Medical practices strive to use EHRs to improve workflow and deliver optimal patient care. US based medical transcription companies help physicians integrate free text, dictated reports, and results of lab and imaging tests into EHRs to improve the usability of patient records. EHRs come with various features to support physicians in providing better healthcare. EHR alerts are intended to provide physicians with reminders and updates regarding potential patient issues. Practices can integrate different types of EHR alerts into clinical workflows to communicate critical patient information and improve care coordination.
These flags can alert a healthcare provider and even a patient about health-related issues through the EHR. Digital alerts can be set up for prescriptions filled from pharmacy to healthcare provider, blood pressure levels, heart rate changes, blood sugar levels, etc. Digital alerts for regular screening tests such as prostate, Pap smears, breast exams and dental check-ups could benefit patients and physicians.
Effective use of EHR alerts can promote patient safety and streamline practice efficiency. EHR Intelligence describes how admission, discharge, and transfer (ADT) notifications or screening reminders can improve the following operations in the following areas:
- Transitions of care: ADT notifications and alerts can promote provider communication during transitions of care. This will ensure that care teams have the information required for proper decision making during patient admission, transfer or discharge to other facilities. Such coordination can improve patient safety and save money.
- Chronic care management: EHR-integrated alerts can help providers better manage patients with chronic illnesses. By reminding clinicians to screen for different conditions, these prompts can help providers diagnose and treat chronic illnesses.
- Patient safety: By reducing incidence of on unnecessary testing, alerts can help minimize potential instances of patient harm, save time, and also reduce hospital spending.
However, EHR notification overload has become a major concern for healthcare providers. Too many alerts or low value alerts compromise patient care instead of improving it and contribute to physician burnout. The Agency for Healthcare Research and Quality (AHRQ) discussed research on the problem of alert fatigue. In one case, researchers found that physiologic monitors in an academic hospital’s 66 adult intensive care unit beds to 187 warnings per patient per day. Another study reported that CPOE systems generate warnings for 3%-6% of all orders that are entered, so that a physician could easily receive dozens of pop-ups each day.
The multiplicity of computerized alerts has led to ‘alert fatigue’ – clinicians have become desensitized to safety alerts, and as a result ignore or fail to respond appropriately to such warnings. Too many alerts occur when alerts are not properly well tailored in context or perception or because alerts are turned on with little specificity. The result is that physicians are ignoring both the annoying, clinically meaningless alarms as well as the important alerts that warn of looming serious patient harm (AHRQ).
Alerts are added to increase the efficiency of EHRs in imparting quality patient care and need to be used with caution for lowering the incidence rates of medical errors, increasing patient safety, and enhancing operational efficiency. Here are the strategies that AHRQ and Medical Economics recommend for using alerts appropriately and efficiently:
- Increase alert specificity by cutting or eliminating clinically insignificant alerts.
- Filter the warnings based on importance and sensitivity.
- Use customized reminder alerts that are color-coded based on severity, such as red for alarm, etc.
- Customize alerts to patient characteristics, for e.g., integrating renal function test results into the alert system will ensure that notifications for nephrotoxic medications are triggered only for high risk patients.
- Ensure that only severe alerts are interruptive.
- Determine the type of alerts that each staff member in the practice sees based on their specific roles.
Recent reports indicate how hospitals are leveraging alerts improve care. Oakland, Calif. -based Kaiser Permanente added a notification to its EHR to alert physicians when a patient has an abnormal test result for chronic kidney disease. Loyola Medicine is using EHR alert capabilities to improve sepsis care, reports Becker’s Hospital Review. The EHR-integrated alert system used by the University of Utah Health has reduced its sepsis mortality rate by 20 per cent, saving 40 lives annually. EHR vendors are also now focused on creating smarter alerts that improve office workflow and patient care.
Providers can outsource medical transcription to ensure that all critical patient information is entered accurately in a structured form to minimize the risk of errors and maximize patient safety. As new features and functionalities are introduced in the EHR, physicians should be properly trained to use the system in a meaningful way.