Best Practice Alerts that increased provider engagement

A leading health system in the Northeast needed to improve engagement with Best Practice Alerts (BPAs) during pre-visit reviews. Providers were missing conditions and important contraindications, creating avoidable care risk and weakening the information available for risk adjustment factor (RAF) score calculation.

The provider had tried adding more BPAs inside its Electronic Health Record (EHR), but engagement continued to decline. The organization turned to the team after successful medical coding work because it needed clinical review, workflow redesign, and provider education that could make alerts useful rather than easy to dismiss.

The Challenge

The provider was not facing a simple EHR build problem. It had already added more BPAs, yet provider engagement continued to fall. The problem grew from alert fatigue: providers saw a constant flow of irrelevant alerts, learned that many alerts would not help the pre-visit review, and often closed them without reading them.

That behavior created clinical, financial, and operational risk. Overlooked conditions and contraindications exposed the provider to preventable care errors. Missed conditions also reduced the completeness of RAF score inputs, creating missed opportunities for care planning and reimbursement. Continuing to build more ineffective BPAs would have increased cost without improving engagement.

The Solution

Curated BPA redesign with provider-led feedback and training

We treated BPA performance as a clinical workflow and engagement problem rather than an alert-build volume problem. The approach was anchored in four mechanisms:

• Current BPA review: Evaluated the existing BPAs in the EHR to understand which alerts lacked relevance, where providers disengaged, and how the pre-visit review workflow shaped alert use.
• Individual provider feedback: Met individually with providers to learn why the alerts were ineffective and to identify the points where alert fatigue caused them to close BPAs without reviewing the content.
• Curated evidence-based BPA design: Worked with subject matter experts to create new BPAs based on provider feedback, then built evidence-based guidelines that helped providers align their workflow with the alerts during pre-visit reviews.
• Customized training and feedback loops: Implemented regular training sessions tailored to provider needs and preferences, using those sessions to answer questions, resolve concerns, and continue improving BPA effectiveness.

The Impact

• BPA acceptance rate improved from under 50% to 90% after curated BPAs and training were implemented, giving leaders a measurable engagement change inside the pre-visit review workflow.
• Provider engagement increased 23% after the alert redesign, exceeding the provider's expectations for engagement improvement.
• RAF score accuracy improved because providers engaged more consistently with BPAs tied to pre-visit review and diagnosis capture.
• Fewer conditions were missed as decreased alert fatigue helped providers engage with alerts that were more relevant to care planning and documentation.
• Timely diagnosis capture and outcomes improved with the provider noting timely capture of patient diagnoses, reduced readmissions, and improved overall health outcomes.

Why Us

The provider had already worked with the team on several successful medical coding projects and trusted the team's healthcare professional services experience. That prior performance, combined with clinical review expertise and reliability, made the team the preferred choice for addressing low provider engagement with BPAs.

Transferable Insights

For CFOs, Chief Revenue Cycle Officers, HIM, coding, CDI, and risk adjustment leaders, the practical lesson is that EHR alerts need clinical relevance and provider trust. Adding more BPAs can increase noise if the workflow does not reflect provider feedback, evidence-based guidance, and recurring education. Better alert design starts with the reason providers ignore the alert.