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Suzanne Bakken, Need for innovation in electronic health record-based medication alerts, Journal of the American Medical Informatics Association, Volume 26, Issue 10, October 2019, Pages 901–902, https://doi.org/10.1093/jamia/ocz155
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Electronic health record (EHR)-based medication alerts have been the focus of decades of biomedical and health informatics research as well as health services research. The editorial by Associate Editor Julia Adler-Milstein characterizes the similarities and differences between health informatics and health services research and points out the requirement of informatics innovation for publication in JAMIA.1 Clinical decision support (CDS) for medication management including dose, route, contraindications, and drug–drug and drug–disease interactions is a core component of commercial EHRs. This begs the question: is there still a need for informatics innovation in EHR-based medication alerts?
In this issue of JAMIA, 5 papers reflect biomedical informatics innovation related to EHR-based medication alerts. In a systematic review of 39 studies, Hussein, Reynolds, and Zheng examined medication safety alert fatigue, finding that interruptive CDS was least accepted by alert recipients.2 Among alternative models such as risk stratification tiers, providing shortcuts for common corrections, and tailoring to role (eg, pharmacist vs prescriber), only the last increased alert acceptance. The authors concluded that improved CDS interaction design and role tailoring may reduce medication safety alert fatigue.