Electronic medical record alerts and reminders are increasingly relied upon as a means of decreasing medical errors and increasing the quality and cost-effectiveness of care. They may serve as useful memory aids and draw attention to a variety of situations in which safety, quality, or optimal utilization of scarce resources might otherwise be compromised. However, clinicians indicate that alerts and reminders can either help or hinder. Discerning the elements that determine what they will do, and the requirements of a helpful alert or reminder was the focus of this study.