Events

Prof. Hossein Piri
Assistant Professor
Operations and Supply Chain Management [OSCM] Haskayne School of Business
University of Calgary

Pharmacists play a central role in preventing medication errors, aided by Computerized Provider Order Entry (CPOE) alert systems that flag potential drug interactions and contraindications. However, to capture risks, these systems generate high volumes of alerts, which can cause alert fatigue and reduce responsiveness to critical warnings. This study develops a fluid optimization framework for CPOE alert design that explicitly models pharmacist fatigue. A key challenge is the dynamic feedback loop: each alert contributes to fatigue, which in turn diminishes responsiveness to future alerts. We show the optimal policy has a decreasing-threshold structure—initially selective, then more permissive as fatigue accumulates. We also find that a fixed-threshold policy is asymptotically optimal for a wide class of distributions. We evaluate our approach using four years of hospital alert data. We find the proposed policies reduce alert volume by up to 50% and patient risk by over 40% compared to current practice. In particular, improper responses to life-threatening alerts drop by 37%, which translates to saving 1,839–4,429 lives and $322–$666 million in cost across the U.S. These results demonstrate that accounting for human cognitive limitations in decision-support systems can yield substantial improvements in patient safety and system efficiency.