EHR alert fatigue causes clinicians to override 49-96% of drug safety warnings, including critical ones

Clinicians in hospitals see 100 to 200 medication safety alerts per day, the vast majority of which are clinically irrelevant, leading them to override 49-96% of all drug safety alerts — including critical warnings about potentially fatal drug interactions. So what? When a genuinely dangerous interaction (e.g., warfarin + a newly prescribed NSAID in an elderly patient) triggers an alert, the clinician dismisses it reflexively because the previous 99 alerts were noise. So what? This directly causes preventable adverse drug events — the kind where a patient bleeds internally because the interaction warning was buried among hundreds of trivial alerts about theoretical risks. So what? Alert fatigue has been implicated as a significant contributing factor in serious medication errors that result in patient harm, extended hospital stays, and death. So what? The problem compounds over time: as more drugs are added to formularies and more interaction data is published, alert volume increases, override rates climb higher, and the signal-to-noise ratio worsens. So what? Hospitals face malpractice liability when harm occurs from overridden alerts, yet cannot simply turn alerts off without regulatory risk. This persists structurally because EHR vendors (Epic, Cerner, etc.) ship drug interaction databases with maximally conservative defaults to avoid liability, and individual hospitals lack the pharmacoinformatics staff to tune thousands of alert rules to their specific patient populations.