Physicians' Perspectives on Prescription Alerts: A Journey Towards Reducing Fatigue

Background Alerts in electronic medical records (EMR) and computerized decision support systems play crucial roles in enhancing patient safety by notifying healthcare providers of potential risks. However, an excessive number of alerts can lead to alert fatigue, in which clinicians become desensitized to notifications, potentially compromising patient safety. This study examined the experiences of physicians with alerts, focusing on their perceptions of and challenges posed by alert fatigue. Methods A mixed-methods approach was employed, combining an anonymous questionnaire survey with an interrupted time series (ITS) analysis. This study targeted physicians to gather insights into their experiences of using alerts. Data were collected through a Google Forms survey, and prescription data from the EMR were analyzed to assess the impact of the strategic reduction in non-critical alerts. Based on the survey feedback and research team discussions, the intervention targeted specific alerts contributing to alert fatigue, removing two types: "Powerful Drugs" and "Multiple Prescriptions." Results While 76% of physicians found alerts helpful, 81% reported being overwhelmed by their volume, leading to alert fatigue. Notably, 55% of physicians admitted to dismissing alerts without reading them. The ITS analysis showed that a reduction of approximately 13,000 non-critical alerts per month did not significantly alter prescription behavior. The most problematic alerts were those related to administrative or cost issues, which contributed to the overall fatigue experienced by clinicians. Conclusion This study highlights the significant impact of alert fatigue on healthcare providers and underscores the need for a more streamlined alert system. Healthcare institutions can better manage alert fatigue and improve clinician efficiency and patient safety by focusing on reducing non-critical alerts and incorporating feedback from frontline clinicians.