[Scoundreller]

My favourite citation from the link:

“In fact, across this same EHR, clinical notes in the United States are nearly 4 times longer on average than those in other countries”

It seems that the EHR isn’t the root cause of the problem.

[jcowdy]

I was one of the people that gathered and analyzed the data that the cited study used and can't agree with your conclusion more. Sure, the EHR makes "note bloat" easier than paper but the difference in length across different countries (using the same software) shows that note length is more a result of the environment than the tool.

I think there is also a general misunderstanding of "the note" in an EHR context. The progress note is really just one aspect of a provider's documentation of a visit. Things like medications and allergies are generally indicated as "reviewed" elsewhere in the chart and yet all of this information is many times also entered into the progress note unnecessarily adding to note bloat. In the days of the paper chart the progress note ended up being the only summary of the visit and even though it's now just one piece of the visit documentation, it's still written as though it will be the only source of truth.

[Scoundreller]

It’s a sad situation.

Unhappy users are much louder than happy or neutral users.

As a result, when a non-US health provider wants to do some informal research on implementing EHRs, they mostly read a lot of angry complaints.