EHR-related alert fatigue: minimal progress to date, but much more can be done

In BMJ Quality & Safety, Shah et al report their evaluation of the degree to which efforts in the US Veterans Health Administration to reduce electronic health record (EHR)-related information overload have achieved their goal.1 Studying the Veterans Health Information System and Technology Architecture (VistA), an internally developed EHR platform used throughout the Department of Veterans Affairs (VA) system, Shah and colleagues report that the median number of mandatory notification types at each VA facility decreased from 15 (IQR 13–19) to 10 (IQR 10–11) preintervention to postintervention, respectively (p<0.001). And, mean daily notifications per primary care physician decreased significantly from 128 to 116 (p<0.001).

I have several reactions to this contribution on EHR-related notifications to clinicians. The first is gratitude for devoting effort towards reducing physician burden and improving safety. A great deal has been written on shortcomings of EHRs and how dissatisfied physicians are with using...

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