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Comment & Response
November 26, 2019

Professionalism and the Review of Systems

Author Affiliations
  • 1US Department of Health and Human Services, Office of the Inspector General, Washington, DC
JAMA. 2019;322(20):2024. doi:10.1001/jama.2019.15581

To the Editor The Viewpoint by Dr Hendrickson and colleagues on review of systems (ROS) and electronic health record (EHR) systems suggested reimbursement incentives might encourage clinicians to complete, or falsely claim to have completed, a full ROS, even when not clinically useful.1 The authors noted that EHR systems can facilitate false documentation when “a generic phrase asserting that the ROS was conducted is automatically included in physician note templates” or “a single mouse click in a series of required clicks records its completion,” and that “a prepopulated attestation statement endorsing that a 10-point ROS was completed may have the unintended effect of introducing dishonesty….” I share this concern and propose that physicians demand greater control of EHR functionalities and eschew functionalities that set them up to fail.