Why Your Doctor Missed Your Alert, and What We’re Doing to Fix It

Pop Quiz.  What percent of patient alerts are considered necessary?

  • 90%
  • 75%
  • 50%
  • 20%

If your answer is 20%, you are either a really good guesser, or likely already aware of just how real and hazardous alert fatigue is.  In fact, it’s listed as ECRI Institute’s #1 health IT hazard in 2015, ahead of mixing up drugs, device failures, and incorrect/incomplete data in your electronic health record.

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The Despondent Doctor: Alert Overload Takes Its Toll

Put simply, providers are being overwhelmed with alerts to the point where patient alerts go unnoticed or unaddressed.  The near constant, often annoying ‘pop up’ alerts in the electronic chart that are unnecessary are absolutely burying the alerts that require action.

This is not intentional of course.  The alerts mean well, and in isolation are effective.  However, when various patient alerts are implemented across an entire population, the alert system becomes interruptive, frustrating, and down-right dangerous due to alert fatigue.

Everyone working in the digital health space must keep alert fatigue as priority number one when designing products that touch the patient’s health.   Just as the best digital health tools help avoid message fatigue, they must also consider provider alert fatigue.  Here’s what we’re doing at Epharmix to combat the #1 health IT hazard:

  • We’re using a clinically validated triaging system to focus attention on patients who need it most. We use a familiar tier design – red, yellow, and green to make it easy to prioritize the patient panel.
  • We mirror the care management model, allowing healthcare staff to work at the top of their license. Epharmix has the ability to route red alerts to the appropriate patient manager in real time, while leaving non-urgent alerts to be rolled up on a weekly or bi-weekly basis.
  • We’ve developed a SMART scheduling system to actively monitor your high risk patients more closely and throttle back on the low-risk, green tier patients reducing patient fatigue, and sending providers more relevant and timely feedback on patients who are at risk of worsening in their chronic illness.

Let’s look at a quick (true) story of putting these concepts into practice.  Below is a chart of actual patients in a large healthcare system (a client of ours).  It’s the familiar concept of red, yellow, green risk levels of patients.




At the start of the Epharmix system, about half the patients are considered at risk.  The stability of patients (green) increases over time, and we’ve successfully pulled the majority of patients in the warning zone back to stable condition.

Those at high risk (red) remain fairly high risk, which doesn’t necessarily come as a surprise.  These patients are very tough to manage, and many will be high risk for the remainder of their lives.  However, by utilizing the SMART system, we can focus provider’s attention on those who need it, while reducing the noise and alert fatigue on patients who can be managed more efficiently by a patient manager triage system and moving patients to increasingly stable conditions.

Ultimately, the finish line is always moving.  We’re in a constant feedback loop of improving our system, analyzing the results, and improving it again.  This is the mindset that Epharmix and anyone else pioneering the digital health space must have.  A hyper-connected patient/provider relationship isn’t healthy if it’s causing alert fatigue and endangering patients who really do need their alert to bubble to the surface.  Getting the right data, at the right time, to the right person – this is what will define digital health in the healthcare of today.

Have you experienced alert overload? Share your experiences on Twitter or LinkedIn, or connect with us directly via team@epharmix.com.