Have you been on the other side of this? I get dozens of sepsis alerts a day, usually on the same patient, and the criteria that triggers them is so broad and non specific they are functionally useless. Each alert locks down the entire system ironically preventing you from reviewing what triggered it in the first place. You cannot do anything until it is addressed and you are forced to commit to an action without all the data because of it like administer a medication or order fluids, which may not be appropriate. Lots of things mimic sepsis criteria including but not limited to decompensated cirrhosis, HF, cancers, leukemias. The worst is that they don’t even pop up at the right time, they usually pop up usually way after the sepsis has been treated. In the past year, I’ve only had about a half dozen appropriate sepsis pop ups among the hundreds I’ve received.
It blocks the system with a demanded action, but doesn't even show you what triggered the alert condition? I would completely expect a "List of conditions that suspect sepsis" and get those details up front and center.
I'd be putting in medical records "Due to software popping up an un-dismissable sepsis screen that does not show details, I dismissed it due to needing the data it was flagged on".
Yes, really. I’ve had to restart my Citrix session to make it go away or dismiss it like the writer did.
You’ll get something like “sepsis criteria triggered by wbc 13, cr 1.5, hr 101, rr 22.” And that’s it - usually in the middle of a night on a new patient I just got a page for. Can’t open documentation to see the patients med history.
It’s ridiculous. I’m not using Epic but I am using a major EMR.
To be fair I’ve written almost exactly what you mentioned out of sheer frustration once or twice but it’s not ideal
Yes, in almost every case, the default "popup" GUI library call is also a modal dialog. You cannot access anything else, anywhere else, in the entire program (even if the program had multiple separate windows open). All you can do is read the dialog's text, and hit the "ok" button to dismiss it (or pick from one of a set of "buttons" that are shown on the popup to dismiss it).
The worst ones also do a global grab, with the result that you can't even switch away to another unrelated application on the system without first "interacting" with and dismissing the popup.
To see the version that is built into Javascript in the browser, put the following into the URL field of a new bookmark, and save the new bookmark.
javascript:(function(){alert("hello");})();
Then, while here on HN (or anywhere else), click that new bookmark you just made, which will pop up the default built in Javascript alert box, and try to interact with the rest of the page it pops up in front of.
UI engineers need to be held legally responsible for false alarms like this.
My older car regularly hallucinates an incoming frontend collision and takes over the speedometer with a flashing red/black screen.
The new one (Kia) overrides the steering and forces the car to depart the lane (usually over double yellow lines).
If the alert regularly produces false positives then such behavior (and the behaviors of these EMRs) should open the vendor to civil and criminal liability. The courts should just assume the behavior will lead to loss of life, in the same way as discharging a firearm randomly in the city might.
It probably makes sense to have a short grace period to push a patch. Maybe one week after 0.1% of users complain?
If your vehicle has a safety defect then you should file a formal complaint with the NHTSA. These things won't get fixed unless customers follow the process.
Safety defect: my Tesla has a really distracting giant screen in the drivers field of view. WTF?
Closed: Working as Intended, Elon has us by the balls.
It’s similar to alarm fatigue in the ED. In most, every piece of equipment is alerting on at least one thing at any given moment, if just because the patients pulse-ox sensor is not attached super well.
But they came in because of a diabetic emergency and we’re just waiting to make sure the treatment worked and 99% of the time it does, so no one really cares, but the UX around silencing it isn’t great (and may be a liability if used). Like in this example.
Because maybe this is one of those 1/1000 cases where the insulin didn’t work, and they lost all peripheral circulation and that pulse-ox sensor’s bad reading is warning you that they are about to lose all their fingers.
Appreciate the added and specific context. I'm not in the medical field but I have worked on EMRs.
What, by your estimation, would be the better user experience for alerting the imminently life threatening situation?
It sounds like a signal to noise ratio with false positives, but IMO I'd rather a provider be at least given the time to pause and consider the diagnosis. I'm not sure about the optimal way to do it.
We are grading a tool which might not need to be there at all. It shouldn't get points for coming in six hours later saying that the patient being treated for sepsis might have sepsis. See what I'm saying? There's a cost to every flag you wave.
