Alert overload causing docs to miss abnormal test results

Follow up failures continue to occur in outpatient settings even when physicians receive electronic alerts of abnormal test results, according to a new study in JAMA Internal Medicine.

Failure to tell patients their test results, particularly abnormal test results, is a major safety concern. The researchers, from the Veteran's Administration Medical Center in Houston, conducted a survey of 2,590 primary care practitioners to assess their perceptions of technological factors, such as ease of electronic health record use and the content of alerts, as well as social factors, such as physicians' workflow and organizational policies and procedures related to alert follow up, that might contribute to missing test results.

They found that the median number of alerts reported a day was 63, which a whopping 86.9 of respondents perceived as an "excessive" amount of alerts. More than two-thirds (69.6 percent) reported that the alerts they received were more than they could effectively manage; almost a third of respondents (29.8 percent) reported that they had personally missed results that led to patient care delays.

"[M]issed results in EHRs might be related to information overload from alert notifications, electronic hand-offs in care, and practitioners perceptions of poor EHR usability. Interventions to improve safety of test result follow-up in EHRs must address these factors," the authors stated.

Alert overload has been a sore point in clinical decision support and functionality. Other studies have revealed similar concerns that alerts impede workflow and add to physicians' burdens.

To learn more:
- read the study abstract