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Is Flood Of Medical Alerts Harming Patients?

Alarms from increasingly sensitive health IT could be desensitizing clinicians to signs of patient danger.
The Joint Commission doesn't track statistics on alarm fatigue cases. However, with the number and frequency of alarm fatigue incidents appearing to be growing over the last year or so, the organization decided to refocus on the issue.

"It's time to relook at this. It appears that underlying issues haven't been solved," such as clinicians turning off alerts, said Schyve.

Meanwhile, "increasing sophistication and sensitivity of equipment that have more alerts, and more alarms" is likely contributing to clinicians' desensitization of the warnings, he said.

"Manufacturers are trying to make their products safer by adding alarms" but the impact may be negative. "Did an alarm go off because of a dangerous change in heartbeat or because the patient moved?" said Schyve. These are the kinds of questions healthcare workers have to investigate many times daily. But, "when people have had a number of these false positives, they begin to ignore the alarms. Our brains tune out something that keeps occurring," he said.

"If every manufacturer puts an alert in their systems for the same thing, but it sounds different, that doesn't help," he said. "There needs to be some standardization of alarms that make them easier to interpret, not just create a cacophony of sounds," he said.

The Joint Commission hopes that by teaming up with the FDA, together they can help shepherd change in behavior among clinicians, and push for more standardization and improvements in alerts from device makers, Schyve said.

Vendors Take The lead

Some EHR vendors are already working on the issue of alarm fatigue. Philips Healthcare, for instance, recently announced the customizable IntelliSpace Event Management system, which gathers clinical data from multiple medical monitoring devices, EHRs, and other systems, and allows alerts to be automatically prioritized and routed as a text messages to the most appropriate clinician, on their preferred mobile device.

While the system doesn't stop noisy alarms from going off on equipment in patient rooms, it could help draw attention to specific alerts from the clinicians responsible for acting on the issues.

"If it's a code blue, the alert will go to a specific group of people," but if it's a less urgent matter, like a patient hitting a call button to request some water, the message will go to someone else, said Philips Healthcare product manager Barbara Sullivan in an interview.

Meanwhile, perhaps more vendors need to recognize that their increasingly sophisticated and "smart" health IT products and medical devices might aim to improve patient care, but too many bells and whistles could be counterproductive to reaching those goals.

"Technology solutions try to catch and prevent mistakes with alerts," said Schyve. However, "we may be entering a new era of being overwhelmed."

Marianne Kolbasuk McGee is a senior writer for InformationWeek.