Loading...
Exploring Secure Chat Usage and Etiquette Perceptions in Clinical Settings
Callard, Danielle Cheng, Ryan Cangiano, Michelle McEntee, Rachel Li, Yao
Callard, Danielle
Cheng, Ryan
Cangiano, Michelle
McEntee, Rachel
Li, Yao
Citations
Altmetric:
License
Attribution-NoDerivatives 4.0 International
Abstract
Background: Secure chat platforms transformed communication within healthcare systems, including the University of Vermont Health Network (UVMHN). While most research focused on inpatient settings, outpatient usage dynamics remain underexplored [1], and its impact on workflow, user experience, and communication etiquette remains unclear. Issues like message overload, interruptions, and unclear guidelines on appropriate usage are emerging concerns [2,3], particularly as these challenges differ by clinical role and setting, influencing how secure messaging is perceived and utilized.
Objective: To assess how clinical staff use Secure Chat, its impact on work and personal time, and perceptions of message appropriateness, with the goal of guiding improvements in training and etiquette standards.
Study Design: A survey was distributed to clinicians and support staff within inpatient Internal Medicine departments and outpatient Family Medicine offices across UVMHN. The questionnaire comprised 15 items covering demographics, usage patterns, impact on workflow, and perceptions of message appropriateness and etiquette.
Results: A total of 126 responses were collected, with nearly equal representation from outpatient ( 46.8%) and inpatient ( 46. 0%) settings. Some message types were consistently viewed as appropriate across settings, while others varied in both perceived appropriateness and frequency of receipt. Urgent clinical concerns (66.7% appropriate) and clinical updates visits (90 .5 % ) were broadly seen as appropriate, with no significant differences by setting. In contrast, clinical updates outside of visits, polite acknowledgments, and administrative messages received mixed ratings ( ~55% appropriate); only polite acknowledgments showed higher frequency of receipt in inpatient settings (93.0% vs. 62.0%; p < .001 ). Greater variation was observed for non-urgent clinical questions, viewed as appropriate by 75.4% (p < .001) and more frequently received by inpatient respondents (91.4% vs. 61.0%; p < .01 ); worldlow-related messages, with higher inpatient endorsement (80.7% vs. 61.0%; p < .05); and message reactions, which were highly favored overall (89. 7%; p < .001) and more strongly endorsed (96.5% vs. 72.4%; p < .001) and frequently received (98.2% vs. 72.4%; p < .001) in inpatient settings. Most respondents showed strong communication awareness, but gaps in effectively managing availability settings and notifications, especially among outpatient providers. A significant portion of providers reported missing important messages ( 43. 7%) due to high message volume and notification fatigue. These findings underscore the need for enhanced guidelines and training support to better align communication behaviors and etiquette standards across clinical settings.
Expected Outcomes: Further analysis will be conducted. Future studies should explore specialty-specific differences and examine underlying reasons for varying attitudes toward communication etiquette.
Citations:
Baratta LR, HarfordD, Sinsky CA, Kannampallil T, Lou SS. Characterizing the Patterns of Electronic HealthRecord-Integra1ed Secure Messaging Use: Cross
Sectional Study. J Med Internet Res. 2023 Oct 6;25 :e48583. doi: I 0.2196/48583. PMID: 37801359; PM CID: PMCI 0589827.
Lew D, Baratta LR, Xia L, Eiden E, Sinsky CA, Kannampallil T, Lou SS. AssociationofEHR-Jntegrated Secure Messaging Use with Clinician Workload and
Attention Switching. J Gen Intern Med. 2025 Mar 14. doi: 10.1007 /s l 1606-025-09466-x.
Lou SS, Lew D, Xia L, Baratta L, Eiden E, Kannampallil T. Secure Messaging Use and Wrong-Patient Ordering Errors Among Inpatient Clinicians. JAMA
Description
Date
2025
Student Status
Journal Title
Journal ISSN
Volume Title
Type of presentation
An error occurred retrieving the object's statistics