JUL 6, 2012 4:14pm ET

Beware of EHR Alert Fatigue


A recent study found that physicians using electronic health records that give alerts about appropriate clinical trials experience alert fatigue.

My next door neighbor has a dog that likes to roam the streets, so to confine him without having to erect a fence, he put one of those electronic collars on Fido. Whenever the dog gets near the boundary of his master's property, the dog is sent a "message" in the form of a mild electric shock. The dog has learned not to leave the yard, but I can see it in his eyes that he would dearly love to roam the streets once again.

Doctors are being handed a kind of collar of their own which can deliver "minimally disruptive" messages containing alerts or requests for referrals. The study speaks of alert fatigue, but what it doesn't discuss is the reasons for such fatigue.

It would seem that those who can twiddle the bits and bytes of the digital world don't get the point with respect to human nature. What fulfills us is not the rapidity of communication but rather the depth and profoundness of it. If the edification of communication is to be measured in terms of the frequency and rapidity of messages, then the best way for people to communicate would be to be buried in a medical version of Facebook.

Frankly, such a prospect turns me off in a very big way. I have worked with several entrepreneurs who have attempted to harness the kind of instantaneous, pithy communication that alerts represent. They had grand hopes for the next billion-dollar company, but when all the smoke had cleared, they exited their companies bankrupt because their understanding of human behavior was deficient and those who were the trial users just didn't like the experience.

I cannot for the life of me believe that doctors would willingly strap on the metaphorical equivalent of an electronic dog collar. As it is, that sense of being on call all the time is draining enough. To make it palpable with a string of alerts whose importance is vetted by a machine and not by a person who has a sense of proportionality would be like adding lead weights to a swimmer.

Robert DeFazio is president at Calabria Consulting. He can be reached at rdefazio@att.net.

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Physicians, frequently perceived as a roadblock to a high-quality/low-cost paradigm, often spearhead IT advances central to the effort.

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