Evaluating the Scope of Clinical Electronic Messaging to Coordinate Care in a Breast Cancer Cohort.

Care coordination has received attention as an opportunity to improve healthcare delivery. Current work to quantify provider coordination has primarily relied on identifying shared patients, but neglects to understand communication patterns. We applied social network analysis to electronic health record (EHR) secure messaging data to compare networks of providers who share patients and networks of providers who communicate about patients. We studied 2175 stage I-III breast cancer patients who received outpatient treatment from 1758 providers at a large academic medical center in the southeastern United States. Patients in our cohort were involved in 94324 appointments and were the subject of 307144 message threads. We found that 9.9% of provider-provider pairs that shared patients were mutually involved in electronic communication about their patients. EHR data sources can be used to evaluate provider communication across a clinical enterprise, which can help identify opportunities to improve collaboration and reduce provider burnout.