3 Effective Ways to Enhance Patient Safety with EHR Alerts

Hospitals that adopt electronic health records (EHR) to optimize clinical workflows face the decision of how to integrate EHR alerts into their workflows. The rationale is to surface actionable data from EHR systems and present healthcare providers with this information to supplement their day-to-day clinical decisions. 

Though providers gain immense value from EHR alerts that are delivered properly, a new predicament emerges when the technology is suboptimally deployed. EHR fatigue stemming from frequent delivery of unactionable alerts raises concerns from overworked healthcare providers. Faced with cognitive overload, care providers report that they experience immense burnout, splitting their attention between patients and large volumes of unactionable alerts. Not only does alert noise create distraction, research suggests that it can result in serious implications to patient safety in unanticipated ways, and result in sentinel events.

That being said, effective delivery of actionable alerts optimizes several healthcare workflows and facilitates coordinated care, providing the right contextual information to the right clinician at their fingertips. When used judiciously, EHR alerts can bring a plethora of unrealized benefits for healthcare organizations.

This blog expands further on the benefits of EHR alerts, and the three ways in which EHR alerts are used to enhance patient health outcomes and streamline clinical workflows.  

Benefits of EHR Alerts

One clear benefit that the EHR system offers is the ease with which clinicians across the patient’s care continuum can access information. In research conducted at Cedars-Sinai Medical Center, it was found that physicians who adhered to EHR real-time alerts experienced lower total costs, shorter lengths of stay and lower readmission rates. 

Further, EHR greatly reduces the likelihood of adverse drug events such as allergies and life-threatening medication interactions by alerting nurses when duplicate or wrong medications are getting administered. In fact, EHRs are known to have reduced medication error by 52%. It must be noted here that benefits can only be realized when systems are used as intended, requiring that the previous medication is scanned and documented on the patient’s profile. 

Before diving more into the details of how EHR alerts complement clinical workflows, let’s address concerns related to alert fatigue, and discuss ways in which organizations can alleviate it.

Addressing EHR Alert Fatigue

While EHR alerts present immense opportunity for hospitals that are seeking to enhance patient care, the true measure of their efficacy is how well they’re being managed. At the outset, healthcare organizations that want to extract full value from EHR alerts must ensure that alert burden is not posed on a single care provider. Clinicians report that frequent alert deliveries to a single practitioner makes decision making onerous. Spreading out alerts across care teams based on expertise can be a plausible solution. 

Further, targeted efforts must be made toward ensuring that only actionable alerts are getting delivered. Urgent alerts must be distinguishable from non-urgent alerts, and they must be delivered on elevated channels beyond the regular channels of alerting. Machine learning can be leveraged to boost accuracy as it learns clinician behavior over time and filters alerts that are non-critical in nature. All of these measures combined may lead to lesser instances of reflexive dismissals of real alerts, and clinicians will build back their sensitivity to EHR alerts.

The sections to follow expands further on this topic and sheds light on several ways to improve patient health using EHR alerts.  

1. Supplementing Transition of Care

Transition of care can be defined as the movement of patients from one care setting to another care setting. For instance, a patient being moved from ambulatory primary care to ambulatory specialty care practice for specialized treatment experiences transition of care. 

During care transition, the exchange of information is central to ensuring a safe handoff. Information related to the patient’s health, medications administered, and lab reports are passed in real time to the next care provider in charge, empowering them with the knowledge needed to provide the best course of care under their supervision.  

Hospitals that use EHR systems to supplement e-handoffs and record-keeping improve accuracy and patient safety, and attenuate the risk of transcription errors. Aside from powering clinical decisions through e-handoffs, EHRs deliver real-time alerts that indicate patient admission and discharge transactions. 

EHR alerts can help to keep care teams apprised of their referrals, presenting them with the opportunity to prepare for the next patient. An EHR alert, for instance, gets triggered when a referral note is generated by a PCP for the on-call radiologist. Since EHR’s native alerting system cannot handle role-based alerting, clinical communication and collaboration (CC&C) systems such as OnPage are used.

2. Sepsis Risk Response

Globally, healthcare organizations face staggering risks from sepsis – a health crisis that causes morbidity and mortality in 6 million patients each year. The ongoing impact from its wide prevalence has forced hospitals to explore tools that are able to alert practitioners when a sepsis risk surfaces. As such, several EHR/EMR vendors offer predictive analytics to detect early warning signs of sepsis, alerting practitioners of high-risk patients on their portal. 

While some health practitioners question the accuracy of this technology due to the false positive alert volumes coming from these systems, one can’t undermine the life-saving opportunities that it presents to care teams. 

3. Supplementing Clinical Decisions

EHRs may also be used to supplement clinical decisions during care delivery. The systems deliver alerts and pop-ups to remind physicians when patients are due for tests and screenings. The goal is to maximize the quality of patient interaction and identify gaps in care, improving overall health outcomes for patients. 

Also, hospitals stand to gain from these alerts as patients build a sense of loyalty towards their physician. Healthcare interactions powered by EHR alerts result in a more comprehensive and personalized care delivery, and patients come out of visits with more hope and a better perception of the quality of care

EHR alerts and CC&C

As the healthcare industry moves towards embracing coordinated care, healthcare leaders must actively seek out workflow optimization opportunities that free healthcare information from the limitations of compartmentalized systems. They must invest in centralized communication systems that streamline urgent communication flow and make information accessible to care providers to support decision making. Further, alerts that are critical in nature must be delivered persistently and reliably until acknowledged, ensuring that no alert goes unnoticed.

To that end, OnPage’s clinical communication and collaboration can be used as a unifying solution to aggregate critical alerts and deliver them to the right on-call practitioner. Alerts are managed based on routing rules and escalation policies and are persistent to ensure reliable delivery. The goal is to enhance EHR’s native alerting, accelerate efficient workflows, establish failsafe mechanisms and minimize costs associated with broken communication.

Conclusion

EHR alerts create immense value for both providers and patients, yet they may also result in alert fatigue if managed incorrectly. Actionable EHR alerts that are leveraged during transition of care, sepsis risk identification and clinical decision making present life saving opportunities for care providers. As such, it helps lower healthcare costs, readmission rates and sentinel events, and improve patient satisfaction and clinician morale.