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Appl Clin Inform 2025; 16(02): 402-408
DOI: 10.1055/a-2508-7039
State of the Art/Best Practice Paper

The Elements of Style for Interruptive Electronic Health Record Alerts

Jessica J. Pourian
1   Division of Clinical Informatics and Digital Transformation, Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States
,
Catherine Blebea
2   Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, San Francisco, California, United States
,
Charumathi R. Subramanian
3   Division of Clinical Informatics and Digital Transformation, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, United States
,
Andrew Auerbach
4   Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, United States
,
Raman Khanna
4   Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, United States
› Author Affiliations Funding None.
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Abstract

Background The proliferation of electronic health record (EHR) alerts has led to widespread alert fatigue and clinician burnout, undermining the effectiveness of clinical decision support and compromising patient safety.

Objectives We introduce a comprehensive style guide for designing interruptive alerts (IAs) in EHR systems to improve clinician engagement and reduce alert fatigue that has been approved by our institutional alert governance committees. This style guide addresses critical aspects of IAs, including format, typography, color coding, title brevity, patient identification, and introductory text. It also outlines the use of typographic emphasis, response options, default actions, and opt-out mechanisms, emphasizing the need for clear, concise, and actionable alerts that consider clinician workflow and cognitive burden.

Discussion A standardized style guide for IAs can enhance clinician experience and clinical outcomes by reducing alert fatigue. Incorporating feedback and continuous evaluation of alert effectiveness is essential for maintaining relevance and supporting patient care within a dynamic clinical environment.

Keywords

clinical decision support - alert fatigue - interruptive alerts - user interface design - patient safety

Protection of Human and Animal Subjects

This study did not involve human subjects. No human subjects protections were applicable.




Publication History

Received: 26 July 2024

Accepted: 27 December 2024

Accepted Manuscript online:
31 December 2024

Article published online:
07 May 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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