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Appl Clin Inform 2026; 17(01): 60-63
DOI: 10.1055/a-2802-2912
Brief Scientific Communication

Characterizing Push Notification Volume and Delivery Patterns in Hospital Medicine

Authors

  • Averi E. Wilson 

    1   Healthcare Information Services, University of Iowa Healthcare, Iowa City, Iowa, United States
    2   Department of Internal Medicine, University of Iowa Healthcare, Iowa City, Iowa, United States
    3   Department of Pediatrics, University of Iowa Healthcare, Iowa City, Iowa, United States

  • Andrew P. Bain

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    5   Department of General Surgery, University of Texas Southwestern, Dallas, Texas, United States

  • Suhani Goyal

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    6   Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, United States

  • Abey Thomas

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    6   Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, United States

  • Robert W. Turer 

    1   Healthcare Information Services, University of Iowa Healthcare, Iowa City, Iowa, United States
    7   Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas, United States

  • Craig Glazer

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    6   Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, United States

  • DuWayne L. Willett

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    6   Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, United States

  • Wendy Yin

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    6   Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, United States

  • Samuel McDonald

    4   Clinical Informatics Center, University of Texas Southwestern, Dallas,Texas, United States
    7   Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas, United States
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Abstract

Background

Push notifications are a common method of clinical communication in inpatient settings, yet their volume and delivery patterns have not been described. Alert fatigue has been well-described in health care, and push notifications may be a new contributor.

Objectives

This study aimed to characterize the volume, type, and temporal distribution of push notifications received by hospitalists across distinct clinical roles in a large academic health system.

Methods

We conducted a cross-sectional analysis of electronic health record (EHR) audit log data from June 1, 2024, to June 1, 2025, at a large academic health system using Epic (Verona, Wisconsin, United States) EHR. All push notifications received by attending hospitalists were extracted, categorized (secure message, results, and other), and summarized by hour, hospitalist role, and device type.

Results

Ninety-seven hospitalists received 1,114,657 push notifications over a year, with a median of 11 (3–24) notifications per hour. Rounding hospitalists received 9 (7–12) notifications per patient per working day. Secure message notifications accounted for the majority, and result-related notifications comprised only 2.2% of notifications. Notifications peaked midday and were received throughout the day, including outside of scheduled shift times.

Conclusion

Hospitalists are exposed to a high volume of push notifications, which may contribute to alert fatigue and ultimately impact patient safety and clinician well-being. System-level efforts to prioritize clinically meaningful notifications, refine notification settings, and enhance secure-messaging infrastructure are needed to protect clinician attention and support patient safety.

Keywords

communication - alert fatigue - notifications

Protection of Human and Animal Subjects

No human subjects were involved in this project.


Contributors' Statement

A.W.: Conceptualization, data curation, formal analysis, investigation, methodology, project administration, writing–original draft, writing–review and editing. A.P.B.: Conceptualization, data curation, formal analysis, writing–review and editing. S.G.: Conceptualization, data curation, methodology, resources, writing–review and editing. A.T.: Conceptualization, investigation, methodology, resources, writing–review and editing. R.W.T.: Conceptualization, data curation, formal analysis, methodology, writing–review and editing. C.G.: Conceptualization, methodology, resources, writing–review and editing. D.L.W.: Conceptualization, methodology, resources, supervision, writing–review and editing. W.Y.: Conceptualization, data curation, formal analysis, methodology, resources, validation, writing–review and editing. S.M.: Conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, supervision, validation, writing–original draft, writing–review and editing.


Ethical Approval

This study was deemed exempted by the University of Texas Southwestern IRB.




Publication History

Received: 05 August 2025

Accepted: 30 January 2026

Accepted Manuscript online:
04 February 2026

Article published online:
20 February 2026

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