Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts.
Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time-the time elapsed from when an interruptive alert is generated to when it is dismissed-could be calculated by using historical alert data from log files. Drug-drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1-4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < 001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < 001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts.
Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Robert B
RB
McDaniel
Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Jonathan D
JD
Burlison
Department of Information Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Donald K
DK
Baker
Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Murad
M
Hasan
Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Jennifer
J
Robertson
Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Christine
C
Hartford
Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA, University of Memphis, Memphis, Tennessee, USA.
Scott C
SC
Howard
Department of Information Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
Andras
A
Sablauer
Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee, USA James.Hoffman@stjude.org.
James M
JM
Hoffman
D056902:Clinical Alarms; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D006801:Humans; D050316:Medical Order Entry Systems; D017010:Reminder Systems; D013997:Time Factors
clinical decision support; computerized prescriber order entry; electronic health record; interruptive alerts; override rates