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Related Concept Videos

Nursing Clinical Information System01:27

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Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
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Alerts in clinical information systems: building frameworks and prototypes.

Rolf Wipfli1, Christian Lovis

  • 1Division of Medical Informatics, University of Geneva, Geneva, Switzerland. rolf@wipfli.ch

Studies in Health Technology and Informatics
|June 15, 2010
PubMed
Summary

Physicians frequently override clinical decision support alerts due to alert fatigue and workflow disruptions. This study examines alerts from system, human-computer interaction, and organizational perspectives to propose improvements.

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Area of Science:

  • Clinical Informatics
  • Human-Computer Interaction
  • Health Systems Management

Background:

  • Clinical Information Systems and Computerized Provider Order Entry (CPOE) alerts are vital for clinical decision support.
  • High rates of alert overrides by physicians contribute to alert fatigue and reduced effectiveness.
  • Existing alerts often suffer from low specificity, high bandwidth, and usability issues, interrupting workflows.

Purpose of the Study:

  • To analyze the challenges associated with clinical decision support alerts.
  • To provide a multi-faceted framework for understanding alert issues.
  • To propose a prototype for improved alert handling to mitigate current problems.

Main Methods:

  • A framework integrating system-based, human-computer interaction, and organizational perspectives was developed.
  • Analysis of alert override rates and contributing factors.
  • Development of a prototype alert handling system.

Main Results:

  • Alert fatigue and workflow interruptions are significant issues stemming from current alert systems.
  • A multi-dimensional view is necessary to fully understand alert system deficiencies.
  • The proposed framework offers a basis for developing more effective alert management strategies.

Conclusions:

  • Addressing alert fatigue requires a comprehensive approach beyond system design.
  • Integrating system, HCI, and organizational factors is crucial for optimizing clinical decision support.
  • The developed prototype demonstrates potential for ameliorating common alert handling problems.