Purpose: This study aimed to establish perceived workload and ambulatory care registered nurse (RN) and medical assistant (MA) emotions about electronic health record (EHR) patient portal messages and provide insight on end user archetypes for leadership to tailor change management prior to widespread adoption/integration of large language models (LLMs) into EHRs.

Background: As healthcare experiences a critical workforce shortage aggravated by pandemic-related burnout, the increasing reliance on electronic health records has intensified stress among clinicians, especially with the burgeoning volume of patient communications facilitated by patient portals. This academic health science center experienced an exponential increase in patient messages from 332,000 messages total between fiscal years (FY) 2014 to 2018 to 1.6 million messages in FY 2023; thereby significantly adding to RN and MA administrative responsibilities. The release of the generative artificial intelligence (AI) product ChatGPT in November of 2022 and the subsequent explosion of large language models hold the potential to transform health care by enhancing patient care through improved diagnostic support, personalized treatment recommendations, and more efficient management of clinical data. Existing discussions around AI's role in health care have largely centered on licensed independent practitioners, leaving a gap in understanding the needs and sentiments of vital support staff like RNCs and PCCs.

Methods: This is descriptive study using validated survey instruments (Joyful Workplace Mini Z 2.0, Knowledge and Perception of AI, and Technology Readiness Index [TRI] 2.0) and investigator-designed questions about burnout and technology readiness. Participants were recruited via convenience sampling from ambulatory care clinics at a large academic health science center.

Results: Data collection is currently in progress with 281 participants, RNs=125 (44.48%) and MAs (n=156, 55.52%), with a target of 300 respondents.

Conclusion: The rapid adoption of AI and large language models is transforming various aspects of life, including health care, where systems are restructuring electronic health records to enhance workflow efficiencies. It is essential to consider the input of ambulatory care nurses and medical assistants regarding these potentially transformative tools for drafting responses to patient portal messages before their further adoption or deployment.

Chrystal Lewis PhD, RN

Appearances