Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 5, 2024
Open Peer Review Period: Nov 15, 2024 - Jan 10, 2025
Date Accepted: Aug 14, 2025
(closed for review but you can still tweet)
Secure messages, video visits, and burnout among PCPs in the Veterans Health Administration: A national survey study
ABSTRACT
Background:
Telehealth use, including use of video visits and secure messages, expanded significantly in Veterans Health Administration (VHA) primary care during the COVID-19 pandemic. However, so did primary care provider (PCP) burnout.
Objective:
To examine the relationships between PCP burnout and video visit and secure message volumes.
Methods:
This study examined the relationship between virtual care modalities (i.e. video visits and secure messages) and burnout as reported by 17,034 PCPs in 138 VA healthcare systems from 2020 to 2023. We created logistic regression models using generalized estimating equations to analyze the relationships between individual-level PCP burnout and healthcare system-level video visits and secure message volume, controlling for individual-level demographic characteristics, healthcare system complexity, and year. We then predicted marginal means of PCP burnout by video visit or secure message volume, based model results.
Results:
Over four years, average PCP burnout increased from 42.1% to 52.7%, median annual video visits per 1000 patients increased from 15.9 to 227.6, and median annual secure messages per 1000 patients increased from 23.4 to 35.3. In our fully adjusted models, video visit volume was not related to burnout, but secure message volume was related – on average, PCP burnout increased by 1.1 percentage points for each additional increase of 40 secure messages.
Conclusions:
As video visits and secure messages continue to grow, solutions to better manage message volume (e.g., automation, provider-led quality improvement) are needed to slow a concurrent rise in PCP burnout.
Citation
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Copyright
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