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December 12, 2012

Electronic Medical Records and Hospital Progress Notes—Reply

Author Affiliations

Author Affiliations: Department of Medicine, Northwestern University, Chicago, Illinois (rober@northwestern.edu)

JAMA. 2012;308(22):2336-2337. doi:10.1001/jama.2012.14498

In Reply: There is no evidence that guidelines or training improve EMR note quality. In the absence of evidence, only expert opinion remains. It is my opinion as a medical educator, experienced if not expert, that training has minimal lasting impact.

Mark Twain wrote, “I didn't have time to write a short letter, so I wrote a long one instead.”1 With EMR features such as copy-and-paste and one-click data import, it takes less time and effort to write long random notes than it does to write short structured ones. Until EMR systems are modified to reverse this time incentive, long notes will remain the norm.