Alert Fatigue, the Target Credit Card Breach, and Implications for Design

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Alert Fatigue, the Target Credit Card Breach, and Implications for Design

March 14, 2014 · Posted by Lee F.

Chances are you were affected by the recent security breach at Target, where over 40 million credit card numbers were stolen. Bloomberg ran a story this week entitled Missed Alarms and 40 Million Stolen Credit Card Numbers: How Target Blew It. I heard the story reported on Marketplace, and was amazed to learn that Target was running the latest and greatest security software. In fact, they received numerous alarms indicating a breach was happening, but they ignored them.

However, this is not all that surprising when you learn that a large corporation like Target is under constant attack. Something like 10,000 to 20,000 attacks are launched at Target’s IT infrastructure every day. My conclusion is that Target ignored the alarms because they suffer from a problem common in healthcare: alert fatigue.

According to Healthcare IT News, alert fatigue “arises when so many different systems – from mobile phones to medical devices to electronic health records – give prompts, alerts or alarms that physicians no longer pay attention to them.” According to studies, alert fatigue causes doctors to miss the majority of drug interaction and drug allergy alerts. Just like the security experts at Target, physicians who get too many alerts, or alerts that are seen as non-consequential or annoying, begin to ignore many if not all alerts. The danger is that a truly important alert will be missed.

Alert fatigue can be the result of poor design. Alert systems, both in healthcare and other industries, should be designed so that only the most critical alerts generate an alarm for the user. But how does a system designer determine which alerts are the most important? It’s part art and part science, and should always include subject matter experts and end-users that represent the population receiving the alerts. It’s a tough job to make the call and deem something unworthy of an alarm, but designing too many alarms just levels the playing field so that nothing seems important anymore.

The result of alert fatigue can be catastrophic in healthcare, and we’re learning that it can be the same in other industries. Target is the target (excuse the pun) of numerous lawsuits, and their CIO, Beth Jacob, recently stepped down amidst the controversy. Healthcare organizations can suffer a similar fate; it just doesn’t typically get so much press. But it’s clear that alert fatigue deserves our attention as a design problem, both in and out of healthcare.

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