Identification of strategies to reduce computerized alerts in an electronic prescribing system using a Delphi approach

Objective: To reach consensus among prescribers of different specialties and experience on the usefulness of computerised alerts and strategies for reducing low-value alerts within a commercial electronic prescribing system. Method: We conducted a Delphi technique where participants were sent a 10-question survey in rounds 1 and 2 to rate the usefulness of existing alert types and to indicate if 1) therapeutic duplication alerts should be adjusted so that they fired only when both medication orders were active; 2) local messages should be changed to hyperlinks rather than alerts. Forty-seven prescribers completed round 1 and 21 round 2. Results and discussion: Prescribers varied in their views on alerts of little value but agreed allergy and intolerance alerts should be retained. Most prescribers indicated that the proposed strategies for reducing local messages and duplication alerts would not compromise patient safety. Involving users in customization of alerts proved to be a successful approach.