There has been a lot of discussion in the Health Information Technology (HIT) community lately regarding the number of alerts physicians receive through electronic health records (EHR) systems. Discussions focus on the possibility of alert fatigue, which is caused by physicians’ frustration at receiving numerous alerts through EHR systems, sometimes leading to warnings being ignored. While the alerts are designed to caution physicians of possible patient safety issues, such as drug interactions, many are afraid the frequency of warnings and the non-essential nature of some alerts may cause physicians to see them as an electronic version of “the boy who cried wolf.”
However, even though the discussion has focused on the potential drawbacks, physicians and patients alike already benefit greatly from EHR alerts currently in place. Many also believe that it’s better to hear complaints about too many alerts, versus not having them in place–thus resulting in poor patient outcomes.
Current electronic alerts include two types–prescription and clinical-decision support. Meaningful Use, as defined by the Office of the National Coordinator for Health Information Technology, requires the implementation of at least one clinical-decision support rule in addition to prescription alerts.
Prescription alerts warn physicians of potential adverse drug events such as interactions with other medications, along with allergy warnings. These alerts benefit physicians by allowing them to save time by quickly choosing another prescription, and by providing instant access to information they can share with patients. Patients benefit because they are saved from potential drug interactions and/or allergic reactions, and also because they are saved the hassle of returning to a pharmacy or physician office to get another prescription. With alerts, patients receive the best treatment from the start.
EHR systems can also provide physicians with alerts that support clinical decisions. These alerts remind physicians about patient tests, procedures or screenings that might be necessary. For example, a flu vaccination alert may be generated for all patients, while a mammogram alert will come up only for female patients of a certain age. The goal is to help physicians properly diagnose patients and identify gaps in care, prompting physicians to ask the right questions or run appropriate tests to prevent errors and improve patient outcomes. These alerts are also benefitting physicians. In a survey by KLAS, nearly one-fifth of healthcare providers said that clinical decision support alerts were one element that had the most positive impact on their organizations.
Recent research, such as a study published in the International Journal of Medical Informatics, found that alerts in EHR systems do need improvements to avoid physician alert fatigue. As technology advances, the management of electronic alerts will become better and more intuitive for physicians. Until then, what types of alerts have you found to be most beneficial for your practice?