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Stephen N. Rosenberg, MD, MPH; Maureen Sullivan, PharmD; Iver A. Juster, MD; Jeffrey Jacques, MD

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Isaac et al,¹ writing in the February 9, 2009, issue of the Archives, describe an important and disturbing situation in which the promise of electronic prescribing systems to protect patient safety has been only partially realized. We have encountered a similar situation, which encompasses both electronic and paper prescriptions, in a system that generates clinical alerts using pharmacy claims data for prescriptions that have recently been filled. We agree with the authors' point (and the article by Shah et al² that they cite) that such systems can achieve better physician acceptance if they limit alerts to those with the highest clinical importance, thereby avoiding the initiation of "alert fatigue." We have also found that adding other sources of information—medical and laboratory claims, test results, feedback from physicians, and self-reported data from patients who are . . . [Full Text of this Article]

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