Difference between revisions of "Alert fatigue"

From Clinfowiki
Jump to: navigation, search
 
m (Alert Fatigue? moved to Alert Fatigue)
(No difference)

Revision as of 13:55, 23 April 2006

Alert fatigue or otherwise known as "pop-up" fatigue is a common occurrence with the recent implementation of EMRs (electronic medical records) and specifically DS (decision support). Given that medical errors receive much press in reality many of the errors are secondary to a providers difficulty with knowledge management. Clearly, given the volume of information an average ambulatory provider must remember is too much. The volume increases daily and in order to keep current a provider needs help. Decision support is one type help that has evolved. As stated by Dr Eric Rose, "where human brains fail, computers excel." One form of tools to aid the provider is alerts. Alerts can be in the form of "pop-ups," contact-dependent (during access of patient's record), and/or contact-independent (alert "delivered" to provider). The alerts, while found to be beneficial in some cases, can result in a type of "fatigue" whereby the provider, after receiving too many alerts, begins to ignore the alerts. Receiving too many alerts can result in slowing the provider down rendering the alert useless. For example, in Portland, Oregon the Multnomah County Health Department, which recently implemented an EMR, decided to significantly reduce the number of drug-drug interactions providers were seeing during order entry. The providers felt in order to "get through their daily work," they were forced to override several of the drug-drug interactions. By changing the severity level of drug-drug interactions providers have commented positively on the drug-drug interaction alerts. Some suggestions to avoid alert fatigue are alerts should be not overused, not repeated several times a day, alert gives enough time to make a decision, and creating selectively targeted alerts. Likewise, an in depth analysis of the practice/provider's needs (e.g. provider wanting alert to remember a lab needing ordered or practice need to identify the eligible influenza immunization patients) can result in a significant "buy-in" resulting in an effective alert with improved outcomes.

Amit Shah, MD

References: Rose E. "Life after Go-Live, Part 4: Preventing Error in an EMR." Journal of Healthcare Information Management. Vol 17, No.4.

Krall M. "Clinicians' Assessments of Outpatient Electronic Medical Alert and Reminder Usability and Usefulness Requirements: A Qualitative Study." May 2002.