ArticleJournal of the American Medical Informatics Association : JAMIA2021
Alert burden in pediatric hospitals: a cross-sectional analysis of six academic pediatric health systems using novel metrics.
Article in Journal of the American Medical Informatics Association : JAMIA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Machine Learning-Based Prediction of Critical Deterioration in the PICU.Critical care explorations · 2026Article
- Experiences of Alert Fatigue and Its Contributing Factors in Hospitals: Qualitative Study.Journal of medical Internet research · 2026Article
- Suicidality Screening: Ensuring Providers Do Not Miss Adolescents at High Risk through Clinical Decision Support.Applied clinical informatics · 2025Article
- Transitioning Ineffective Medications on Hold Alert from Interruptive to Noninterruptive Alert to Decrease Alert Burden.Applied clinical informatics · 2025Article
- Clinical implementation of AI-based screening for risk for opioid use disorder in hospitalized adults.Nature medicine · 2025Observational
- Analyzing Physician In Basket Burden and Efficiency Using K-Means Clustering.Applied clinical informatics · 2025Article
- Alert design in the real world: a cross-sectional analysis of interruptive alerting at 9 academic pediatric health systems.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Guidance for reporting analyses of metadata on electronic health record use.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- In pursuit of the alert fatigue: an assessment of drug alert burden at a large academic medical center.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Addressing Alert Fatigue by Replacing a Burdensome Interruptive Alert with Passive Clinical Decision Support.Applied clinical informatics · 2024Article
- Comparative effectiveness of generic commercial versus locally customized clinical decision support tools to reduce prescription of nonsteroidal anti-inflammatory drugs for patients with heart failure.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Pseudorandomized Testing of a Discharge Medication Alert to Reduce Free-Text Prescribing.Applied clinical informatics · 2023Article
- Trends in computerized provider order entry: 20-year bibliometric overview.Frontiers in digital health · 2023Review
- Effectiveness, quality and implementation of pain, sedation, delirium, and iatrogenic withdrawal syndrome algorithms in pediatric intensive care: a systematic review and meta-analysis.Frontiers in pediatrics · 2023Review
- Appropriateness of Alerts and Physicians' Responses With a Medication-Related Clinical Decision Support System: Retrospective Observational Study.JMIR medical informatics · 2022Article
- Clinical Decision Support Stewardship: Best Practices and Techniques to Monitor and Improve Interruptive Alerts.Applied clinical informatics · 2022Review
- Celebrating Randolph A. Miller, MD, 2021 Morris F. Collen Award winner and pioneer in clinical decision support.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExcessive electronic health record (EHR) alerts reduce the salience of actionable alerts. Little is known about the frequency of interruptive alerts across health systems and how the choice of metric affects which users appear to have the highest alert burden.
objective(1) Analyze alert burden by alert type, care setting, provider type, and individual provider across 6 pediatric health systems. (2) Compare alert burden using different metrics. MATERIALS AND
methodsWe analyzed interruptive alert firings logged in EHR databases at 6 pediatric health systems from 2016-2019 using 4 metrics: (1) alerts per patient encounter, (2) alerts per inpatient-day, (3) alerts per 100 orders, and (4) alerts per unique clinician days (calendar days with at least 1 EHR log in the system). We assessed intra- and interinstitutional variation and how alert burden rankings differed based on the chosen metric.
resultsAlert burden varied widely across institutions, ranging from 0.06 to 0.76 firings per encounter, 0.22 to 1.06 firings per inpatient-day, 0.98 to 17.42 per 100 orders, and 0.08 to 3.34 firings per clinician day logged in the EHR. Custom alerts accounted for the greatest burden at all 6 sites. The rank order of institutions by alert burden was similar regardless of which alert burden metric was chosen. Within institutions, the alert burden metric choice substantially affected which provider types and care settings appeared to experience the highest alert burden.
conclusionEstimates of the clinical areas with highest alert burden varied substantially by institution and based on the metric used.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.