Electronic Messages Research Articles

"Interstitial lung abnormalities": translation to and use in Portuguese.

To conduct a survey on the use of the term "interstitial lung abnormalities" in radiology reports in Brazil, propose an appropriate Portuguese-language translation for the term, and provide a brief review of the literature on the topic. A survey was sent via electronic message to various radiologists in Brazil, asking about their familiarity with the term, which translation of the term they use in Portuguese, and whether they use the criteria proposed by the Fleischner Society. A total of 163 responses were received, from all regions of Brazil. Although the vast majority (88%) of the respondents stated that they were familiar with the term "interstitial lung abnormalities", there was considerable variation regarding the equivalent term they used in Portuguese. We suggest that the term "anormalidades pulmonares intersticiais" be used in order to standardize radiology reports and disseminate knowledge of these findings in Brazil.

Self-sufficiency of e-mail as a marketing tool

Through their development modern digital communication channels modify newly established patterns and very quickly influence changes in marketing practice. Starting from the questions of whether marketing messages sent to consumers via e-mail are useful or can they be used as a standalone tool, this paper presents a preliminary study conducted on a sample of 192 respondents. The study aims at collecting guidelines for a larger study on the impact of modern digital communication channels on consumer behavior, i.e. on the necessary adaptations in marketing practices that are already based on digital technologies. The paper specifically focuses on electronic marketing messages and newsletters as frequently used modern marketing tools. The research was conducted through a specially designed questionnaire and it has determined that e-mail as a standalone marketing tool is not effective and should be used in combination with some other tools. It has not been found that email positively influences the purchase decision nor is the newsletter as a marketing tool completely positively accepted by the respondents

Analysis of methods of classification of electronic messages based on neural network models

In the article, the creation of a mechanism for detecting and classifying messages is considered, with an assessment of how effectively different neural networks work and can recognize and classify different types of electronic messages, including phishing attacks, spam, and legitimate messages. A preliminary analysis of incoming messages has been performed, encompassing their headers, text, and other relevant attributes. For instance, in the case of emails, these attributes could be the 'subject' and 'sender' of the message. Methods for data preparation and processing have been reviewed, including text vectorization, noise removal, and normalization, to be utilized in training neural networks. Message tokenization has been performed by transforming them into a numerical format while considering the selection of features. For text messages, it is crucial to execute both tokenization and text vectorization. The model training was performed on the test data with prior splitting into two parts: 80% for training and 20% for testing. The training set is utilized for training the model, while the test set is used to evaluate its effectiveness. The peculiarity of the class structure of the data, namely the uniformity of the distribution of classes, is considered. In this case, spam occurs less frequently than legitimate messages, so class balancing techniques such as random deletion of redundant examples, upsampling, and subsampling were applied to ensure adequate model training. Optimization of network parameters was performed, by researching the optimal parameters of neural networks, such as the number and size of layers, activation functions, and optimization of hyperparameters to achieve the best performance. Hyperparameter optimization includes determining optimal settings for neural networks, such as layer size, activation functions, learning rate, and other parameters. The effectiveness was assessed by comparing the results and performance of various classification methods based on neural networks using metrics such as precision and F1-score. It was determined how well the methods can avoid misclassifications where legitimate messages are mistakenly identified as spam, and vice versa. A comparison of the methods' effectiveness in processing a large volume of messages in real time was conducted. An analysis of different architectures of neural network models was performed. Based on the analysis, it was revealed how effectively different neural network models can recognize and classify messages as spam.

Decisional style, sleepiness, and online responsiveness

As sleep problems can impair quality of work, an online questionnaire was used to examine relationships between sleepiness and decision making while obtaining unobtrusive indices of performance. Participants (N = 344) completed the Insomnia Severity Index, Epworth Sleepiness Scale, and the Melbourne Decision Making Questionnaire in a Qualtrics survey while reporting mobile phone use. Qualtrics recorded the time and the number of clicks required to complete each page of the survey. Multiple regression indicated that insomnia was associated with daytime sleepiness and Hypervigilance, and mobile phone use before bed. Participants with moderate sleepiness required a greater number of clicks to complete the questionnaire. Greater sleepiness was associated with longer times to complete these self-assessment tasks. Clinically significant sleepiness produces changes in performance that can be detected from online responsivity. As sleepy individuals can be appreciably and quantitatively slower in performing subjective self-assessment tasks, this argues for objective measures of sleepiness and automated interventions and the design of systems that allow better quality sleep. Practitioner summary: Work can require processing of electronic messages, but 24/7 accessibility increases workload, causes fatigue and potentially creates security risks. Although most studies use people’s self-reports, this study monitors time and clicks required to complete self-assessment rating scales. Sleepiness affected online responsivity, decreasing online accuracy and increasing response times and hypervigilance.

Embracing emojis: Bridging the gap in workplace technology adoption and elevating communication effectiveness

An emoji is a small digital picture or icon that is used in electronic messaging to show a feeling, thought, or idea. Emoticons are frequently employed in written communication, such as text messaging, social media platforms and various digital mediums, with the purpose of expressing emotions or providing more meaning to a statement. Adopting emojis in the professional environment has become a modern method to convey emotions, offer feedback, and express appreciation amongst peers. This exploration underlines the intersection of technology – specifically the use of emojis – and its influence on interpersonal interactions and dynamics within the professional setting. This draws attention to the need for effective communication, setting clear expectations, and understanding the implications of technology on workers' attitudes and behaviours. For deeper analysis, this study employs two pivotal frameworks: the theory of operant conditioning and the Technology Acceptance Model (TAM). The former probes into the effects of outcomes, such as the usage of emojis, on employees' behaviours in the office context. The latter, on the other hand, explores the acceptance and perceptions employees have towards such technological innovations. Emphasizing effective communication becomes paramount when we consider the role technology plays in shaping our interactions and viewpoints. While emojis can potentially enhance the clarity and effectiveness of communication, they come with their set of challenges. It's vital to approach their use with discretion, particularly in sensitive scenarios like performance evaluations. In such contexts, the margin for misunderstanding is high, and incorrect interpretations can lead to unintended consequences.

Standardized electronic messages to enhance communication in transfusion and transplantation.

Standardized electronic messages to enhance communication in transfusion and transplantation.

A review of application, modification, and prospect of melamine foam

Abstract Melamine foam (MF), a promising development in light materials, finds application in construction, agriculture, aviation, transportation, electronic message, and other fields due to its excellent thermal insulation performance, sound absorption and noise reduction capabilities, safety and health benefits, as well as easy processing. However, its own shortcomings such as hardness, poor toughness, fragility, and slag removal greatly limit its application scope. In this review, a survey of the literature from two aspects of toughening of melamine resin and regulation of MF pore structure are reviewed to explore the research progress of toughening modification of MF. The principle, merit, and demerit of different modification methods are analyzed. In addition, owing to the extensive literature available, this article also summarizes the representative achievements of the nanotechnology modification of MF derivatives (carbon foam and carbon aerogel). Eventually, based on an assessment of current application status for both MF and its derivatives while considering existing challenges in their modification processes using nanotechnology approaches, we discuss future prospects for their application.

Natural language processing system for rapid detection and intervention of mental health crisis chat messages

Patients experiencing mental health crises often seek help through messaging-based platforms, but may face long wait times due to limited message triage capacity. Here we build and deploy a machine-learning-enabled system to improve response times to crisis messages in a large, national telehealth provider network. We train a two-stage natural language processing (NLP) system with key word filtering followed by logistic regression on 721 electronic medical record chat messages, of which 32% are potential crises (suicidal/homicidal ideation, domestic violence, or non-suicidal self-injury). Model performance is evaluated on a retrospective test set (4/1/21–4/1/22, N = 481) and a prospective test set (10/1/22–10/31/22, N = 102,471). In the retrospective test set, the model has an AUC of 0.82 (95% CI: 0.78–0.86), sensitivity of 0.99 (95% CI: 0.96–1.00), and PPV of 0.35 (95% CI: 0.309–0.4). In the prospective test set, the model has an AUC of 0.98 (95% CI: 0.966–0.984), sensitivity of 0.98 (95% CI: 0.96–0.99), and PPV of 0.66 (95% CI: 0.626–0.692). The daily median time from message receipt to crisis specialist triage ranges from 8 to 13 min, compared to 9 h before the deployment of the system. We demonstrate that a NLP-based machine learning model can reliably identify potential crisis chat messages in a telehealth setting. Our system integrates into existing clinical workflows, suggesting that with appropriate training, humans can successfully leverage ML systems to facilitate triage of crisis messages.

Inter-physician Communication in Pediatric Orthopaedics: What do Pediatricians Want to Hear From us?

Pediatric orthopaedic surgeons often communicate with general pediatric providers to facilitate patient care, but little data exist on communication preferences. This study investigates pediatric provider preferences regarding when they would like to receive patient updates from pediatric orthopedists, which communication modalities they prefer, and what information they like to receive. We developed a 19-question e-mail survey to evaluate provider preferences on communication modality, timing, frequency, and what data they deem important as it relates to musculoskeletal patient care. A total of 111 general pediatric providers in our geographical region completed the survey. Among the providers, 55.9% preferred fax, 40.5% electronic health record inbox message, 19.8% e-mail, 12.6% mail, and 7.2% call/voicemail. The majority (67.9%) preferred information in a traditional note format, whereas 24.8% preferred a summary in paragraph format. Patient diagnosis and treatment plan for shared patients were the most important pieces of information for general pediatric providers to receive from pediatric orthopedists. Of various patient-specific scenarios included in the survey, referrals for osteomyelitis concern, fractures requiring surgery, scoliosis concern, and developmental dysplasia of the hip requiring treatment were considered most important for pediatric orthopedists to send updates. In terms of frequency of communication, over half of the pediatric providers (59.5%) desired updates after the first visit and after care plan changes (50.5%). Only 43.5% of pediatric providers feel like current communication with pediatric orthopaedic surgeons is "always" or "often" adequate. Most of our surveyed providers preferred occasional SOAP notes through fax as communication from pediatric orthopaedic surgeons. The communication deemed most important to providers related to referrals where the provider makes the initial diagnosis and then refers the patient to orthopaedics for a condition with potential long-term patient impacts. Finally, providers felt communication was most important after the first pediatric orthopaedic office visit. Level III, survey based.

Improvement in post-ablation chest pain and same-day discharge with the use of active esophageal cooling

Abstract Background Active esophageal cooling is a common method of esophageal protection during radiofrequency (RF) ablation for the treatment of atrial fibrillation (AF). Compared to the main alternative, luminal esophageal temperature (LET) monitoring, active esophageal cooling reduces esophageal injury. Recent findings in the community hospital setting indicate that procedure time and post-ablation chest pain may also be reduced, leading to greater same-day patient discharge. Objective We aimed to compare the differences in same-day discharge rates and patient-reported post-ablation chest pain between patients treated with either LET monitoring or active esophageal cooling while undergoing RF ablation in a large academic medical center. Methods We reviewed data from RF ablations performed between January 2020 and October 2022 by five attending electrophysiologists and four electrophysiology fellows. These data were extracted from Epic’s Clarity database by two clinical informaticists. Extracted data points were paired with a manual chart review of inbound phone calls, electronic messages, follow-up visits, and readmissions within 30 days of the procedure. Results A total of 175 patients underwent RF ablation between January 2020 and October 2022, with 63 (36%) patients treated with LET monitoring and 112 (64%) treated with active esophageal cooling. Chest pain was reported by 11 patients (18%) in the LET monitored group and 7 patients (6%) in the actively cooled group (P=<0.001). Of the patients treated with LET monitoring, 13 (20.6%) were discharged within 12 hours of admission compared to 44 (39.3%) of the patients treated with active esophageal cooling (P=0.016). Conclusions The adoption of active esophageal cooling during RF ablation was associated with less postoperative chest pain and increased same-day discharge rates.

Design of Electronic Module ATS Message Handling System (AMHS) as Learning Media on Learning Management System (LMS) Aviation Polytechnic of Surabaya

The ATS Message Handling System (AMHS) electronic module was developed using the ASSURE model which is an acronym for (Analyze Learners, State Standards and Objectives, Select Methods and Strategies, Utilize Media, Require Learners Participation, and Evaluate & Revise). ASSURE is one of the simple learning designs that can create a learning that is expected to guide educators effectively, efficiently, and systematically and attractively. The aims of this research are: 1) To build and produce an electronic Module Design product ATS Message Handling System (AMHS) which can be used as learning on the Learning Management System (LMS) of Aviation Polytechnic Surabaya, 2) To determine and test the feasibility of the ATS Message Handling System (AMHS) electronic Module Design as a learning media on the Learning Management System (LMS) of the Aviation Polytechnic Surabaya. From this study it was found that the results of the Material Expert Validation Test obtained the "Valid" and "Very Understandable" categories. Then Media Validation Test 1 obtained the "Valid" and "Understandable" categories and Media Validation Test 2 obtained the "Valid" and "Very Understandable" categories, and the Learner Response Test obtained 90.4% of the "Very Good" or "Very Feasible" category. As a result, the ASSURE model in the ATS Message Handling System (AMHS) is very worthy (effective and efficient) in the context of utilizing learning on the Learning Management System (LMS) in Aviation Polytechnic of Surabaya.

Utilization of the medical oncology pager and call center: Characterizing forgotten pillars of telemedicine in the digital era.

518 Background: Oncology has entered the digital era, accompanied by changes in patient interactions and expectations involving telemedicine. While much emphasis is appropriately placed on digital interactions with patients, little is known about modern non-digital interactions with patients in oncology practices. Methods: We analyzed Medical Oncology Pager (MOP) data from 7/1/18 – 4/14/23, during which patients had access to the electronic health record and messaging capabilities. The MOP for Mayo Clinic (Rochester) is covered by the medical oncology fellows, including after hours (6PM – 7AM). It covers consults and direct patient calls after hours and during weekends, in addition to critical results back up and inpatient oncology matters at all times. We also analyzed Medical Oncology Call Center (MOCC) data since 6/1/22, which takes inbound patient calls during working hours (7AM – 6PM) and is staffed by appointment office employees. Results: The MOP received a total of 17,679 pages during the analyzed period for a mean of 10.1 pages per day. Of these, 6,319 pages occurred after hours. The most after-hours pages were received on Fridays (n=1,091) and the least on Sundays (n=701); of those years with fully available data, 2022 had the highest volume (n=1,405) (Table 1). When comparing the MOP activity pre-pandemic (7/1/18 – 3/10/20) and intra-pandemic (3/11/20 – 4/14/23), the mean number of after-hours pages per day was relatively stable with 3.47 pre-pandemic and 3.69 intra-pandemic. Since 6/1/22, the MOCC has averaged 6,464 inbound calls per month during working hours, each of which had an average talk time of approximately five minutes. The majority of inbound calls occur on Monday mornings between 9 – 11AM, with over 6,500 recorded throughout the previous year. Conclusions: Telemedicine is multi-faceted, comprised of both digital and non-digital patient interactions. We show that many oncology patients utilize telephone communication with the healthcare system despite increased availability of digital capabilities. These data have implications for addressing the digital divide for those with limited digital access, serving older patient populations unfamiliar with digital technologies, healthcare navigation, trainee responsibilities, and resource allocation. Further work and standardization in non-digital telemedicine is necessary as it remains a pillar of modern healthcare delivery and oncology practices.[Table: see text]

Pilot implementation study of a default genetic referral process for patients with young-onset colorectal cancer.

429 Background: Young-onset colorectal cancer (yCRC) diagnosed under age 50 is increasing at alarming rates, with >75% of young-onset cases occurring in patients between 40-49 years old. Although national guidelines recommend germline genetic risk evaluations for all patients with yCRC, multiple studies have shown suboptimal rates of guideline-recommended genetic evaluations. Methods: We conducted a pilot implementation study of a default genetic referral process for patients diagnosed with CRC between ages 40-49 from 1/2019-4/2022 at five hospitals in an academic health system. Patients previously referred to genetics were analyzed as a historical comparator cohort. In the intervention cohort, a research coordinator notified patients and their oncologists of their eligibility for a default genetic referral via an electronic patient portal message or telephone call, after which all patients who did not opt out within two weeks were referred for genetic counseling, testing, and result disclosure as per usual care. The primary outcome was feasibility, defined as a ≥60% referral rate; secondary outcomes included the proportion of genetic referrals that were scheduled, completed, and resulted in testing within three months of referral. Semi-structured exit interviews were conducted with a subset of patients and oncologists to assess attitudes toward the default genetic referral process. Results: We identified 128 patients with yCRC; 75 (59%) had previously been referred to genetics and were assigned to the historical cohort. There were no significant differences in sex, race, or ethnicity between the historical and intervention cohorts. All 10 patients with mismatch repair deficient tumors had previously been referred to genetics. Of the 53 patients in the intervention cohort, 49 (92%) were referred to genetics after one oncologist opted out on behalf of an international patient due to financial concerns and three patients requested to discuss with their oncologist before being referred. Of the patients who were referred, 38 (78%) were scheduled, 22 (45%) completed genetic counseling, and 13 (27%) underwent testing within three months of referral. Reasons for failing to complete the germline genetic risk evaluation process included lack of interest, competing priorities, communication/scheduling challenges, and failure to return saliva-based genetic testing kits. In exit interviews with 10 patients who completed testing and 10 oncologists, participants reported finding the default genetic referral process to be acceptable and feasible to implement. Conclusions: A default genetic referral process is feasible and results in a high referral rate for patients with yCRC, but subsequent scheduling, evaluation, and testing rates remain suboptimal. Multilevel implementation strategies are needed to address the patient, clinician, and system barriers identified in this study. Clinical trial information: NCT05018156 .

Changes in Physician Electronic Health Record Use With the Expansion of Telemedicine

Understanding the drivers of electronic health record (EHR) burden, including EHR time and patient messaging, may directly inform strategies to address physician burnout. Given the COVID-19-induced expansion of telemedicine-now used for a substantial proportion of ambulatory encounters-its association with EHR burden should be evaluated. To measure the association of the telemedicine expansion with time spent working in the EHR and with patient messaging among ambulatory physicians before and after the onset of the COVID-19 pandemic. This longitudinal cohort study analyzed weekly EHR metadata of ambulatory physicians at UCSF Health, a large academic medical center. The same EHR measures were compared for 1 year before the COVID-19 pandemic (August 2018-September 2019) with the same period 1 year after its onset (August 2020-September 2021). Multivariable regression models evaluating the association between level of telemedicine use and EHR use were then assessed after the onset of the pandemic. The sample included all physician-weeks with at least 1 scheduled half-day clinic in the 11 largest ambulatory specialties at UCSF Health. Data analyses were performed from March 1, 2022, through July 1, 2023. Physicians' weekly modality mix of either entirely face-to-face visits, mixed modalities, or entirely telemedicine. The EHR time during and outside of patient scheduled hours (PSHs), time spent documenting (normalized per 8 PSHs), and electronic messages sent to and received from patients. The study sample included 1052 physicians (437 [41.5%] men and 615 [58.5%] women) during 115 weeks, which provided 35 697 physician-week observations. Comparing the period before to the period after pandemic onset showed that physician time spent working in the EHR during PSHs increased from 4.53 to 5.46 hours per 8 PSH (difference, 0.93; 95% CI, 0.87-0.98; P < 0.001); outside of PSHs, increased from 4.29 to 5.34 hours (difference, 1.04; 95% CI, 0.95-1.14; P < 0.001); and time documenting during and outside of PSHs increased from 6.35 to 8.18 hours (difference, 1.83; 95% CI, 1.72-1.94; P < 0.001). Mean weekly messages received from patients increased from 16.76 to 30.33, and messages sent to patients increased from 13.82 to 29.83. In multivariable models, weeks with a mix of face-to-face and telemedicine (β, 0.43; 95% CI, 0.31-0.55; P < .001) visits or entirely telemedicine (β, 0.91; 95% CI, 0.74-1.09; P < .001) had more EHR time during PSHs than all face-to-face weeks, with similar results for EHR time outside of PSHs. There was no association between telemedicine use and messages received from patients, whereas mixed modalities (β, -0.90; 95% CI, -1.73 to -0.08; P = .03) and all telemedicine (β, -4.06; 95% CI, -5.19 to -2.93; P < .001) were associated with fewer messages sent to patients compared with entirely face-to-face weeks. The findings of this longitudinal cohort study suggest that telemedicine is associated with greater physician time spent working in the EHR, both during and outside of scheduled hours, mostly documenting visits and not messaging patients. Health systems may need to adjust productivity expectations for physicians and develop strategies to address EHR documentation burden for physicians.

Программные инструменты создания и анализа массивов текстов коротких электронных сообщений пользователей социальных сетей

The research aims at developing an algorithm for creating and analyzing a text data bank of short electronic messages (posts) from social networks using free software tools. The scientific novelty lies in the fact that to solve such a problem, an interdisciplinary approach is used, taking into account the latest achievements of applied and mathematical linguistics and information security, with the involvement of the current regulatory framework. In the course of the work, according to the proposed graphical model, textual research material of ca. 1.5 MB was collected using the Web Scraper plug-in; a text data bank of short electronic messages was generated, converted into a CSV format suitable for further processing; a basic analysis of this data bank was carried out using PolyAnalyst free software package, which included such procedures as the extraction of terms, entities and keywords, sentiment analysis and determination of the subject matter of texts. As a result, the functionality of the created algorithm was proven, prospects for further research were identified – working with big text data and analyzing this data to find destructive content in them.

Characterizing the Patterns of Electronic Health Record-Integrated Secure Messaging Use: Cross-Sectional Study.

Communication among health care professionals is essential for the delivery of safe clinical care. Secure messaging has rapidly emerged as a new mode of asynchronous communication. Despite its popularity, relatively little is known about how secure messaging is used and how such use contributes to communication burden. This study aims to characterize the use of an electronic health record-integrated secure messaging platform across 14 hospitals and 263 outpatient clinics within a large health care system. We collected metadata on the use of the Epic Systems Secure Chat platform for 6 months (July 2022 to January 2023). Information was retrieved on message volume, response times, message characteristics, messages sent and received by users, user roles, and work settings (inpatient vs outpatient). A total of 32,881 users sent 9,639,149 messages during the study. Median daily message volume was 53,951 during the first 2 weeks of the study and 69,526 during the last 2 weeks, resulting in an overall increase of 29% (P=.03). Nurses were the most frequent users of secure messaging (3,884,270/9,639,149, 40% messages), followed by physicians (2,387,634/9,639,149, 25% messages), and medical assistants (1,135,577/9,639,149, 12% messages). Daily message frequency varied across users; inpatient advanced practice providers and social workers interacted with the highest number of messages per day (median 19). Conversations were predominantly between 2 users (1,258,036/1,547,879, 81% conversations), with a median of 2 conversational turns and a median response time of 2.4 minutes. The largest proportion of inpatient messages was from nurses to physicians (972,243/4,749,186, 20% messages) and physicians to nurses (606,576/4,749,186, 13% messages), while the largest proportion of outpatient messages was from physicians to nurses (344,048/2,192,488, 16% messages) and medical assistants to other medical assistants (236,694/2,192,488, 11% messages). Secure messaging was widely used by a diverse range of health care professionals, with ongoing growth throughout the study and many users interacting with more than 20 messages per day. The short message response times and high messaging volume observed highlight the interruptive nature of secure messaging, raising questions about its potentially harmful effects on clinician workflow, cognition, and errors.

Feasibility and Usability of a Mobile App-Based Interactive Care Plan for Migraine in a Community Neurology Practice: Development and Pilot Implementation Study.

Migraine is a common and major cause of disability, poor quality of life, and high health care use. Access to evidence-based migraine care is limited and projected to worsen. Novel mobile health app-based tools may effectively deliver migraine patient education to support self-management, facilitate remote monitoring and treatment, and improve access to care. The risk that such an intervention may increase the care team workload is a potential implementation barrier. This study aims to describe a novel electronic health record-integrated mobile app-based Migraine Interactive Care Plan (MICP) and evaluate its feasibility, usability, and impact on care teams in a community neurology practice. Consecutive enrollees between September 1, 2020, and February 16, 2022, were assessed in a single-arm observational study of usability, defined by 74.3% (127/171) completing ≥1 assigned task. Task response rates, rate and type of care team escalations, and patient-reported outcomes were summarized. Patients were prospectively recruited and randomly assigned to routine care with or without the MICP from September 1, 2020, to September 1, 2021. Feasibility was defined by equal to or fewer downstream face-to-face visits, telephone contacts, and electronic messages in the MICP cohort. The Wilcoxon rank-sum test was used to compare continuous variables, and the chi-square test was used for categorical variables for those with at least 3 months of follow-up. A total of 171 patients were enrolled, and of these, 127 (74.3%) patients completed ≥1 MICP-assigned task. Mean escalations per patient per month was 0.9 (SD 0.37; range 0-1.7). Patient-confirmed understanding of the educational materials ranged from 26.6% (45/169) to 56.2% (95/169). Initial mean headache days per week was 4.54 (SD 2.06) days and declined to 2.86 (SD 1.87) days at week 26. The percentage of patients reporting favorable satisfaction increased from a baseline of 35% (20/57) to 83% (15/18; response rate of 42/136, 30.9% to 28/68, 41%) over the first 6 months. A total of 121 patients with MICP were compared with 62 patients in the control group. No differences were observed in the rate of telephone contacts or electronic messages. Fewer face-to-face visits were observed in the MICP cohort (13/121, 10.7%) compared with controls (26/62, 42%; P<.001). We describe the successful implementation of an electronic health record-integrated mobile app-based care plan for migraine in a community neurology practice. We observed fewer downstream face-to-face visits without increasing telephone calls, medication refills, or electronic messages. Our findings suggest that the MICP has the potential to improve patient access without increasing care team workload and the need for patient input from diverse populations to improve and sustain patient engagement. Additional studies are needed to assess its impact in primary care.

SAT135 Prospective Analysis For Improvement For Glycemic Control Using A Patient Portal And Automated Messages

Abstract Disclosure: C.C. Cristancho: None. M. Brandao: None. A. Lema Morocho: None. T. Amorim: None. Background: Type II diabetes is a complex metabolic disorder which is influenced in part by patient dietary choices, medication adherence, and environmental factors. Behavioral health interventions offer an opportunity to potentially affect patient outcomes in a cost-effective manner. Purpose: To study whether automated clinical messaging via the electronic medical chart would be associated with improvement in diabetes-related health measures. Methods: We created an automated clinical messaging system (January 2020) via our electronic medical record. Patients who opted-in for this service received bi-weekly messages which included reminders about diabetes medication adherence as well as exercise and dietary recommendations. We then performed a retrospective longitudinal analysis of patients followed in our diabetes clinic, comparing those who opted-in for messing vs those who did not, and assessed diabetes-related biomarkers including baseline and follow-up hemoglobin A1c, lipid markers, and BMI using linear mixed-effects regression models. Results: 69 patients who had at least 2 measures of hemoglobin A1c were followed longitudinally, of whom 37 (54%) had opted to receive automated messaging. Patients who opted-in were younger (53±12 vs 62±11 years old, p&amp;lt;0.1), but not different in terms of sex (60% F vs 61% F), BMI (31±6 vs 30±7, p=0.84), or A1c (9.4±2.3 vs 8.8±2.7, p=0.34). In the group that received messages, we did not find any significant pre-post differences in A1c, LDL, or BMI over time. In the opt-in group, mean change (over average follow-up of 256 days) in HgbA1c was -0.4 (p=0.42) compared to a change of 0.0 in the non-opt-in group (p=0.99). Discussion: Patients who opted-in to electronic messaging were younger on average. We did not observe any significant longitudinal change in diabetes-related biomarkers within or between groups as related to an automated clinical messaging service, although there was a directional trend toward improvement. Given the cost-effectiveness and ease of this program, consideration should be given toward a trial with a larger sample size and longer follow-up. Presentation: Saturday, June 17, 2023

Primary Care Physicians’ Preferences Regarding Communication from Orthopaedic Providers

Category: Other Introduction/Purpose: Musculoskeletal consultations constitute a growing portion of primary care physician (PCP) referrals. Optimization of communication between PCPs and orthopaedists can potentially reduce the time PCPs spend in the electronic medical record (EMR). This, in turn, may help reduce burnout. However, little is known about the preferences of PCPs regarding communication from orthopaedic specialists. The current study therefore investigated the preferences of PCPs across a large health network regarding communication from orthopaedists. Methods: One hundred and seventy-five PCPs across 15 practices within our health network were surveyed. These providers universally used the Epic Systems EMR. PCPs were asked to report their years in practice, panel size, typical number of electronic clinical messages received each day, time spent in the EMR after normal clinical hours, and burnout level. Likert scales and top-box scores were used to assess the PCPs’ perceived importance of communication from orthopedists in specific clinical scenarios. PCPs were further asked to report their preferred method of communication in each scenario and overall interest in communication from orthopaedists. Regression analyses were performed to determine if any PCP characteristics are associated with communication preferences and overall PCP interest in communication from orthopaedists. Results: A total of 107 (61%) PCPs completed the survey. PCPs most commonly rated communication from orthopaedists as highly important when the orthopaedist needed information from the PCP. In this scenario, PCPs preferred to receive an Epic Staff Message. Other scenarios rated as important included: the decision for surgery, hospitalization, and a major clinical change. In these scenarios, a CC’d Chart rather than Staff Message was preferred. Increased EMR use after-hours was associated with diminished odds of having high interest in communication from orthopaedists (odds ratio=0.65, 95% confidence interval: 0.48-0.88, P=0.005). Ninety-three PCPs (86.9%) reported spending at least 1 hour a day in Epic after normal clinical hours. Twenty-seven (25.2%) spent more than 3 hours. Forty-six PCPs (42.9%) reported experiencing at least one symptom of burnout. Conclusion: In the current study, there were distinct preferences among PCPs regarding clinical communication from orthopaedic surgeons. In addition, there was evidence of substantial burnout and after-hours work effort by PCPs. Our results may be helpful in optimizing communication between PCPs and orthopaedists, while also reducing time spent in the EMR by PCPs.

P‐IT‐3 | Communicating Information on Blood and Cell Products in HL7 FHIR Electronic Messages

P‐IT‐3 | Communicating Information on Blood and Cell Products in HL7 FHIR Electronic Messages