Best Practice Advisories (BPAs) and Our Practice Advisories (OPAs): What Are They and What Happens When Healthcare Providers Ignore Them?

Best Practice Advisories (BPAs), also referred to as Our Practice Advisories (OPAs) in some electronic health record (EHR) systems, are electronic alerts embedded within a patient’s medical record. These alerts notify a clinician when their patient’s data matches certain criteria and prompt them on how to respond, offering reminders about possible diagnoses, treatment suggestions, and potential warnings.

Today, EHRs (and BPAs/OPAs) are widely used nationwide. These electronic records are faster, more convenient, and, thanks to BPAs/OPAs, can vastly improve a patient’s treatment and diagnostics. However, they are not without problems.

Unfortunately, BPAs/OPAs are now so common that they often lead to alert fatigue. This state of mental exhaustion happens when the brain is exposed to constant stimuli, causing it to subconsciously tune out critical warnings. With so many BPAs/OPAs constantly alarming in a patient’s record, clinicians often miss critical information regarding their patient’s treatment. As a result, a system meant to improve a patient’s life can, in some cases, actually make it worse.

Benefits of Best Practice and Our Practice Advisories

At their best, BPAs/OPAs enable healthcare professionals to provide safer and more effective treatment with fewer errors. For example, sepsis is a life-threatening infection if not treated promptly. A sepsis BPA/OPA can help identify patients at risk by flagging parameters in the EMR that would suggest a diagnosis of sepsis if not already made. If a nurse is screening a patient who hasn’t received a flu shot, a BPA/OPA might pop up on the screen, prompting the nurse to discuss it with the patient and order a flu shot. These advisories can also alert healthcare providers to potential negative consequences, such as contraindications with certain drugs and treatments.

Alarm Fatigue and BPA/OPA Overload

BPAs/OPAs are designed to convey important messages to a clinician at the most appropriate time. However, research indicates that 85-95% of these notifications are false alarms or non-actionable alerts. And with so many alerts, alarms, and notifications bombarding them during the workday, healthcare providers easily become desensitized, often putting off important alerts or missing them altogether. For the patients under their care, serious—sometimes fatal—results can occur.

In 2022, a 71-year-old patient died because medical staff didn’t hear the oxygen alarms notifying them of her dangerously low levels. In another case, a clinician at Good Samaritan Hospital in Massachusetts prescribed a pain medicine to a patient with a clearly documented allergy to that exact drug. Luckily, the patient survived, but only after being rushed to the ICU for life-saving intervention. (At the same hospital, a surgeon operated on the wrong side of a patient’s body after failing to follow specific markup procedures.) Faulty monitoring and delayed reactions are also major contributors to the 350,000 annual sepsis deaths in the United States, and a huge reason why NICUs across the country are arguing for fewer alarms altogether.

Most Impactful Use of Best Practice and Our Practice Advisories

As with many technologies, BPAs/OPAs are only effective if hospitals implement them properly. Problems occur when hospitals allow healthcare providers to ignore the BPAs/OPAs in the EMR. Hospitals must develop the necessary policies and procedures to utilize BPAs/OPAs effectively and must hold their healthcare providers accountable when BPAs/OPAs are not appropriately evaluated. Not every BPA/OPA that appears in the EMR is appropriate for each patient, but every BPA/OPA requires careful consideration and analysis.               

Contact a Skilled Medical Negligence Lawyer Today

If you or your family have been injured because of a healthcare provider’s professional negligence, the skilled medical malpractice attorneys at Sommers Schwartz can help. We will review your situation, determine the most appropriate legal strategy for moving forward, and protect your rights and best interests throughout the entire process. Contact Sommers Schwartz today for a confidential consultation about your case.

Updated November 2, 2026