Being constantly connected to our networks is mostly good. You can get real-time updates from work and home. Unfortunately, this hyper-connectivity challenges us to prioritize incoming messages and act accordingly. The incessant alerts can lead to “alert fatigue,” a state where the user ignores all alerts, regardless of their relative value. Ideally, we would like to filter out the notifications that can wait (“white noise”) and focus on the ones that require urgent action.
In my role as vice president of clinical information at Advocate, I am responsible for prioritizing inpatient clinical information system physician projects. Advocate is a large health care system (with plans to get even bigger), that utilizes multiple electronic medical records (EMRs) in the inpatient and outpatient settings. One organizational objective is to use information technology to better coordinate care across different settings. Since our physicians use different EMRs, our challenge was to find an EMR-vendor agnostic solution.
Our initial test case was notifying physicians that their patients were being discharged from the emergency department for rapid outpatient follow-up. Many organizations use some form of HIPAA-compliant text messaging to communicate patient health information among physicians. Our goal was to notify each patient’s primary care provider about their patients using an automated process. We had used this same approach to notify inpatient physicians about pathology results without requiring a phone call or logging into an EMR. Some physicians really appreciated hearing about their patients getting discharged, but not in the middle of the night. We adjusted the discharge alerts so they only went out twice a day. Other physicians felt the patient would be better served if the message went to their office staff to schedule the patient for a follow-up appointment in the office. We are now working to implement the next phase of customizing the notification process to accommodate clinician preferences and workflow.
Despite the hype about new technology entrants in the healthcare market, I believe that only those technology services that better serve physicians, patients and caregivers will persist. Customizing clinician communication methods to better meet their needs can only help us move forward. We are excited about the journey toward a better health care system using information technology to deliver high-value notifications, with less white noise.