Clinician “Alert Fatigue” Contributes to Ignored Medication Warnings

 

Researchers recently found that medical professionals may unintentionally ignore computerized drug warnings generated in hospitals, putting patient health at risk.  These electronic medical record (EMR) alerts are triggered by several alterations in patient care, including a change in a patient’s laboratory test results and the prescription of a new medication.  These computerized provider order entry (CPOE) systems are intended to warn when the following risks exist:

  • Adverse Events (0.1% of warnings)

  • Allergy (6% of warnings)

  • Interactions (47% of warnings)

  • Duplications (47% of warnings)

However, this study found that only 4% of the 40,391 drug warnings were accepted by medical professionals.  Researchers believe that too many visual and audio alerts lead to a condition called “alert fatigue,” where medical providers are desensitized to these warnings. 

One problem with the current system is that after an order is placed, all possible health warnings are listed on the computer screen with no indication of how severe each risk is.  The type of warning is not differentiated and the list appears in identical font. 

In addition to the overwhelming number of warnings that may appear, some may not apply to patients while other alerts may provide too much detailed information. Researchers have found these factors contribute to why so many of these warnings are ignored. 

With this abundance of unclear information, clinicians are frequently frustrated, leading to this “alert fatigue.”  In response, a restructuring of these programs has been proposed to help curb this trend and ensure patient safety. 

Alissa Russ, Ph.D., a research scientist who served as an author of the study, explained that “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.”   

An Indiana University School of Medicine press release about this study can be found here