In theory, the rich trove of information captured by EMRs supports patient care. But in practice, when the data gets overwhelming it can have the opposite effect, according to a new study of primary care physicians within the VA system.
A group of Houston researchers, including the VA Health Services Research and Development Center of Excellence, surveyed almost 2,600 VA PCPs between June 2010 through November 2010, asking about their experience witih EMR-based alerts.
According to a report in Modern Healthcare, almost 30 percent of PCPs said they had missed notification of test results which then lead to care delays. (These results were presented in a research letter in the AMA journal JAMA Internal Medicine.)
Under the circumstances, it’s hardly surprising that doctors would sometimes lose track of EMR alerts. Respondents in the Houston study reported that they received a median of 63 alerts a day (no, that’s not a typo). Almost 87 percent of the PCPs surveyed thought that was an excessive level.
Aside from the sheer volume alerts, other reasons PCPs felt they missed test results included poor EMR usability and gaps in electronic handoffs of a patient’s record to another provider, Modern Healthcare reports.
The researchers behind the study argue that it’s time to adapt EMRs to allow for the safe handling of test result follow-up in EMRs.
I’d argue that this, for once, can’t be laid strictly on the doorstep of the EMR vendors. Alarm fatigue of all kinds comes up as a major IT health risk over and over again when researchers take on the subject. So even if EMRs had embedded a way to track and highlight abnormal test results intelligently, it won’t do much to lower the distraction level in hospitals generally.
This study is just one more alarm of its own, warning us that even the best-rested, most-focused PCP is only human and can only adapt to so many interruptions. Lowering alarm overload in hospitals generally, be it within EMRs or outside, clearly continues to be a critical issue for hospital IT leaders to consider.