Excessive EHR alerts can lead to information overload for primary care doctors

Primary care physicians are bombarded with so many alerts from their electronic health record systems that they're in danger of overlooking important test results, creating potential patient-safety issues, according to a new study.

Primary care physicians (PCPs) are bombarded with so many alerts from their electronic health record (EHR) systems that they're in danger of overlooking important test results, creating potential patient-safety issues, according to a new study.

"Our data suggest that PCPs using comprehensive EHRs are vulnerable to information overload, which might lead them to miss important information," stated a research letter published in JAMA Internal Medicine.

The study was driven by the results of a survey that was answered by about 2,600 PCPS in the U.S. Department of Veterans Affairs (VA). In the VA, abnormal test result alerts are generated automatically for prespecified abnormal laboratory values.

And PCPs in the VA get plenty of those alerts every day; the median number per physician per day was 63, according to the study. Nearly 87% of the physicians surveyed said they receive an "excessive" number of alerts every day, and 70% said they receive more alerts per day than they can effectively manage.

Nearly 56% of responding physicians said that their EHR systems as currently implemented made it possible for them to miss test results, and nearly 30% reported missing results that led to delays in care, according to the study.

So what's the solution to information overload? Designing EHR systems that have a greater ease of use for physicians would be a start, but that's unlikely to completely solve the problem. Efforts to improve usability should be tied to an overall "real-world" context that factors in broader "sociotechnical" aspects of the primary care work environment, the study authors said.

"An isolated reduction in alert numbers without attention to the broader PCP experience related to information overload might be insufficient to improve outcomes," the researchers wrote.

More broadly, concerns about workflow problems caused by EHRs are nothing new to most physicians. In a Medical Economics survey of 500 physicians last year, one-third said the greatest challenge associated with EHR adoption was the disruption to practice productivity during implementation.

Proper staff and physician training is among the most critical components in overcoming these types of challenges, the Medical Economics study has found.

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