Electronic alerts can hinder patient safety, need refining, experts say

EHR automated safety alerts are pinging in abundance on clinicians' digital devices, and some in the medical community have expressed concern that alert fatigue could ultimately compromise patient safety, according to a recent article published in The Washington Post.

Alert fatigue is not an esoteric concept for anyone who carries a smartphone. Alerts from social media applications along with reminders for appointments and social engagements can fill a hand-held screen in moments, leading to some form of digital alert burnout.

Physicians have their own brand of alert fatigue. Pop-up messages regarding patients can become unmanageable over time. While one alert may issue a warning about a drug being prescribed that could adversely interact with medications a patient is already taking, others can be less helpful. Redundancies can occur when an alert is issued every time a patient is prescribed a painkiller, which can assist with addiction detection, but is less helpful if a patient has just come from major surgery. Or the alerts could be inept all together, warning of health concerns pertinent for an elderly female when the patient is a male in his twenties.

Shobha Phansalkar, PhD, an assistant professor of medicine at Harvard Medical School in Boston, told the Post clinicians ignore safety notifications between 49 percent and 96 percent of the time. This proves problematic as a critical alert could go unnoticed by a clinician bombarded by pop-up alerts.

"This is an issue that everyone's going to have to wrestle with eventually," Bill Marella, executive director of patient safety operations and analytics at ECRI Institute, told the Post. In April, ECRI listed the implementation of new health IT systems as a top 10 safety concern for 2016.

For its part, Epic Systems has added features to their EHRs that allow certain alerts to be turned off. According to the Post, systems designers are attempting to better understand the complexity of medical needs so they can streamline the warning system.

Helen Haskell, president of Mothers Against Medical Error, told the Post that the alert systems have had a positive impact on patient safety. "All of these alerts have really reduced medication interactions. It's a service...it just needs to be refined," she said.

More articles on quality: 
Ohio Hospital Association launches patient tracking system for mass casualty incidents, disasters 
White House puts $200M toward shortening organ waiting list 
The Beryl Institute calls for presentation submissions for Patient Experience Conference

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