ACP Calls for Reduction in Low-Value EHR Alerts

Reducing burden on physicians has long been an advocacy priority for the American College of Physicians, and in its latest position statement on the issue, ACP calls for cutting down on low-value electronic health record (EHR) alerts and messaging functions.

“We know that our members are overburdened by EHR inbox/in-basket items,” said Dr. Ross W. Hilliard, chair of the ACP Medical Informatics Committee. “These drive burnout and frustration, as the tasks seem to be unending and are generally uncompensated, though they are important for good patient care. There are also lots of additional alerts that are generally distracting though intended to be helpful.”

EHR vendors can help redirect messages as appropriate and suppress messages that are not necessary for care, according to Hilliard. “In addition, we know that there are chances to help reduce message and alert burden across the board,” he said.

Specifically, vendors can provide standard, freely available default features that automatically log the volume of alerts and messages by category. These data could then be used to reduce low-value alerts, ACP states in the position statement. Another suggestion is to make sure a new alert or message is useful and not harmful or overly burdensome before launching it for routine use.

Removing the physician from the messaging chain when appropriate can also help reduce the burden. ACP suggests streamlining alerts and messages so that the physician is rarely the first person on the team to see them. “We know that physicians don't need to be involved in every single interaction,” Hilliard said.

In addition, health care systems should include physicians in the design and testing of new alerts and messaging features and allow end users to exert discretionary power over their use.

ACP also supports further research into artificial intelligence and machine learning technologies to determine whether they can lessen the burden of EHR alerts and messages without negatively affecting patient care.

“There are huge opportunities to continue to address low-value messages/alerts and to redirect tasks to members of the care team that are best suited to address [them],” Hilliard explained. “We have seen some vendors recognize the value of limiting message volume and the need to suppress some low-value messages.”

ACP members can all do their part to make sure that these changes are made by weighing in on messaging that does not add value or improve outcomes. “Members can continue to share cases where alerts/messages/work in the EHR are not valuable or at the level of physician work,” Hilliard suggested. “This allows us to keep advocating for decreased workload and messages/alerts.”