Characterization of interprofessional electronic health record secure messaging related to hospitalized oncology patients.

591 Background: Electronic health record (EHR)-based secure messaging (SM) facilitates communication among healthcare professionals (HCPs). Understanding these communication patterns regarding oncology inpatients could improve quality and patient outcomes. We characterized differences among inpatient SM related to distinct oncologic services. Methods: This IRB-approved retrospective cohort study analyzed SM metadata related to adults admitted to solid tumor (ST), malignant hematology (MH), or BMT services across 3 NYU hospitals from Jan '23-Aug '24. Metadata included patient and clinician messages. Primary oncologists were defined as the two outpatient providers seen most often over the past 5 years. Mean daily SM volumes per patient were compared across oncologic services using Kruskal-Wallis test. SM volume was also compared by HCP role. Results: Among 2,480 hospitalizations, 905,806 SM were sent. ST admissions (n=1,315) accounted for 484,400 SM, averaging 58.7 messages per patient per day (IQR: 39.4–69.1). MH (n=608) patients saw similar daily averages (59.4, IQR: 40.4–71.9) with 257,730 SM. BMT patients (n=557) had significantly lower daily message volumes (47.0, IQR: 24.3–62.3, p < 0.001) with 163,676 total messages. Nurses sent the majority of inpatient SM and represented the largest group across all services (Table 1). Medicine attendings contributed most to ST messaging, whereas housestaff and APPs had the largest share in BMT. Daily SM volumes for all admitted oncologic patients exceed those from historical general medicine inpatients previously described by our group by over 40% (33.7 messages/patient/day, per Small et al. JAMA Network Open 2023). Further data will be presented with direct comparisons of this control group. Conclusions: Total and role-based SM volumes differed across inpatient oncologic services and was greater than published volumes for hospitalized general medicine patients. These results suggest that oncology patients require a higher degree of interprofessional communication that may be related to the acuity of their inpatient care. Ongoing analyses are examining associations between cancer stage, comorbidities, and inpatient acuity with SM volume to identify potential targets to optimize care and reduce SM burden on HCPs. HCP ST (N=484,400) (%) 1 MH (N=257,730) (%) 1 BMT (N=163,676)(%) 1 Medicine Attending 51492 (10.6%) 17492 (6.8%) 2122 (1.3%) Medicine Housestaff 55994 (11.6%) 55394 (21.6%) 1056 (0.7%) Medicine APP 70297 (14.5%) 22500 (8.7%) 55645 (34%) Primary Outpatient Oncologist 12318 (2.5%) 4650 (1.8%) 3572 (2.2%) Nurse 149271 (30.8%) 84847 (32.9%) 63611 (38.9%) Consultants 66092 (13.6%) 33573 (13.0%) 6604 (4.0%) Allied Health Professionals 50662 (10.4%) 26211 (10.2%) 23636 (14.4%) Technician & Other 28274 (5.8%) 13063 (5.1%) 7430 (4.5%) 1 Percent of total SM among all 3 services.