Abstract 4369842: A Growing Burden of Electronic Medical Record Messages in ACHD Care

Background: The rapid growth in the adult congenital heart disease (ACHD) population has led to an associated increase in the volume of patient visits at congenital heart centers. This has in turn led to a rise in the number of electronic medical record (EMR) messages to ACHD Care Teams. We aimed to evaluate the rate of growth in clinically related patient messages in the EMR for the ACHD service compared to the pediatric cardiologists at a large quaternary care center. Material and Methods: In this single center retrospective analysis performed at an accredited ACHD and pediatric cardiology referral center, the EMR was queried to obtain the number of annual outpatient clinical visits and the volume of patient messages received by an ACHD cardiologist from January 2022 through December 2024, compared with four established pediatric cardiologists during the same timeframe. Results: The number of messages received by a single established ACHD cardiologist increased significantly over the three years: 2022: 3,386 messages, 2023: 4,536 messages, 2024: 6,863 messages. In comparison, the average number of messages received by four pediatric cardiologists were: 2022: 2,440 messages, 2023: 2,714 messages, 2024: 2,763 messages. Over three years, the number of messages received by an ACHD cardiologist increased by 102.7%, compared to a 13% increase in the average number of messages received by the four pediatric cardiologists. Over three years, the ACHD cardiologist received 4,928 messages (SD ± 1,565), while pediatric cardiologists received a mean of 2,639 messages (SD ± 142) (p-value < 0.05). The ratio of patient messages relative to annual outpatient clinic visits for the ACHD service was noted to be three to four times greater than the pediatric cardiology providers. Conclusions: In a high-volume congenital heart center, the total volume of patient messages and the annual rate of increase were significantly higher for the ACHD service compared to the pediatric cardiology providers. This highlights the need for innovative and creative strategies to address the growing indirect clinical care needs of this complex patient population.