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Provider pop-up alerts can simultaneously be one of the most positive and most negative of an EHR’s features – depending on how they’re implemented. In theory, the more you alert a provider to potential problems, the better care the patient will receive. Too many alerts – Mayday! – understandably lead to alert fatigue – an alarming problem! 

IT and project teams often use alerts when an EHR is first implemented or when pushing a new update. However, if providers are inundated with pop-up messages, they tend to focus less on the patient. More often than not, these providers try to get out of the system faster rather than use the information to help the patient. Therefore, the IT and project teams must use caution when setting up alerts.  

Consider the following guidelines for better alert notification practices: 

1. Less is more. 

When implementing new alerts, start slowly. Test, test, test on the backend.  Make sure they’re firing at the appropriate time and with pertinent information.  If an alert is set to pop up when steroids come into play, that must be tested to ensure that medicines that include steroids, such as eye drops, aren’t flagged when it’s not necessary. Remember, unnecessary alerts lead to alert fatigue. 

2. Test in the live environment’s background. 

Unfortunately, alerts cannot be completely vetted in the test environment.  After testing in the test environment, launch the alerts in the background of the live environment. These should be visible for analysts to test, but not visible for end users.  No matter how thorough your application team is, they can never simulate every possible scenario that clinicians face when seeing patients in the live environment. 

3. Consider the audience. 

Do not install pop-up alerts at the request of someone who is not receiving the alert. Case examples include if HIM wants providers to get a pop-up to elicit a specific action or if nurses want physicians to get an alert. Alerts should help the recipient do their job or improve patient care, not try to get someone to perform an action desired by another department.  

4. Integrate alerts naturally into workflows. 

Integrate Pop-up alerts into the clinician’s decision-making process within the EHR workflow. These alerts should provide ways to address issues or provide more information. Use your clinician super users to ensure that alerts are properly timed. 

Alerts in action… 

With a recent client, Optimum’s team of EHR experts analyzed medication alert results over the span of a few months. The results were alarming! Due to the system’s settings, the average clinician received 49 alerts for every 100 medications they ordered. Worse, providers only acted on 12% of alerts received. 

The team reviewed why the alerts were firing and edited alert patterns over a four-month period. They reduced the rate of alerts from 49/100 to 27/100. When providers received fewer alerts, they acted on 33%. The major takeaway is simple: increased alerts don’t necessarily lead to increased patient safety.   

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