Reducing Alert Burden in the EHR: Multi-institutional Evaluation

Key Takeaways:

• Highlighting innovative methods to reduce alert fatigue, thereby enhancing the focus and efficiency of healthcare providers.
• Offering actionable guidance and best practices for clinical informaticists and healthcare leaders to build robust programs for managing EHR alerts.
• By refining alert management practices, showcase the potential for improved patient care and clinician well-being, fostering an environment where technology complements rather than complicates medical practice.

INTRODUCTION

Within the modern healthcare systems, the incessant buzz of electronic health record (EHR) alerts has emerged as a double-edged sword. On one hand, these alerts are designed to aid clinical decision-making; on the other, their overwhelming frequency has led to alert fatigue, risking patient safety and clinician efficacy. The paper by McGreevey et al, "Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems," serves as a focus for healthcare entities grappling with this issue, offering a compilation of strategies and insights from four healthcare institutions at the forefront of addressing this challenge.

APPROACH

The core approach advocated is a holistic review and reformation of alert management practices across varied healthcare settings, from academic to community-based institutions. This involves a meticulous analysis of governance structures, management strategies, and the dynamics of human-computer interactions that underpin alert systems. By drawing on the collective experiences and successes of the participating health systems, the article provides a roadmap for implementing structural changes that prioritize clinical relevance and minimize unnecessary interruptions.

RESULTS

Embarking on this journey reveals a multi-dimensional landscape of alert management, encompassing a broad spectrum of considerations:

• Background Literature: An exploration into the genesis and evolution of alert fatigue, underpinning the necessity for strategic intervention.
• Governance and Alert Metrics: The establishment of governance frameworks that entail regular review cycles, ensuring alerts remain relevant and effective. Concurrently, the adoption of alert metrics facilitates a quantitative assessment of alert utility and impact.
• Optimization Strategies: Success stories from participating institutions showcase the tangible benefits of alert optimization, including reduced alert volumes without compromising patient care quality.

This comprehensive analysis underscores the potential for marked improvements in alert management, highlighting instances where targeted interventions have led to significant reductions in alert burden and enhanced clinical workflows.

DISCUSSION

The discourse surrounding alert management in EHR systems is a testament to the nuanced interplay between technology and human-centric care. The discussion in the article emphasizes the necessity for solutions that respect the unique operational dynamics of healthcare institutions. It acknowledges the constraints inherent in current evaluation methodologies for alerts and advocates for an ongoing dialogue within the medical informatics community to refine and evolve alert management practices.

Furthermore, the discussion casts a spotlight on the broader implications of alert fatigue, linking it to clinician burnout and the imperative for creating a sustainable healthcare ecosystem where technology acts as a facilitator rather than a hindrance.

EVALUATING YOUR CDS USING THESE METHODS

For healthcare organizations seeking to harness the insights from this paper, the path forward involves a commitment to iterative improvement and adaptability. The process begins with a critical evaluation of existing alert systems, identifying areas where alerts may be redundant, irrelevant, or improperly targeted. Key steps include:

• Implementing Structured Governance: Establishing a governance model that enables regular scrutiny and recalibration of alert systems. This involves forming multidisciplinary teams that bring together clinical experts, informaticists, and IT professionals to oversee alert management policies.
• Leveraging Data for Informed Decision-Making: Utilizing analytics to gather actionable insights on alert performance, enabling data-driven decisions to optimize alert thresholds, parameters, and delivery mechanisms.
• Fostering a Culture of Continuous Learning: Encouraging feedback loops where clinicians can share their experiences and challenges with alert systems. This collective intelligence can inform ongoing refinements, making alert systems more intuitive and less intrusive.

By adopting these strategies, healthcare organizations can transform their alert systems into efficient mechanisms for enhancing patient safety and clinician satisfaction. The ultimate goal is to achieve a harmonious integration of EHR alerts into clinical practice, where alerts serve their intended purpose without contributing to the noise that clouds clinical judgment.

Journal Club Source

McGreevey, John, et al. “Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems.” Applied Clinical Informatics, 2020; 11(01): 001-012. DOI: 10.1055/s-0039-3402715