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For busy health care workers, the electronic health record (EHR) can feel like an endless stream of clicks and prompts. But three Michigan Medicine studies suggest that well-designed alerts for critically ill cardiac patients can change what happens at the bedside, prompting clinicians to make recommended treatment decisions and recognize when patients are deteriorating.

The studies—published in Heart & Lung, the Journal of Cardiac Failure and JACC: Case Reports—demonstrated the effectiveness of EHR alerts in two settings for critically ill cardiac patients: the emergency department and the cardiac intensive care unit.

The results reveal that implementing alerts directly into the digital workflow can nudge clinical teams toward evidence-based decisions in these situations.

"These clinical decision support (CDS) tools are most useful when they help clinicians make the right decision in the moment, rather than adding more noise to their busy workflows," said Scott Ketcham, M.D., a cardiologist at the University of Michigan Health Frankel Cardiovascular Center and an author of all three studies.

"These findings suggest that well-designed EHR CDS tools have potential to improve clinical decision-making, even in the fast-paced environments of the emergency department and cardiac intensive care unit."

In the emergency department study, researchers evaluated a tool designed to help clinicians choose the appropriate dose of an intravenous loop diuretic for patients with acute decompensated heart failure. The medication removes excess fluid, allowing the heart to pump more effectively and relieving shortness of breath.

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