A hospital emergency department’s electronic health record issued many unnecessary and clinically insignificant alerts for opioids, contributing to alert fatigue among providers, according to a studypublished in the Annals of Emergency Medicine, FierceEMR reports (Durben Hirsch, FierceEMR, 11/10).
Study Details
For the study, researchers at the University of Colorado School of Medicine examined clinical decision support tools included in a commercial EHR at the ED of an unspecified urban academic medical center (Genco et al, Annals of Emergency Medicine, 11/6). The researchers reviewed 4,581 patient records and 4,692 opioid-related alerts intended to avert 38 adverse drug events.
Study Findings
The researchers found that to prevent one adverse drug event providers received about 123 unnecessary alerts.
According to the study:
- 98.9% of opioid-related alerts failed to result in or avoid an actual adverse drug event; and
- 96.3% of opioid-related alerts were overridden by providers.
In addition, the study found the EHR’s CDS tools failed to avert 14 adverse drug events that did occur, including eight that were related to opioids.
The researchers recommended that EHR vendors redesign alerts using a more tiered approach that would make less clinically significant less intrusive and the most specific and critical alerts difficult to override.
The study’s lead author Emma Genco in a statement said, “We need to improve the ‘signal to noise’ ratio of these alerts, especially in the chaotic environment of the [ED],” adding, “Interruptions are already a significant fact of life in [EDs], which is why we need to eliminate the meaningless ones”
