Teams Tackle Patient Messages Together, Saving Time for Providers

UNC Health, which serves patients across North Carolina, conducted a workforce engagement survey and found its providers had trouble disconnecting from work. Follow-up focus groups identified a prevailing contributor: patient medical advice request messages. Quickly after the survey, UNC Health formed a workgroup of executive sponsors, physicians, informaticists, operational leaders, and analysts to help make tangible improvements. Pools of nurses and medical assistants were already replying to patients’ initial messages that fell within the scope of their responsibilities and escalated messages to providers when appropriate, and now those pools do the same when the patient replies to a provider’s message. With other quick wins like closing threads after 30 days and allowing patients to message only providers they had recently seen, UNC Health reduced the number of messages going to providers by 25%. Still, providers might feel the pressure to respond immediately and continue to work on messages after hours, so the workgroup also established an expected response time of three business days. The nurses and MAs in the pools were given protocols and tools for handling patient messages, which decreased the average response time by approximately 60%.

How They Did It

• Routed all patient messages to pools of nurses and medical assistants
• Closed threads after 30 days and allowed patients to message only providers they had recently seen
• Standardized a response time so clinicians and patients know when a response is expected
• Piloted SmartPhrases for common responses to patient messages at three clinics
• Directed patients to use self-service tools in MyChart instead of messages

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