Four researchers affiliated with various Veterans Affairs facilities across the U.S. developed a program to reduce "low-value" EHR notifications, according to study results published in BMJ Quality & Safety.
Seventy percent of primary care practitioners at VA facilities cite EHR inbox notifications, which communicate a range of clinical information, to be of "unmanageable volume," the study authors wrote. The researchers opted to create a national quality improvement program to address the challenges associated with EHR-related information overload and alert fatigue.
To develop the program, researchers assessed primary care practitioners' daily notification load at 148 VA facilities. Based on their review, the researchers restricted mandatory notification types to one standardized list across all VA facilities and provided hands-on training for primary care practitioners on how to customize and process notifications more effectively.
The average daily notifications per primary care practitioner decreased significantly from 128 notifications before the program's implementation to 116 after the intervention. Based on prior estimates of the time it takes providers to process notifications, the researchers said the results indicate the program saved each physician 1.5 hours per week on EHR work.
"Our project suggests feasibility of using large-scale 'de-implementation' interventions to reduce unintended safety or efficiency consequences of well-intended electronic communication systems," the study authors concluded. "The number of daily notifications remained high, suggesting the need for additional multifaceted interventions and protected clinical time to help manage them."