Impact of Electronic Medical Record Alerts on Emergency Physician Workflow and Medical Management.

ABSTRACT

BACKGROUND: Electronic medical record (EMR) alerts are automated messages that notify the physician of important information. However, little is known about how EMR alerts affect the workflow and decision-making of emergency physicians (EPs). STUDY OBJECTIVES: This study aimed to quantify the number of EMR alerts EPs receive, the time required to resolve alerts, the types of alerts EPs receive, and the impact of alerts on patient management. METHODS: We performed a prospective observational study at a tertiary care ED with 130,000 visits annually. Research assistants observed EPs on shift from May to December 2018. They recorded the number of EMR alerts received, time spent addressing the alerts, the types of alerts received, and queried the EP to determine if the alert impacted patient management. RESULTS: Seven residents and six attending physicians were observed on a total of 17 shifts and 153 patient encounters; 78% (119) of patient encounters involved alerts. These 119 patients triggered 530 EMR alerts. EPs spent a mean of 7.06 s addressing each alert and addressed 3.46 alerts per total patient seen. In total, EPs spent approximately 24 s per patient resolving alerts. Only 12 alerts (2.26%) changed clinical management. CONCLUSION: EPs frequently receive EMR alerts, however, most alerts were not perceived to impact patient care. These alerts contribute to the high volume of interruptions EPs must contend with in the clinical environment of the ED.