TY - JOUR
T1 - Evaluating the Impact of Interruptive Alerts within a Health System
T2 - Use, Response Time, and Cumulative Time Burden
AU - Elias, Pierre
AU - Peterson, Eric
AU - Wachter, Bob
AU - Ward, Cary
AU - Poon, Eric
AU - Navar, Ann Marie
N1 - Publisher Copyright:
© 2019 Georg Thieme Verlag. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background Health systems often employ interruptive alerts through the electronic health record to improve patient care. However, concerns of alert fatigue have been raised, highlighting the importance of understanding the time burden and impact of these alerts on providers. Objectives Our main objective was to determine the total time providers spent on interruptive alerts in both inpatient and outpatient settings. Our secondary objectives were to analyze dwell time for individual alerts and examine both provider and alert-related factors associated with dwell time variance. Methods We retrospectively evaluated use and response to the 75 most common interruptive (popup) alerts between June 1st, 2015 and November 1st, 2016 in a large academic health care system. Alert dwell time was calculated as the time between the alert appearing on a provider's screen until it was closed. The total number of alerts and dwell times per provider per month was calculated for inpatient and outpatient alerts and compared across alert type. Results The median number of alerts seen by a provider was 12 per month (IQR 4-34). Overall, 67% of inpatient and 39% of outpatient alerts were closed in under 3 seconds. Alerts related to patient safety and those requiring more than a single click to proceed had significantly longer median dwell times of 5.2 and 6.7 seconds, respectively. The median total monthly time spent by providers viewing alerts was 49 seconds on inpatient alerts and 28 seconds on outpatient alerts. Conclusion Most alerts were closed in under 3 seconds and a provider's total time spent on alerts was less than 1 min/mo. Alert fatigue may lie in their interruptive and noncritical nature rather than time burden. Monitoring alert interaction time can function as a valuable metric to assess the impact of alerts on workflow and potentially identify routinely ignored alerts.
AB - Background Health systems often employ interruptive alerts through the electronic health record to improve patient care. However, concerns of alert fatigue have been raised, highlighting the importance of understanding the time burden and impact of these alerts on providers. Objectives Our main objective was to determine the total time providers spent on interruptive alerts in both inpatient and outpatient settings. Our secondary objectives were to analyze dwell time for individual alerts and examine both provider and alert-related factors associated with dwell time variance. Methods We retrospectively evaluated use and response to the 75 most common interruptive (popup) alerts between June 1st, 2015 and November 1st, 2016 in a large academic health care system. Alert dwell time was calculated as the time between the alert appearing on a provider's screen until it was closed. The total number of alerts and dwell times per provider per month was calculated for inpatient and outpatient alerts and compared across alert type. Results The median number of alerts seen by a provider was 12 per month (IQR 4-34). Overall, 67% of inpatient and 39% of outpatient alerts were closed in under 3 seconds. Alerts related to patient safety and those requiring more than a single click to proceed had significantly longer median dwell times of 5.2 and 6.7 seconds, respectively. The median total monthly time spent by providers viewing alerts was 49 seconds on inpatient alerts and 28 seconds on outpatient alerts. Conclusion Most alerts were closed in under 3 seconds and a provider's total time spent on alerts was less than 1 min/mo. Alert fatigue may lie in their interruptive and noncritical nature rather than time burden. Monitoring alert interaction time can function as a valuable metric to assess the impact of alerts on workflow and potentially identify routinely ignored alerts.
KW - decision support systems
KW - electronic health records
KW - medical order entry systems
KW - patient care
KW - workflow
UR - http://www.scopus.com/inward/record.url?scp=85075714267&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075714267&partnerID=8YFLogxK
U2 - 10.1055/s-0039-1700869
DO - 10.1055/s-0039-1700869
M3 - Article
C2 - 31777057
AN - SCOPUS:85075714267
SN - 1869-0327
VL - 10
SP - 909
EP - 917
JO - Applied Clinical Informatics
JF - Applied Clinical Informatics
IS - 5
ER -