for the Primary Care Investigative Group of

The authors used a real-time survey instrument and subsequent focus group among primary care cli-nicians at a large healthcare system to assess useful-ness of automated drug alerts. Of 108 alerts encoun-tered, 0.9 % (n = 1) represented critical alerts, and 16% (n = 17) were significant drug interaction alerts. Sixty-one percent (n = 66) involved duplication of a medica-tion or medication class. The rest (n = 24) involved topical medications, inhalers, or vaccines. Of the 84 potentially relevant alerts, providers classified 11% (9/84), or about 1 in 9, as useful. Drug interaction alerts were more often deemed useful than drug duplication alerts (44.4 % versus 1.5%, P<.001). Focus group partic-ipants generally echoed these results when ranking the relevance of 15 selected alerts, although there was wide variance in ratings for individual alerts. Hence, a “smarter ” system that utilizes a set of mandatory alerts while allowing providers to tailor use of other automated warnings may improve clinical relevance of drug alert systems. (Am J Med Qual 2005;20:7-14