In 2010, a The Boston Globe investigation linked over 200 deaths in the United States (2005-2010) to problems with vital monitor alerts – many of them relating to “alarm fatigue.” In this case, “alarm fatigue” refers to the reduced response by clinicians to audible alarms set off by medical devices monitoring patients due to an onslaught of reoccurring alerts throughout the day.

We believe there may be a similar type of “fatigue” concern emerging within Clinical Decision Support (CDS), an EHR process that provides clinicians with relevant medical knowledge and patient information to enhance their decisions at the point of care. In many cases, an overwhelming number of automatic alerts are being sent to clinicians from previous electronic clinical orders. If a physician is bombarded with hundreds of alerts a day, CDS is facilitating a comparable desensitization to the alerts or “alert fatigue” as well as frustration towards the technology. This is a huge problem because not only is CDS an extremely powerful tool for clinicians but it plays a part in healthcare organizations’ Meaningful Use requirements.

Every hospital will face the challenge of building sophisticated CDS tools without causing “alert fatigue.” Key factors should include:

1) A strategic plan which supports existing policies and practices

2) Clinicians intimately familiar with best practices and the ways and means to deliver the right information at the right time and in the right format

3) Skilled technical personnel familiar with your CDS within your EHR

4) A highly engaged clinical leadership team

This is not suggesting “alert fatigue” is associated with patient mortality; merely stating there is a fine line between information empowerment and information overload and hospitals should learn from previously documented human propensities. Hospitals need to find a healthy balance in order to maximize the benefits and increase the adoption of a complete Clinical Decision Support integration.

http://www.makingrounds.com/2011/08/clinical-decision-support-and-the-risk-of-information-overload/