implementation of an EHR-integrated secure messaging tool in October 2024. The primary outcome was overall communication satisfaction pre-post implementation. We also compared nursing communication satisfaction and repeat consult order proportions. Survey domains (ease of use, efficiency, timeliness, clarity, overall satisfaction) were graded using a four-point forced-choice Likert scale.Results Response rates were 35% (33/95) pre-implementation and 36% (34/95) post-implementation. Although face-to-face communication maintained superior clarity ratings, secure chat received significantly higher overall satisfaction than phone communication (median 3 [IQR 3-4] vs 2 [2-3], P < .001) and higher ratings than the existing consult workflow across all domains (all P ≤ .03). Overall nursing communication satisfaction shifted toward higher scores post-implementation (median 3 [3-4] vs 3 [2-3], P = .03). Repeat consult order proportion decreased from 22% to 18% (risk difference, -3.5%; 95% CI, -4.5% to -2.5%; P < .001).Conclusion Electronic health record-integrated secure messaging demonstrated high user satisfaction among emergency physicians and may reduce repeat consultant communications. Secure chat provides a complementary communication channel in the ED setting.
SN - 1936-900X
SN - 1936-9018
ER -