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Robert E. Hirschtick, MD
Chicago, Ill
rober@northwestern.edu

JAMA. 2006;295:2335-2336.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The electronic medical record (EMR) arrived at our teaching hospital one year ago and the resultant changes in medical student and physician notes have been remarkable. While EMR is highly efficient in producing notes, virtually all of its notes are longer, recombinant versions of previous notes. Even notes of different authors are morphed by EMR into clones of one another. As physicians have become more adept with the time-saving features of EMR, their notes have been rendered incapable of conveying usable information by their bloated and obfuscated nature.

There are two features of EMR that contribute to the increased length and decreased effectiveness of notes. The first is automatic insertion of prion-like phrases into notes such as "The patient complains that . . . ". Authors are oblivious to these automatic phrases when their notes are created and, although the resultant statements may be true, their syntax is awkward:

Hospital . . . [Full Text of this Article]