Editorial
Copy and Paste: A Remediable Hazard of Electronic Health Records

https://doi.org/10.1016/j.amjmed.2009.02.010Get rights and content

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Problem Lists Never Change

House staff have recognized that if they organize problems by system (eg, gastrointestinal; fluids, electrolytes, nutrition; cardiovascular), they can copy and paste the same problem list day after day, even if new diagnoses appear or priorities have changed. The lists contain updated information, but they do not reflect what is new, different, or important. If “pulm” was the most important problem on day one, it will remain first on the list through the admission, irrespective of the patient's

Corrective Action

Why do smart, caring, dedicated, and skilled physicians write such conspicuously deficient notes? Can we change the behavior? Attending physicians tend to view charting as a means of justifying the bill and reducing liability risk. House staff are focused on direct patient care and consider the note a low priority chore. They do not bill. Few of them have endured a deposition. As a result, their understanding of the purpose of the health record differs from that of the attending, and no amount

The Future of Electronic Charting

At present, the literature about the impact of health information technologies is limited in its scope and generalizability.16 Electronic health record systems have been developed for many purposes, and it is crucial to make sure these “tools” advance the values we want medicine to be and reflect rather than undermine important components of medical culture, such as communication between house staff and nursing staff and faculty. Coiera17 acknowledges the primary importance of clinical

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Funding: None.

Conflict of Interest: None.

Authorship: Both authors played a role in writing the manuscript.

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