Study Advises Healthcare Executives to be Aware of EHR Overload

by webadmin on March 5, 2013

Now that electronic health records are taking root within most hospitals and health systems, data on how they are helping or hindering those systems is gradually coming out.

Chelsea Rice at HealthLeaders Media reports that EHRs have become “the latest source of information overload” for physicians.

A research letter published in the Journal of the American Medical Association (JAMA) reveals, “Nearly one-third of physicians miss electronic notifications of test results in electronic health record systems.”

Researchers surveyed 2,590 primary-care providers in the Department of Veterans Affairs, Rice writes, and found, “86.9 percent perceived the quantity of EHR alerts to be excessive, and 69.6 percent said they received more alerts than they could effectively manage. More than half (55 percent) of surveyed physicians said current EHR systems made it possible to miss the alerts.”

The study’s lead author, Hardeep Singh, M.D., MPH, observed, “What stood out was information overload and the easier the systems were to use, you tended to miss [fewer] test results.”

However, it’s not so much the volume of data physicians are receiving, but the way in which “systems display data,” he added. Besides test results, physicians must sift through a plethora of other communication material, such as notes from colleagues, that appear “alongside” those test results.

“I would say that it is a similar problem to alarm fatigue where you tend to get desensitized because there are too many alarms going off at once, so in the same way, you tend to get desensitized because there’s too many alerts to receive,” Singh said.

He is concerned with how this could impact patient care in the long run. He believes that hospitals and health systems need “to pay attention to their systems,” especially if they “leave their physicians vulnerable to information overload, and their patients vulnerable to that missed information.”

Also, workflow and organizational policies might need to be reexamined in order for EHRs to be effective, not harmful. The study found 30 percent of providers simply don’t have the time built into their workflow that would allow them to examine alerts and information.

Singh explained, “One thing that stood out were electronic hand-offs, which occurred with doctors going on vacation for a few weeks and trying to transfer the alerts to their covering doctors, but not knowing how. So what we realized were these handoffs of care, the covering practitioners could not ever be receiving the messages or alerts either.”

He concluded, “For hospital executives and health leaders, it’s really important for them to know that it’s time to develop a measurement system for these types of things, to understand how much these lost bits of information are affecting things.”

What are your thoughts on this study? Have your physicians and/or clinical staff complained about the number of alerts they’ve been receiving? Have alerts been missed that were critical to a patient’s care? What are you doing to stave off this problem?

-by Pete Fernbaugh

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