The “Inboxologist” — A Novel Approach to In-Basket Management in Primary Care

Abstract

Primary care providers are spending more time responding to electronic patient requests and completing other tasks in their digital in-basket that do not require their level of expertise. This contributes to job dissatisfaction and burnout. Last year, at two large primary care practice sites, Corewell Health West implemented a pilot program that introduced a new in-basket triage system involving a registered nurse completing initial triage and an advanced practice provider serving as an “inboxologist.” Under this model, primary care providers handled 41% fewer in-basket messages than before the pilot and spent an average of 47% less time on the messages they did receive. Self-reported time spent on the in-basket during office hours and after office hours decreased by an average of 37% and 32%, respectively. The number of messages that were resolved by the nonphysician staff member who initially triaged the message increased by 14.2% from pre-pilot to the end of the pilot period. Time to resolution of patient-generated messages decreased by 93%, with subsequent improvement in patient satisfaction scores. Given the favorable reception by physicians, patients, and staff, Corewell plans to expand the inboxologist program to all of its primary care sites and to selected specialty practices.