Surprisingly Helpful: The Introduction of Portal Practice Slots to Address the Inbasket Explosion

• DOI: 10.1007/s11606-025-09582-8
• Publication Date: 2025-05-29T12:12:07Z
• Authors: Jennifer Reilly L...; James Henderson; Audrey Fan; Julia Chen; John Brinley; Joel Scharboneau; Eve A. Kerr

Abstract

Background Despite the dramatic increase in the volume of electronic health record (EHR) inbasket work, most organizations have not provided additional time to attend to this asynchronous care delivery.

Aim To improve physician well-being and reduce time spent in the EHR outside of work by providing structured time during the workday to address inbasket workload.

Setting An academic health system in the Midwest.

Participants Physicians in general medicine and medicine pediatrics with ≥ 1 half-day of clinic per week.

Program Description Implementation of one 20-min “portal practice slot” (PPS) in schedule templates per clinic half-day (4 h).

Program Evaluation After the intervention, a survey was distributed to assess physicians’ perceptions regarding the impact of PPS on workload and work-life balance. We also assessed for change in hours spent in the EHR on evenings and weekends (“pajama time”), relative value units (RVUs), and patient visits.

Discussion Despite no decrease in measured pajama time, most physicians reported that PPS improved their ability to complete asynchronous care and inbasket tasks in a timely manner during the workday. There was no significant change in the number of visits, visit hours, or RVUs generated. PPS appeared to be a successful tool to decrease the sense of “overwhelm” created by inbasket work and improve physician well-being.