Alert overload could prompt physician turnover

Primary care physicians who are dissatisfied with electronic health record-based alert notification systems may throw up their hands and quit if those systems are too intrusive, according to a study published at the American Journal of Managed Care.

Previous research had determined that providers using these systems receive 56 to 63 alert notifications a day, and most doctors do little to customize their alert interface to help them be more effective. As a result, many providers become overloaded with alerts they see as unnecessary and feel create more work.

This study involved a survey of 2,590 doctors at 131 Department of Veterans Affairs facilities about their satisfaction with the systems and whether dissatisfaction could influence them to switch jobs. It became clear that providers need to fully understand the value of the alert systems, and that dissatisfaction with the alerts could spur unhappiness with EHRs overall.

The study also found that system monitoring/feedback, training and supportive norms had little impact on provider satisfaction. However, monitoring/feedback were associated with greater intention to quit.

The authors suggest organizations think carefully about how monitoring and feedback are done. Providers' perceptions of being monitored constantly by the organization, if done poorly, could have them heading for the door.

"From a practical perspective knowing that [these systems] have to be perceived as performance enhancing by physicians in order for them to not negatively affect turnover should signal facility leadership to take care regarding how such systems are designed, marketed within the facility, and supported," the authors write.

While physicians are still learning how to use clinical decision support systems more effectively, design of the systems has to support workflow as well. A study from the Richard Roudebush VA Medical Center in Indianapolis found that redesigned alerts can reduce prescribing errors and increase user satisfaction.

To learn more:
- check out the research

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