How do healthcare providers react to medication alerts generated by electronic medical record systems?
To learn about the strengths and weaknesses of electronic medication alerts, a study by Regenstrief Institute and US Department of Veterans Affairs investigators involved observing providers as they treated patients. The study appears in the April 2012 issue of the International Journal of Medical Informatics.
Medication alerts supply healthcare providers with computer-generated information on a variety of drug-related issues, including patient allergies, drug interactions, and duplicate prescriptions. Triggered by many factors, such as the prescription of a new medication or a change in a patient’s laboratory test results, the alerts are critical to patient safety.
However, alert fatigue, where providers become desensitized and begin unintentionally ignoring some important warnings, may set in if:
- Too many medication alerts are generated by the electronic medical record system
- Alerts do not currently apply to the patient (ie, warning about a drug the patient has already been taking without problems)
- The alert provides too much extra information
“As a human factors research scientist, I am interested in learning how to improve the usability of electronic medical records systems so doctors, nurses and pharmacists can work more effectively. I also am interested in finding ways to make healthcare delivery safer for patients,” said Regenstrief Institute investigator Alissa Russ, PhD, first author of the study and a research scientist with the Center of Excellence on Implementing Evidence-Based Practice at the Richard L. Roudebush VA Medical Center in Indianapolis.
During the study, an electronic medical record system generated 320 medication alerts as 30 doctors, nurse practitioners, and pharmacists treated 146 patients in a variety of outpatient clinics. As study authors analyzed factors that influenced how healthcare providers perceive, interpret, and respond to alerts, they identified 9 factors that influence prescribers as they encounter alerts. Researchers then generated descriptions of 44 components that contribute to these factors.
Study results showed prescribers were sometimes unsure why an alert was appearing, and that alert designs were oriented more toward pharmacists than physicians or nurse practitioners. The researchers plan to use this information to improve the design of medication alerts.
“Too many alerts and overly detailed alerts are a common source of frustration across electronic medical record systems,” Russ said. “Unless we improve medication alerts so they contain information that users need to make decisions, the problem of alert fatigue will grow as EMR systems expand beyond single hospitals and share more data.”
Source: Indiana University.