Scholes Julianne, Schiff Lauren, Jacobs Alicia Ann, Cangiano Michelle, Sandoval Marie
University of Vermont Larner College of Medicine, Burlington, United States.
Family Medicine, University of Vermont The Robert Larner MD College of Medicine, Burlington, United States.
Appl Clin Inform. 2025 May 22. doi: 10.1055/a-2618-4580.
Electronic Health Record (EHR) patient portal messaging has become as essential tool for patient-clinician communication by improving accessibility to primary care. While messaging is beneficial for patients, it can increase clinicians' workloads. Female clinicians receive a greater number of EHR messaging, resulting in an increased workload.
This evaluation explores the factors in clinician gender disparity in EHR messaging burden.
The first phase of the evaluation included a retrospective analysis of the messages to 267 primary care clinicians in the University of Vermont Health Network (UVMHN). The second phase analyzed patient demographics and panel complexity. Statistical analysis was performed on the types of patient-initiated messages to primary care clinicians and subsequently on all messages across the UVMHN.
Female clinicians received significantly more patient-initiated medical advice requests than their male counterparts (68.28 vs. 49.22 messages/month, p=0.005) and spent more time managing messages (1.85 vs. 1.35 min/day, p=0.006). Despite this increased workload, response times remained similar between genders. Female clinicians have a higher proportion of female patients, and analysis of all messages sent across the organization demonstrated that female patients send more messages than male patients. (59 vs. 52 messages/female vs. male, p=0.001). Panels size and complexity were similar for both male and female providers.
These findings highlight an unequal messaging burden for female clinicians, largely due to patient demographics. Patient panel complexity and clinician full-time equivalent (FTE) were similar between genders. Disparities in message volumes appear to be driven primarily by patient communication behavior differences between genders rather than differences in workload allocation. These findings likely contribute to increased burnout risk among female clinicians. Addressing this imbalance through workflow optimization and AI-driven message triage systems may help to mitigate the burden on female clinicians and promote greater equity in primary care.
电子健康记录（EHR）患者门户消息传递已成为患者与临床医生沟通的重要工具，有助于提高初级医疗服务的可及性。虽然消息传递对患者有益，但它会增加临床医生的工作量。女性临床医生收到的EHR消息数量更多，导致工作量增加。
本评估探讨EHR消息传递负担中临床医生性别差异的因素。
评估的第一阶段包括对佛蒙特大学健康网络（UVMHN）中267名初级医疗临床医生收到的消息进行回顾性分析。第二阶段分析了患者人口统计学特征和患者组复杂性。对患者发起给初级医疗临床医生的消息类型进行了统计分析，随后对UVMHN中的所有消息进行了分析。
女性临床医生收到患者发起的医疗建议请求明显多于男性同行（每月68.28条对49.22条，p = 0.005），且花费更多时间管理消息（每天1.85分钟对1.35分钟，p = 0.006）。尽管工作量增加，但不同性别的响应时间保持相似。女性临床医生的女性患者比例更高，对整个机构发送的所有消息进行分析表明，女性患者发送的消息比男性患者多（女性患者平均每人59条对男性患者平均每人52条，p = 0.001）。男性和女性医疗服务提供者的患者组规模和复杂性相似。
这些发现凸显了女性临床医生承担的消息传递负担不平等，主要原因是患者人口统计学特征。不同性别的患者组复杂性和临床医生全职等效工作量（FTE）相似。消息量的差异似乎主要由不同性别的患者沟通行为差异驱动，而非工作量分配差异。这些发现可能导致女性临床医生倦怠风险增加。通过工作流程优化和人工智能驱动的消息分类系统来解决这种不平衡，可能有助于减轻女性临床医生的负担，并促进初级医疗服务中的更大公平性。
