Effective Medication Alert Systems Require Optimization for Improvement

Medication alert systems (MAS) are designed to make pharmacy practice safer, but new research suggests that excessive alerts, poor clinical relevance, and system limitations are leaving pharmacists frustrated. According to a study in the Journal of Pharmaceutical Health Care and Sciences, the alert settings, system integration, and clinical relevance of alerts among MAS need optimization for effective use going forward.¹

“MAS have been introduced as essential clinical decision support systems integrated into electronic health record (EHR) and computerized physician order entry systems to mitigate the risk of medication errors,” wrote the authors of the study. “MAS provide real-time alerts on the EHR interface to notify prescribing physicians of potential medication-related risks, such as drug-drug interactions, allergies, and inappropriate dosages.”

The findings reveal a complex landscape where MAS are widely implemented yet fundamentally underutilized due to systemic friction. Although over 80% of hospitals surveyed had secondary alert systems specifically for pharmacists, the level of satisfaction varied significantly depending on the type of check performed.¹

READ MORE: Pharmacists Essential for Managing Patient Safety in Self-Medication

For instance, although drug-drug contraindication checks received a moderate median satisfaction score of 5, disease contraindication and drug allergy checks plummeted to scores of 2 and 2.5, respectively. This dissatisfaction often stems from a poor signal-to-noise ratio, where a high volume of alerts is generated for issues that pharmacists deem clinically irrelevant or already managed. This phenomenon has led researchers to question whether these systems are effective or merely exasperating.^1,2

Alert fatigue is not just a nuisance but a legitimate threat to patient safety, as providers become desensitized and may unintentionally ignore critical warnings. In the current study, pharmacists frequently cited excessive alerts and discrepancies between the system’s output and their own professional clinical judgment as primary reasons for their frustration.

The Common Hurdles Among MAS

This mirrors broader research suggesting that when alerts provide too much extra information or do not currently apply to the specific patient, such as warning about a drug the patient has tolerated for years, the risk of clinician burnout increases. To combat this, health systems are being urged to analyze alert data consistently to identify trends, such as which alerts are most frequently overridden, to initiate quality improvement projects that refine these electronic workflows.^2,3

Furthermore, the lack of seamless system integration serves as a significant barrier to the optimization of MAS. Pharmacists in the primary study specifically noted a lack of linkage between EHRs and pharmacy management systems, which often necessitates redundant manual data entry and prevents the system from checking against a patient's full medication history, including their own personal medications.¹

This gap in knowledge is particularly detrimental in community pharmacy settings, where limited access to patient health information like lab values, vitals, and diagnoses is a known reason for delays in care and dispensing errors. When pharmacists are granted comprehensive EHR access, they can perform more confident assessments of drug therapy problems and assist in the appropriate escalation or de-escalation of chronic medications based on real-time data, according to a study in Pharmacy.⁴

Improving MAS from Pharmacist Feedback

Optimization requires a shift in how alerts are designed and categorized. Clinical decision support systems typically utilize both interruptive alerts, which require an immediate action like acknowledging a receipt or snoozing the warning, and noninterruptive alerts that serve as general reminders without stopping the workflow.³

For these to be effective, experts suggest that medication safety systems must be employed correctly, which includes ensuring that the medication list is reconciled with the patient at every visit to include OTC medications, vitamins, and herbal supplements. Without such comprehensive data entry, the automated checks for drug interactions cannot be performed accurately, according to the Medical Group Management Association.⁵

The goal of optimizing these systems is to ensure that the act of putting patient safety first remains at the heart of care delivery. This involves not only technical improvements, such as enhancing alert language and readability, but also a commitment to continuous clinical training on the functions of EHR software.^3,5

Despite technology significantly reducing the risk of harmful interactions, it cannot replace human judgment. Instead, it should serve as a high-quality reference material that supports the pharmacist's expertise.

By addressing system interoperability, reducing unnecessary alert frequency, and enhancing the clinical relevance of warnings, health care organizations can transform MAS from a source of frustration into a powerful tool for safer, data-driven practice.^1,3

“Pharmacists commonly reported excessive alerts, discrepancies between alert results and clinical judgment, and system-related limitations as reasons for dissatisfaction,” they concluded.¹ “These findings highlight the need to optimize alert settings, improve system integration, and enhance the clinical relevance of alerts.”

READ MORE: Leveraging Technology in Clinical Services for Pharmacy Sustainability

REFERENCES

1. Omoto T, Inagaki M, Asaka J, et al. Implementation of medication alert systems and pharmacist satisfaction: a questionnaire-based study. J Pharm Health Care Sci. July 17, 2026. doi:10.1186/s40780-026-00611-0

2. Electronic medical record medication alerts: effective or exasperating? The Oncology Nurse. Accessed July 20, 2026. https://www.theoncologynurse.com/articles/ton-3671

3. How EHR alert data can drive decision-making in healthcare. Phrase Health. December 27, 2021. Accessed July 20, 2026. https://www.phrasehealth.com/resources/how-ehr-alert-data-can-drive-decision-making-in-healthcare

4. Krauss ZJ, Abraham M, Coby J. Clinical pharmacy services enhanced by electronic health record (EHR) access: an innovation narrative. Pharmacy (Basel). 2022 Dec 5;10(6):170. doi: 10.3390/pharmacy10060170.

5. Digiovanni D. Using the medication safety systems in your EHR to reduce risk. Medical Group Management Association. January 1, 2018. Accessed July 20, 2026. https://www.mgma.com/articles/using-the-medication-safety-systems-in-your-ehr-to-reduce-risk