Combating Alert Fatigue in Healthcare

13 Jul Combating Alert Fatigue in Healthcare

Alerts intended to improve patient care result in a paradoxical increase risk of harm

Most healthcare technologies include automated alert systems so clinicians can prevent or act in unsafe situations. However, healthcare professionals are flooded with alerts from electronic health record (EHR) software and clinical decision support systems (CDSS) some of which are irrelevant to the patient. In some cases, the number of pop-up messages has become unmanageable which is overwhelming practitioners and causing alert fatigue.

Busy healthcare professionals are increasingly becoming desensitized to safety alerts, and as a result, ignore or fail to respond to such warnings ¹. Alert fatigue occurs because of the extraneous noise (a vast number of clinically inconsequential alerts) drowns out the useful signal (critical alerts that warn of serious patient harm).

In prescribing, the use of alerts when selecting a drug is not a successful strategy and such alerts are ignored in 50-95% of cases ². According to a recent study conducted by the Brigham and Women’s Hospital, Boston, most medication-related Clinical Decision Support (CDS) alerts are over-ridden in the ICU (88.5%)³. Inappropriate over-rides, often for geriatric alerts, were associated with a six-fold increased risk of ADEs, compared with appropriately over-ridden alerts.

Improving clinical decision support is critical to increasing patient safety. Instead of relying on alerts, information about individual patients can be used to generate treatment options that are personalized and safe for each individual. An alternative to alerts is a condition-based system that provides safe and effective options for a given patient⁴.

Precision prescribing software

TreatGx is an innovative precision prescribing software that starts by considering the patient condition and provide all the possible options for treatment, eliminating the need for alerts and enabling accuracy and efficiency.

TreatGx includes a list of optimal, individualized drug therapy options adjusted for renal and hepatic function, other conditions, current medications and genetics.

As a patient-centered solution, TreatGx assesses the potential drug-drug, drug-condition,drug-gene and drug-drug-gene interactions.

The drug options in TreatGx are the least likely to cause harm and most likely to be effective for the patient.

1. PSNET-AHRQ (2017) Alert Fatigue. https://psnet.ahrq.gov/primers/primer/28/alert-fatigue
2. van der Sijs H, Aarts J, Vulto A, et al.(2006) Overriding of drug safety alerts in computerized physician order entry. J Am Med Inform Assoc 13:138–47.
3. Wong A, Amato M, Seger D, et al. (2018) Prospective evaluation of medication-related clinical decision support over-rides in the intensive care unit. BMJ Quality & Safety doi: 10.1136/bmjqs-2017-007531.
4. Kuperman GJ, Bobb A, Payne TH, et al. (2007) Medication-related clinical decision support in computerized provider order entry systems: a review. J Am Med Inform Assoc 14:29–40.