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- Presentation
EHR-Embedded Tools to Improve Dermatology Patient Communication, Triage, and In-Basket Efficiency
Description
Kelly Flanagan presented a quality improvement project from UMass Dermatology aimed at improving patient communication, intake, and triage while reducing provider and staff burden from growing EHR in-basket volume. The department had seen steadily increasing portal messages and calls, with many direct patient questions requiring multiple touch points and substantial clinician time, contributing to fatigue and burnout. To address this, the team created EPIC-embedded SmartPhrases and a DERM intake smart button that guides staff through structured forms for common concerns such as rash, lesion of concern, surgical/laser issues, and medication refills. These tools standardize data gathering, identify red flags, and route messages appropriately so urgent issues are escalated quickly and non-urgent concerns reach providers with the needed information already collected. The project’s goals are to reduce patient response times, increase the proportion of messages handled independently by staff, and decrease provider hours spent on inbox management. Early experience has already shown improved independent handling by staff, and future evaluation will use EPIC dashboards, repeat provider surveys, and staff feedback. The team also noted strong support from union leadership, which estimated the tools could save significant staff time each day.
View moreConclusions
- Patient communication volume in dermatology is steadily increasing, making inbox management a growing operational burden.
- Before the intervention, only a small minority of messages were being handled independently by clinical staff, and message chains required many touchpoints.
- Inefficient triage and routing of calls and portal messages can delay care and potentially contribute to disease progression and patient harm.
- Provider inbox workload is substantial and is perceived by most clinicians as contributing to fatigue and burnout.
- Embedding standardized Epic Smart Phrases and intake tools can improve data gathering, triage, and routing of patient concerns.
- Structured intake workflows help staff identify urgent issues more quickly and route nonurgent issues with the needed information already collected.
- Early implementation plus staff training increased the share of messages handled independently by clinical staff.
- The intervention is intended to reduce response times, decrease provider burden, and improve both patient and staff experience.
- The projected time savings for staff suggest the tools may meaningfully improve clinic efficiency if sustained and expanded.
- Further analysis with Epic data and surveys is needed to determine the long-term impact and to guide broader rollout of additional smart phrases.
- Kelly Flanagan, MD MS; Jessica St. John, MD MBA MPH; Leona Cote; and Rita Khodosh, MD PhD. UMass Chan Medical School. AAD Resident Quality Improvement Symposium March 2026.
- UMass Dermatology Internal Provider Survey (January 2026).
- Data Source: EMR (Epic).