{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:48:10Z","timestamp":1791852490295,"version":"4.3.4"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Although interruptive alerts, or pop-ups, are one of the most common forms of clinical decision support (CDS) tools within the electronic health record (EHR), they are often ignored. Interruptive alerts have the potential to enhance patient care and reduce clinician burden, but end-users frequently experience alert fatigue and override alerts, defeating their purpose. Few studies have elicited the perspectives of all stakeholder groups involved in the development, experience, and review of inpatient interruptive alerts in the modern vendor EHR era.<\/jats:p>\n                  <jats:p>Objectives This study aimed to understand the perspectives of multiple stakeholders involved in development, governance, and use of inpatient interruptive alerts.<\/jats:p>\n                  <jats:p>Methods We conducted a qualitative study, interviewing 22 participants, including 15 end-users, 4 governance group members, 2 clinical leads, and 1 information systems staff member. The semi-structured interview guides were designed to explore different participant perspectives on interruptive alerts.<\/jats:p>\n                  <jats:p>Results We found three domains across end-users related to interruptive alert helpfulness, proportionality, and alarm fatigue. We found three domains across the governance, clinical lead, and information system groups about the causes of high-volume and high-sensitivity interruptive alerts, differing definitions of interruptive alert success from end-users, and reluctance to add new interruptive alerts but limited changes or retirement of existing interruptive alerts. Barriers to successful CDS could be grouped into end-user, technical, and governance-level barriers. We found one governance-level facilitator and gathered several recommendations for CDS improvement from all stakeholder groups, including changing alert \u201cinterruptiveness,\u201d customizability, design, responsiveness, and involving end-users in alert analysis.<\/jats:p>\n                  <jats:p>Conclusion This study highlights the need for robust, user-centered alerts and CDS development and evaluation to improve clinician experiences and potentially patient outcomes.<\/jats:p>","DOI":"10.1055\/a-2955-9555","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:16:01Z","timestamp":1790378161000},"page":"889-898","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative Study of Inpatient Hospital Medicine Interruptive Alerts and Clinical Decision Support"],"prefix":"10.1055","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9825-8550","authenticated-orcid":false,"given":"Afifah","family":"Khan","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Massachusetts, United States","place":["Boston"],"department":["Department of General Internal Medicine"]},{"name":"Harvard Medical School, Massachusetts, United States","place":["Boston"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Schnipper","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Massachusetts, United States","place":["Boston"],"department":["Department of General Internal Medicine"]},{"name":"Harvard Medical School, Massachusetts, United States","place":["Boston"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"13","key":"ref1","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1001\/archinte.1994.00420130107014","article-title":"Effect of computer-based alerts on the treatment and outcomes of hospitalized patients","volume":"154","author":"D M Rind","year":"1994","journal-title":"Arch Intern Med"},{"issue":"15","key":"ref2","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.280.15.1339","article-title":"Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review","volume":"280","author":"D L Hunt","year":"1998","journal-title":"JAMA"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1197\/jamia.M1370","article-title":"Ten commandments for effective clinical decision support: making the practice of 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Knight","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1136\/jamia.2009.002030","article-title":"Governance for clinical decision support: case studies and recommended practices from leading institutions","volume":"18","author":"A Wright","year":"2011","journal-title":"J Am Med Inform Assoc"},{"key":"ref41","first-page":"624","article-title":"A pragmatic guide to establishing clinical decision support governance and addressing decision support fatigue: a case study","volume":"2018","author":"K Kawamanto","year":"2018","journal-title":"AMIA Annu Symp Proc"},{"issue":"03","key":"ref42","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1136\/amiajnl-2011-000113","article-title":"Development and evaluation of a comprehensive clinical decision support taxonomy: comparison of front-end tools in commercial and internally developed electronic health record systems","volume":"18","author":"A Wright","year":"2011","journal-title":"J Am Med Inform Assoc"}],"container-title":["Applied Clinical 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