Almost half of EHR medication alerts overrides are inappropriate

Alert fatigue defeats the purpose of EHR medication alerts, according to a study published in the Journal of the American Medical Informatic Association (JAMIA). The study, published October 27, looked at how often medication-related clinical decision alerts were overridden, the reasons given for the overrides, and how appropriate the reasons were.

The rate of overrides varied by type, but in total 73.3% of patient allergy, drug interaction, and duplicate drug alerts were overridden. Fortunately, most (60%) of the alerts were appropriate; however, the level of appropriateness varied significantly by type. Only 2.2% of overrides of renal-based medication substitutions were appropriate and only about a quarter (26.4%) of age-based medication substitutions were appropriate. However, most duplicate drug, patient allergy, and formulary substitution alerts could be refined to reduce alert fatigue, according to the study.

The study suggests that organizations should adjust alert types and frequencies to make them more clinically relevant overall. Creating better, more meaningful and relevant alerts will reduce alert fatigue and the amount of alerts that are inappropriately overridden, according to the study.