I’ve seen a number of side comments on the challenges of Copy and Paste functions in an EMR. However, I’ve seen very few people really address the challenge that is copy and paste functions that are built into almost every program in the world.
Before I talk about the challenges, of copy and paste with an EMR I will first profess my amazing love for these 2 functions. I use them probably 100+ times a day. On a good day it’s probably a few hundred times and on a bad day it might only be 50 or so. I can’t imagine doing what i do without copy and paste. Even in this post I’ll likely using copy and paste a dozen or so times.
I’ll admit that I probably use it more than most. However, it’s amazing how many people use copy and paste. It’s really become a major part of computer use. The fact that it is almost automatically integrated with every application is a testament to this fact. When used right, those two functions are an amazing utility.
Of course, when used wrong it can cause some really ugly problems. In your personal life it might just be an email sent to someone with someone else’s name on it. Usually not a major problem, but a minor annoyance. Now apply that same situation to an EMR.
Let’s say you copy a nice physical exam assessment. Despite the very best of intentions, many times you’re going to forget to change something after you paste it. Yes, it happens all too often. Not purposefully of course. Usually something happens to distract you right after you paste it. Maybe the phone rings, your cell buzzes, you get an IM, the nurse comes to talk to you, etc etc etc. Each of these distractions often lead you to forget to change/add something that you just copy and pasted. I don’t need to describe why it’s a problem to have it say “normal rhythm” when it’s not normal or why having other pertinent positives missing is a major problem.
Now, this is just the most obvious case. It’s pretty easy to see how it’s easy to miss things when you start copying and pasting into an EMR. However, the EMR copy and paste challenges don’t stop there. However, the problems might not be as obvious.
One example, is how the length of EMR notes BALLOON with the use of copy and paste. Yes, that means that you might have more robust notes, but that also means that we’re missing out on the “minimum necessary” documentation which makes those notes really useful and functional. Sure, insurance billing has ruined notes in this regard, but copy and paste hasn’t helped either.
I also haven’t talked about the potential HIPAA issues related to copy and paste. I’ll save that for the lawyers out there.
It’s amazing how a function which can be so useful can also be so dangerous. Although, I guess this is true of most tools.