Why standard ADT alerts don't work for value-based care

Alert fatigue occurs when clinicians are exposed to such a high volume of warnings, notifications, and pop-ups within electronic health records (EHRs) that they become desensitized to them over time. What begins as a well-intentioned safety feature — flagging drug interactions, allergies, abnormal lab values, or overdue screenings — can quickly become an overwhelming stream of interruptions, many of which are low-value or redundant.

Studies have consistently shown that physicians override the vast majority of clinical decision support alerts, in some cases more than 90%, often without fully reading them. This isn't necessarily a sign of carelessness; rather, it reflects a system that has trained clinicians to tune out noise in order to keep pace with patient care. The problem is that this desensitization can cause truly critical alerts, the ones that could prevent serious harm, to get lost in the shuffle.

The consequences extend beyond patient safety. Alert fatigue is frequently cited as a contributor to physician burnout, adding cognitive burden to an already demanding workflow, as Medical Economics has explored in a look at how technology solutions can ease administrative burdens driving burnout.

Health systems and EHR vendors have been exploring solutions, including smarter alert tiering, AI-assisted filtering, and customization based on specialty or individual provider preferences, but the challenge remains a persistent one across nearly every care setting.

There is also the problem of ADT (admission, discharge, transfer) alerts that are supposed to help care teams track patients. But these alerts are really geared toward fee-for-service reimbursement setups, and don’t really meet the needs of today’s value-based care arrangements, says Steven Lane, CMO, Health Gorilla. Medical Economics spoke to Lane about these alerts and how they can be managed better.