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Electronic medical record alerts and reminders are increasingly employed as a means of decreasing medical errors and increasing the quality and cost-effectiveness of care. However, clinicians indicate that alerts and reminders can be either help or hindrance. Discerning the elements that determine which they will be, and the requirements of a helpful alert or reminder, was the focus of this study. We convened three focus groups, comprised of a total of 16 participants. During analysis, five themes emerged: Efficiency, Usefulness, Information Content, User Interface, and Workflow. In addition there were some New Ideas and Surprises. Specific usability and usefulness requirements emerged from within the themes and these are described.