Vendors, government officials and providers themselves have tried many different things to transform electronic health records into integrated elements of clinical decision support. EHR alerts that flag suspicious data entries or modify diagnoses made by physicians have made strides in recent years as effective ways to improve clinical performance. According to Healthcare IT News, Chicago's Northwestern Medicine has been using an EHR alert system since 2010 to interrupt physicians with relevant information when clinically relevant.
However, EHR alerts may be more detrimental to health care than first thought. According to a recent study conducted by researchers at the U.S. Department of Veterans Affairs and published in the American Journal of Managed Care, incessant alerts may be conditioning physicians to ignore them outright or simply leave their positions.
In a study of 2,590 providers, the researchers cross-referenced turnover rates within the VA with attitudes on health information technology. Departments with high turnover also showed low opinions on the potential of their health IT capabilities, with EHR alerts signaled out as primary offenders.
Physicians told the authors that EHR alerts increase their workload, make each item more time-consuming and reroute clerical work to clinical staff. Many doctors said that they ignore the alerts anyway, favoring their own clinical experience over digitally crowdsourced recommendations.
The study concluded that, if EHRs are to move forward as clinical tools, the alert system may need to be revamped to satisfy their primary users – clinical staff – above all else. If EHR alerts are analytically sound tools that do not mesh well with the daily activities of front-line physicians and nurses, then they need to be adjusted to that end. Otherwise, EHRs may not become the clinical support technology the industry so badly needs it to be.