CYA Alerts Not Working Well

In order to supposedly help doctors from making mistakes:

96% of hospitals that use computerized physician order entry (CPOE) systems also have clinical decision support (CDS) tools. The CDS tool enables prescribers to access real-time patient data, ideally resulting in enhanced patient safety and medication accuracy. CDS can also alert the prescriber about potential patient warnings to prevent errors and additional adverse drug events from happening.

While both systems aim to aid the prescriber and lower patient harm, both have unintended consequences, such as alert fatigue, missed alerts, and ultimately clinician burnout.

This is the problem with the wrong people being in charge of EHRs. No one wants responsibility for anything going wrong so these damn things send out alerts for everything. After a while, the doctor doesn’t give a crap anymore and just stops checking. The EHR people don’t care because they can always go back and say, “The system alerted you” if something happens and so they are happy. But doctors are miserable.

Let’s just call these things what they are and that is COVER YOUR ASS (CYA) alerts but they are only there to cover the ass for the EHR system and the hospital and no one else.

Because there was minimal improvement against nuisance orders, but modest improvement overall and for fatal orders, researchers posited that too many alerts had been turned on. And too many alerts typically result in alert fatigue and clinician burnout.

Too many alerts makes a doctor insane. It’s pretty simple.

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