The perils of alert fatigue

In an era of unprecedented support for the implementation of electronic decision support, and the widespread roll out of these systems, it is easy to focus exclusively on the upside of these strategies. The systems give the appearance of being sophisticated, but in the case of systems used to order medications, are based on the implementation of a relatively small rule set, based on allergy history, dosage bands and potential drug interactions. It has been estimated that such systems generate warnings for up to 6% of all orders that implemented, meaning that prescribers may receive many “warnings” each day, some of which will be of tenuous clinical relevance. Alert fatigue is a description of the phenomenon where busy health workers may become less responsive to safety alerts, and may ignore them, primarily because there are so many alerts and many are not clinically important. The US Department of Health and Human Services has posted a useful discussion of the phenomenon, worth reading for anyone with a serious and objective interest in medication safety. See here for more details