Quantifying the impact of telemedicine and patient medical advice request messages on physicians' work-outside-work

• Published in: NPJ digital medicine 2024-02, Vol.7 (1), p.35-35, Article 35
• Main Authors: Mandal, Soumik, Wiesenfeld, Batia M., Mann, Devin M., Szerencsy, Adam C., Iturrate, Eduardo, Nov, Oded
• Format: Article
• Language: English
• Subjects: 692/700/1538; 692/700/228; Biomedicine; Biotechnology; Digital technology; Medicine; Medicine & Public Health; Pandemics; Physicians; Primary care; Telemedicine; Working hours; Workloads
• ISSN: 2398-6352; 2398-6352
• DOI: 10.1038/s41746-024-01001-2

The COVID-19 pandemic has boosted digital health utilization, raising concerns about increased physicians’ after-hours clinical work ("work-outside-work”). The surge in patients’ digital messages and additional time spent on work-outside-work by telemedicine providers underscores the need to evaluate the connection between digital health utilization and physicians’ after-hours commitments. We examined the impact on physicians’ workload from two types of digital demands - patients’ messages requesting medical advice ( PMAR s) sent to physicians’ inbox (inbasket), and telemedicine. Our study included 1716 ambulatory-care physicians in New York City regularly practicing between November 2022 and March 2023. Regression analyses assessed primary and interaction effects of ( PMAR s) and telemedicine on work-outside-work. The study revealed a significant effect of PMAR s on physicians’ work-outside-work and that this relationship is moderated by physicians’ specialties. Non-primary care physicians or specialists experienced a more pronounced effect than their primary care peers. Analysis of their telemedicine load revealed that primary care physicians received fewer PMAR s and spent less time in work-outside-work with more telemedicine. Specialists faced increased PMAR s and did more work-outside-work as telemedicine visits increased which could be due to the difference in patient panels. Reducing PMAR volumes and efficient inbasket management strategies needed to reduce physicians’ work-outside-work. Policymakers need to be cognizant of potential disruptions in physicians carefully balanced workload caused by the digital health services.