According to a Comment article, the effect of the type of behavioural intervention will depend on the context in which it is applied as this study was conducted in a tertiary-care academic institution in which existing capability might be high and in-hospital mortality rates were lower than those reported elsewhere. In addition, the automated alerts were not tested in outpatient or primary care where review of results might be less frequent. The commentator notes that the publication of this study is timely as a recent National Patient Safety Alert in England mandated the use of a detection algorithm for acute kidney injury in pathology laboratory information systems. He concludes “this important and informative study does not close the book on automated alerting or decision support in acute kidney injury, but opens a new and potentially exciting chapter.