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Despite the American Heart Association's published best-practice standards (Circulation 2017; 136:e273), cardiac monitoring or telemetry often is used inappropriately in hospitalized patients. Most telemetry alarms are nonactionable and result in alarm fatigue (NEJM JW Hosp Med Sep 2017 and J Hosp Med 2017; 12:447).
Using a cluster-randomized trial design in 12 non–intensive care inpatient medicine units, researchers in San Francisco assessed the effect of providing electronic health record (EHR) telemetry alerts that prompted physicians to discontinue telemetry, write a new telemetry order, or dismiss the alert when guideline-based indications for monitoring expired for a patient. Intensive care unit patients were excluded. During the 6-mon…