Background: Effective interpersonal communication is critical in healthcare. Historically, pagers, phone calls, and in-person conversations have been the main form of in-hospital communication. New communication technologies, such as electronic messaging, are increasingly becoming the primary way for healthcare workers to communicate. In 2017, 27% of Society of Hospital Medicine responding organizations reported some use of [...]

Background: With the advent of the Electronic Medical Record (EMR), documentation occupies up to 50% of doctors’ time1 and prior work has revealed that internal medicine residents spend more than four hours daily on documentation2. Secure messaging (SM) has been recently integrated into the inpatient EMR system, allowing healthcare team members to directly message physicians; [...]

Background: Early discharges from inpatient units improve throughput from the Emergency Department (ED) and reduce ED boarding. ED boarding increases patient safety events, provider burnout, and decreases patient satisfaction. Multidisciplinary communication between hospitalists, nursing staff and case management is essential for facilitating early discharges from inpatient medicine units. Such communication frequently requires in-person care coordination [...]

Background: Secure text messaging is a primary mode of clinician-to-clinician communication in large acute care hospitals. However, the accessibility and ease of secure messaging, and a lack of best practice recommendations, raise the risk of overuse. Multitasking demands from secure messaging challenge clinicians as they engage in focus-intensive patient care tasks. To address this, we [...]

Background: Large Language Model (LLM) chatbots, like ChatGPT (from Open-AI), have received widespread attention in the last year for their ability to process large amounts of text data and produce human-like script responses on a wide array of topics. In particular, LLM chatbots have performed well in areas of patient communication, whether it’s answering cardiovascular [...]

Background: The personal statement (PS) is a crucial factor in a residency program’s evaluation of applicants and has traditionally been helpful in understanding applicants’ journeys in medicine, values, and written communication skills. Now, with accessible large language models (i.e. ChatGPT) designed for language composition, there is interest in how these models may be utilized by [...]

Background: The process by which patients are admitted to the inpatient setting after evaluation in the emergency department (ED) is a critical component of their care transition. Striking the proper balance between the speed of the process and the quality of the communication is paramount to optimizing workflows and ensuring patient safety. At our institution, [...]

Background: We created a generative artificial intelligence chatbot (“VLRChat”) that draws from a comprehensive curricular resource (the 480-page Vanderbilt Housestaff Handbook) to answer point-of-care clinical questions by hospitalists and inpatient clinical teams. Time constraints and cognitive overload frequently prevent hospitalist faculty and learners from determining the optimal, most current answers to clinical questions: as many [...]

Background: Recent research highlights that in-hospital communication increasingly is relying on secure electronic messaging with notable unintended consequences, including increasing task switching and the overall burden of communications. This study sought to quantify non-actionable, non-urgent messages to better understand their prevalence and to develop interventions aimed at optimizing communication workflows. Methods: A qualitative content analysis [...]

Background: Evidence suggests female physicians experience higher rates of burnout compared to male counterparts1,2. The Electronic Health Record (EHR) is a recognized source of physician burnout (4,5,6). Therefore, efforts to understand gender disparities in EHR use may offer insights into burnout disparities at large. Studies in outpatient settings have found female physicians spend more time [...]