With alert fatigue threatening to infiltrate the electronic medical records systems, EMRs of the future will take a more streamlined, personalized approach to the way they use clinical decision support tools.
That was one of the conclusions at a panel discussion on EMRs at MedCity News’ CONVERGE conference this week.
Dr. Anil Jain, chief medical information officer with Explorys and a physician at the Cleveland Clinic, said future generations of CDS tools will have a reduced number of alerts because they will be more tailored to both patients and physicians. For example, when a patient comes in with an artificial hip, the clinical decision support system might alert the doctor that it needs to be replaced and a surgical procedure would be scheduled. Jain also observed that a physician who has been practicing for several years probably doesn’t require the same number of alerts that a physician with fewer years of experience would and future systems could use that information accordingly.
Reports published earlier this year by BMC Medical Informatics highlighted the concern over alarm fatigue associated with EMRs and clinical decision support tools,which has been flagged up as an issue with medical devices and monitors in hospitals by the ECRI Institute and has come under scrutiny by the U.S. Food and Drug Administration.
Brian Wells, associate chief information officer of health technology and academic computing at Penn Medicine, highlighted a predictive analytics tool his institution is developing that could catch any critical information the care team missed.
By Stephanie Baum
Stephanie Baum is the East Coast Innovation Reporter for MedCityNews.com. She enjoys covering healthcare startups across health IT, drug development and medical devices and innovations deployed to improve medical care. She graduated from Franklin & Marshall College in Pennsylvania and has worked across radio, print and video. She's written for The Christian Science Monitor, Dow Jones & Co. and United Business Media.Visit website | More posts by Author
Alert fatigue is obviously a huge problem, but CDS tools can minimize the number of alerts by incorporating a personalized medicine approach and providing alerts only when appropriate for the patient. Another filter that should be applied in the future is an 'experience' filter; I appreciated Dr. Jain's suggestion that the number of alerts be reduced according to the level of experience of the physician.
However, there is one type of CDS system will always be a step ahead of even the most experienced physician, and that is one that provides drug safety alerts captured from the real world of drug use. The information driving these alerts is developing day by day as new drugs enter the market or are used for different indications, and therefore are not experienced-based. The Medloom CDS (www.LeadHorseTech.com) uniquely delivers pharmacovigilance data to the point-of-care in alerts that encompass the 4 P's of personalized medicine: personalized, predictive, preventive, and participatory.
In an initial clinical study, Medloom had a greater than 80% rate of predictive accuracy for life-threatening adverse drug events. At a rate of ~1 alert for every 50 patients, Medloom does not contribute to alert fatigue, but instead accurately pinpoints patients at risk.
Ramie Leibnitz, Ph.D.
President, Lead Horse Technologies
ramie@leadhorsetech.com