Even the Best Make Terrible Alerts

Be direct and clear, explain and enable.

This is a little article put together by a group surveying the electronic health record alert content of nine children’s hospitals.

The authors approached this descriptive study using a qualitative instrument evaluating a few basic functions of design and purpose. A good alert explains its purpose. A good alert describes the potential for harm if dismissed or declined. A good alert allows the action to be taken from within the alert context.

It goes without saying, essentially, if an institution has the informatics wherewithal to be a part of this group, we ought to be looking at a decent selection of the most competent and mature EHR implementations.

How do our friends at these institutions do at alert design?

I don’t think there’s much sugar-coating this when the best-scoring qualitative design measure still had 1 in 4 alerts failing to clearly identify its function. Only mere handfuls of alerts explicitly described the hazards of inaction. A bare majority allowed users to take the appropriate clinical action from within the alert. Not only that, nearly 1 in 5 alerts was purely of an administrative purpose, and not for patient care.

Considering the burden electronic systems and alerts place on clinicians, it’s quite obvious our informatics staff needs to do better.