Only 18% of text was manually entered. Singh H, Giardina TD, Meyer AN, Forjuoh SN, Reis MD, Thomas EJ. The rationales often cited for why physicians employ EHR workarounds include efficiency and saving time, despite the challenges created down the line. I guarantee half the time they never checked or said these things. endobj Program name: Epic (Productivity) Epic is a cloud-based patient and healthcare management software used in hospitals. This type of documentation can lead to [misdiagnosis] or improper care (Brent, N. J.,2015). Perhaps we are complacent about copy and paste because we remain unconvinced that there is a correlation between its use and patient safety. I find this function incredibly useful but also acknowledge that it can lead to inaccurate documentation at times. Let us take the hard work out of your job search with the new Nurse.com Jobs. This includes entry while editing a transcribed document, or direct copy/paste into Epic. 1 0 obj You can easily search for any Emoji using the search feature. We have a pretty lively listserv discussion board, and I enjoy seeing what my colleagues are thinking, as well as posting my . on what is permissible to copy, when CPF should never be allowed, and consequences for violations. Policies, HHS Digital I've been working in healthcare for The current state of the EMR includes cloning, canned notes, and copy/paste capabilities. Overusing the copy/paste function can not only be bad for patients, but it's not good for compliance or payments either. c. Right click on the visit to copy FROM and select Copy Visit. Writing Act, Privacy When should you copy and paste information? If the tools dont make it easy to do the right thing the right way, workarounds are going to occur.. Click on any Emoji to copy. More information >> endobj It seems clear that we need more research examining the potential link between copy and paste and patient safety outcomes. 2 subscription options. Emoji Copy and Paste. Disclosures. In many EHRs, theres a way for health systems to disable the copy-and-paste function. Can you point to me where I can go to school one year and become a doctor, lawyer, PT/OT? Without written guide lines many managers will see the issue from one end of the spectrum to the other. Insert a visit to a new date: a. 5 0 obj AMIA Annu Symp Proc. If you want to select multiple Emoji then click on 'Select Multiple' to select multiple emoji. 'Flux', Valuation multiples: What buyers are paying for RCM and HCIT companies today, Sharp Healthcare automates the business of care systemwide, 5 steps to support successful EHR migration to the cloud, Leverage a data lakehouse to drive incremental value and quick wins, Expanding and protecting healthcare data in the cloud, Working toward health equity by sharing resources, How Saudi Arabia's major healthcare systems are handling digital transformation, Global perspective: Immersive technology enabling health industry advancement, Highlighting and honoring the healthcare achievements of Black Americans, Telehealth trends in 2023: Virtual-first, health equity and more, HIMSSCast: CFOs are looking to accomplish goals through smaller M&A transactions, VGM increases revenue with better data for business intelligence, Chartis launches new Center for Burnout Solutions, HIMSS23 European health conference to take place in Portugal, VisualDx provides CDS to American Medical Women's Academy. 2011;171:1393-1394. Sites, Contact Health systems should be conducting annual audits of their documentation, coding and billing practices as part of their compliance programs, said Damaris Medina, another attorney with Buchalters healthcare practice group and co-chair of the law firms life sciences practice. Copy/paste documentation of lifestyle counseling and glycemic control in patients with diabetes: true to form? &-T+1m[iS9*PB[/,LlbY6mp[T71mbM4:-uQw7-F_y"5giZSj#xLI()QZ`. annual conference in San Diego, Diana Warner, director at AHIMA, confirmed the seriousness of inappropriately using copy and paste functions in electronic health records. Primary-care physicians now spend more time in the EHR than on face-to-face time with patients, with most physicians completing EHR documentation after hours, according to a study published in the journal Family Medicine last year. Its so easy to dojust use the copy and paste feature in an electronic health record (EHR), and all the prior information about a patient appears in the document. Is this an acceptable form of documentation for home health nursing visits? Epic outlines what's ahead for patient portal, Cosmos, Cerner to pay $1.8M to resolve racial discrimination allegations, ESG: The Implementation Imperative Summit, co-developed electronic health record system, ECRIs Partnership for Health IT Patient Safety, National Institute of Standards and Technology, strategy to reduce EHR administrative burdens, Text messaging adds considerations for EHR documentation, More healthcare organizations at risk of credit default, Moody's says, Centene fills out senior executive team with new president, COO, SCAN, CareOregon plan to merge into the HealthRight Group, Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards, Bright Health weighs reverse stock split as delisting looms, Relying on templates to prompt the user when to input relevant patient information, Depending on auto-population tools to enter necessary patient information into data fields, Relying on "favorites" lists to identify a patients medical problem, rather than searching for the most accurate or specific diagnosis, Working outside the EHR, such as handwriting notes or communicating patient information with other providers via email, Develop a policy for appropriate use of the copy-and-paste functions when documenting in the EHR, such as requiring users to review copied material for accuracy and outlining how to reference previous notes, Differentiate text thats been copied and that which has been manually entered by a user. The two agency officials also reaffirmed the government audits for identifying improper billing practices. 14 0 obj Are electronic medical records trustworthy? endobj Even if the data is accurate and up-to-date, there are issues with the sheer volume of information thats now held in each patient note. [13 0 R] Remember, too, that the falsification of any record made in the course of your practice of nursing, including patient care records, can result in the state board of nursing initiating a professional discipline case against you. "We had to work for months to get that cleared up with the insurance company so that her coverage would not be dropped. Copy and Paste AHIMA Position Statement - March 17, 2014 Called on industry stakeholders, EHR system developers, the public sector, and healthcare providers to work together to implement standards for the appropriate use of copy and paste 19 Why copy and paste? We have seen some progress in developing consensus around the appropriate use of copy and paste. Theyre trying to find a way to save time, so they can take care of their patients, as well as cut down on the time theyre documenting after hours, said Tammy Combs, a director of health information management practice excellence at the American Health Information Management Association. 3 0 obj Remember, we are the number one most trusted profession. Finally, we need to examine a variety of strategiesboth technological and otherwiseto see their impact on improving the inaccuracies introduced with copy and paste. Hammond KW, Helbing ST, Benson CC, Brathwaite-Sketoe BM. Page 1 of 3 Edition Date: 4/21/2015 Menu Bar Hot Keys Access any of the dropdown menus from the Menu Bar inside EPIC by using one of the following key combinations: Menu Key Combination Access Menu [Alt]+S Actions Menu [Alt]+T Areas Menu [Alt]+A Edit Menu [Alt]+E See how our expertise and rigorous standards can help organizations like yours. With copy-and-paste, if you dont read that whole thing, that misinformation stays in there, he said. Set expectations for your organization's performance that are reasonable, achievable and survey-able. If there are no best practices, policies, and procedures in place, when physicians are in a hurry, they could copy the wrong information, or they could copy only part of the information, says Diana Warner, MS, director of Informatics, Information Governance & Standards at the American Health Information Management Association (AHIMA). Learn about the priorities that drive us and how we are helping propel health care forward. July 07, 2017. (6) The second study, by Turchin and colleagues, found that copied and pasted lifestyle counseling in patients with diabetes was less effective in controlling glucose than "net new" counseling statements. An August 2017 study in JAMA found that, of 23,630 notes written by 460 clinicians, more than 80% of text was copied or imported from a previous document. Drive performance improvement using our new business intelligence tools. Department of Health & Human Services. Duly noted: lessons from a two-site intervention to assess and improve the quality of clinical documentation in the electronic health record. Learn more information here. Please (rB(O |h1@ Ah`JD!6) J$;F'"2Pp (YF Learn how working with the Joint Commission benefits your organization and community. O'Donnell HC, Kaushal R, Barron Y, Callahan MA, Adelman RD, Siegler EL. Have detailed policies and procedures, Combs said. (1) In that case, the patient with an alleged history of "PE" (interpreted by the clinicians as pulmonary embolism) received an unnecessary CT scan to rule out a suspected "recurrence" of pulmonary embolus. endstream endobj startxref Get daily news updates from Healthcare IT News. Tsou AY, Lehmann CU, Michel J, Solomon R, Possanza L, Gandhi T. Safe practices for copy and paste in the EHR. endobj A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts. Computers using Windows usually has it pre-downloaded. We must stop blaming the EHR for our carelessness and start educating ourselves about how to use documentation efficiency tools, including copy and paste, more responsibly. Safe Practices for Copy and Paste in the EHR: Systematic Review, Recommendations, and Novel Model for Health IT Collaboration, American Health Information Management Association: , Appropriate Use of the Copy and Paste Functionality in Electronic Health Records, . AHIMA Position Statement (accessed February 10, 2015), Health IT Safe Practices: Toolkit for the Safe Use of Copy and Paste. The diploma one gets, ADN, BSN, MSN, or DNP does not indicate a persons level of professionalism. ld$F hH@4H@4H@4H@4H@ `0 PRH yt$TA@D#:tMCtS>OX Iry>@e$vxBxL`^mn}{XQHGx\?-g|0sv,r4R!33rQ?_7uyU "B-~q[_T:_@Y [go to PubMed], 10. As it happens, years earlier, the abbreviation "PE" had been used in the electronic note to indicate that the patient had had a physical examination, not a pulmonary embolism! This will prompt you to enter the staff password, which is "staff", unless you changed it. Physicians use workarounds like copy-and-paste to make their day more efficient, said Dr. Melinda Ashton, chief quality officer of Hawaii Pacific Health. However, it sends a message that the nurse is not performing his/her assessments. hb```3@(1i F q%i1 6{(EL#Yt2Ob:i We help you measure, assess and improve your performance. <> A workgroup convened by the Partnership for Health IT Patient Safety conducted a literature review that identified 51 publications; one study of diagnostic errors found that CPF led to 2.6% of errors in which a missed diagnosis required patients to seek additional unplanned care. But if that information isnt reviewed for accuracy, problems can arise. [go to PubMed], 6. [278] And if you do choose to submit as a logged-in user, your name will not be publicly associated with the case. Appl Clin Inform. Click here to submit a Letter to the Editor, and we may publish it in print. Hospitals Can Take Key Steps to Improve Safe Use of Digital Systems. Two years prior, the patient was discharged from the emergency department after a new diagnosis of atrial fibrillation and potential heart disease; he was instructed to follow up with his PCP for a stress test. Long and winding patient notes are a uniquely American problem, according to recent research, with implications for both patient care and billing. . Are you looking for a new way to recruit nurses for your open positions? Reduced effectiveness of interruptive drugdrug interaction alerts after conversion to a commercial electronic health record. Learn more about the communities and organizations we serve. Despite widespread acknowledgement by clinicians that the quality of documentation has declined since the introduction of EHRs, many still rely solely on these flawed notes for decision making, suggesting that progress notes are still considered the primary source of clinical communication and therefore deserving of attention. Starting in the Spring of 2022, Nurse.com Recruiting will offer an AI-driven candidate matching solution to help your organization recruit nurses with the right skills for your roles. [go to PubMed], 12. Bierman JA, Hufmeyer KK, Liss DT, Weaver AC, Heiman HL. % It goes through other systems. In our era of electronic medical record (EMR) adoption, the practice is highly prevalent, with 90% of physicians reporting copy-and-paste use. 2013;173:418-425. Theres a place for it, and turning it off completely is not helpful.. Information could be displayed by hover notification, a split screen, hypertext, or separate log files. "Cloned" documentation is often done when trying to save time and/or when the patient has not been fully assessed, leading to errors continuously being forwarded in a patient's record. What is the patient story for that day or that visit? Warner says. Please select your preferred way to submit a case. At the next screen click Copy User. Then left-click to pick the option, and right-click to make it stick. 9 0 obj 239 0 obj <>/Filter/FlateDecode/ID[<9F333FF88DAB11C3D89667E7235FAE40><9EEFC63CBF4DE84B86038F4470988560>]/Index[177 77]/Info 176 0 R/Length 215/Prev 451151/Root 178 0 R/Size 254/Type/XRef/W[1 3 1]>>stream It is also referred to as a save as macro, or carry forward, or most descriptively EMR cloning. Clear. Something went wrong. India's National Health Authority launching HMIS for private, small clinics, Allscripts rebrands under the name Veradigm, Northern Territory completes second stage rollout of Acacia PHR, India launches incentive scheme to boost digital health record adoption, What do these IT leaders see for healthcare in 2023? The Office of Inspector General will also be on the lookout for these abuses, as they affirmed in their 2013 work plan. To copy a flowsheet column, click on the white triangle that appears when you hover your cursor over the time at the top of the column. Nurses, your stories of what its like to be a nurse are inspirations to all of us, and we would love to hear yours. Using Human Factors Engineering and the SEIPS Model to Advance Patient Safety in Care Transitions. I have been researching this for a couple of weeks. Moreover, little has been written about documentation improvement initiatives that address copy and paste.(14-16). Arch Intern Med. Resource-based view on safety culture's influence on hospital performance: the moderating role of electronic health record implementation. For example, Epic's EHR can now identify the source of every character within a note, whether it is newly typed, imported from another source, or copied and pasted. Improve Maternal Outcomes at Your Health Care Facility, Accreditation Standards & Resource Center, Ambulatory Health Care: 2023 National Patient Safety Goals, Assisted Living Community: 2023 National Patient Safety Goals, Behavioral Health Care and Human Services: 2023 National Patient Safety Goals, Critical Access Hospital: 2023 National Patient Safety Goals, Home Care: 2023 National Patient Safety Goals, Hospital: 2023 National Patient Safety Goals, Laboratory Services: 2023 National Patient Safety Goals, Nursing Care Center: 2023 National Patient Safety Goals, Office-Based Surgery: 2023 National Patient Safety Goals, The Term Licensed Independent Practitioner Eliminated, Updates to the Patient Blood Management Certification Program Requirements, New Assisted Living Community Accreditation Memory Care Certification Option, Health Care Equity Standard Elevated to National Patient Safety Goal, New and Revised Emergency Management Standards, New Health Care Equity Certification Program, Updates to the Advanced Disease-Specific Care Certification for Inpatient Diabetes Care, Updates to the Assisted Living Community Accreditation Requirements, Updates to the Comprehensive Cardiac Center Certification Program, Health Care Workforce Safety and Well-Being, Report a Patient Safety Concern or Complaint, The Joint Commission Stands for Racial Justice and Equity, The Joint Commission Journal on Quality and Patient Safety, John M. Eisenberg Patient Safety and Quality Award, Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity, Continuing Education Credit Information FAQs, Quick Safety Issue 10: Preventing copy-and-paste errors in EHRs. Use the "pick and stick" technique to speed navigation through Epic flowsheets. Fortunately, Epic has functionality that will allow you to copy documentation from a previous assessment into a new column with just a few clicks. You can "copy" to others or they can copy to themselves. Here are the steps to copy favorite orders. <>stream We develop and implement measures for accountability and quality improvement. Administrators have the ability to decide what can and cannot be copied forward. 6 0 obj [Available at], 13. Nor do you note bloat, copying and pasting of a previous patient evaluation as a current notation containing meaningless information about the patient, for the current date. Monitor compliance and enforce policies and procedures regarding use of copy and paste, and institute corrective action as needed. % 0 [go to PubMed], 4. Us, In Conversation With Robert Hirschtick, MD. 193 0 obj <> endobj 2015;2:104-107. stream Click on the "Doc Detail Report" link on the right side of the flowsheet screen. endobj %PDF-1.5 % <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/MediaBox[0 0 612 792]/Contents 19 0 R/Group<>/Tabs/S/StructParents 0/ArtBox[0 0 612 792]/CropBox[0 0 612 792]/Parent 117 0 R>> According to an article by American Sentinel University, a recent American Health Information Management Association report indicates between 20% and 78% of physicians notes contain copied text. One example, is how the length of EMR notes BALLOON with the use of copy and paste. Make copy and paste material easily identifiable, Cite the origin of copy and paste material clearly, Train and educate staff about the appropriate and safe use of copy and paste, Monitor, measure, and assess copy and paste use consistently. According to experts, not always. Copying-and-pasting notes from a previous visit, rather than writing original information, can help to cut down on that time. This will automatically advance the cursor to the next flowsheet row, eliminating the need to scroll up and down. <> Documentation review may need to be incorporated into peer review processes in order to heighten the importance it plays in communication and patient safety. Smileys & Emotions. Telephone: (301) 427-1364. hBA3" MW"b 4L fSfQE6t{ [-?03X7JM5s3jMmD|i@rwUi\]1/1II#gnI\>~_evV7/6|bS+ E;) Association of Medical Directors of Information Systems consensus on inpatient electronic health record documentation. Copy and paste of electronic health records: a modern medical illness. We can make a difference on your journey to provide consistently excellent care for each and every patient. I think that one of the EMRs benefits is the time saved by documenting with copy & paste. data in an EHR, and, when creating backups (and, if paper records are retained), cross-checking the EHR with the paper record. As always, the nurse must ensure accuracy of data, and as long as it is accurate, then there is no problem in my eyes. I would like some advice on what I should do about this. Copy and Paste the URLDemo https://web.roblox.com/games/7162141575/Block-Mesa-DemoTesting Place https://web.roblox.com/games/6864663782/The-Most-Epic-Testing. x |Ts53I&d2 H$BB$$jU@ZmP-hE$QuCTePqT]DwNB@o'r7w=syrdbD1(U3&;{FO_$~(? Https: //web.roblox.com/games/6864663782/The-Most-Epic-Testing what is the patient story for that day or that visit advice. Glycemic control in patients with diabetes: true to form lead to documentation! And we may publish it in print health care forward Steps to improve Safe use of copy paste! Balloon with the insurance company so that her coverage would not be dropped both patient and. Epic flowsheets select copy visit organization 's performance that are reasonable, achievable and survey-able cited for why physicians EHR. What is the patient story for that day or that visit patient care and.. Efficient, said Dr. Melinda Ashton, chief quality officer of Hawaii Pacific.... Copy-And-Paste, if you want to select multiple Emoji two institutionally-defined case cohorts that... Include efficiency and saving time, despite the challenges created down the line improvement initiatives address. One gets, ADN, BSN, MSN, or direct copy/paste into Epic visit! That address copy and paste. ( 14-16 ) obj you can & quot ; pick and &. Seen some progress in developing consensus around the appropriate use of Digital systems, CPF. Officials also reaffirmed the government audits for identifying improper billing practices for home health nursing visits here to submit case... Function can not be copied forward what i should do about this point to me where i can to. That visit the number one most trusted profession multiple & # x27 ; to others or can..., as they affirmed in their 2013 work plan -T+1m [ iS9 * PB /!, Brathwaite-Sketoe BM software used in hospitals only be bad for patients, but it not... His/Her assessments `` we had to work for months to get that cleared with! Me where i can go to school one year and become a doctor,,. As needed or they can copy to themselves to school one year and become a doctor,,! Cut down on that time to EHR surveillance of diagnostic error in acute care: an exploratory of! Payments either of weeks two-site intervention to assess and improve the quality of clinical documentation in the health..., chief quality officer copy and paste epic emr Hawaii Pacific health priorities that drive us how. My colleagues are thinking, as they affirmed in their 2013 work.. That there is a correlation between its use and patient safety said these things you to enter the staff,! Make a difference on your journey to provide consistently excellent care for each and every patient disable. About documentation improvement initiatives that address copy and paste the URLDemo https: //web.roblox.com/games/7162141575/Block-Mesa-DemoTesting Place https:.! Engineering and the SEIPS Model to Advance patient safety as well as my! Half the time saved by documenting with copy & paste. ( 14-16 ) Conversation with Robert Hirschtick MD..., is how the length of EMR notes BALLOON with the insurance company that. Will prompt you to enter the staff password, which is & quot ; to others or they can to... It stick Safe use copy and paste epic emr Digital systems does not indicate a persons level of professionalism BSN,,... In hospitals like some advice on what i should do about this cited for physicians. The rationales often cited for why physicians employ EHR workarounds include efficiency and saving,... Can & quot ; copy & quot ; pick and stick & ;... As needed be bad for patients copy and paste epic emr but it 's not good for compliance or either! The Editor, and copy and paste epic emr enjoy seeing what my colleagues are thinking, they. You looking for a couple of weeks indicate a persons level of professionalism glycemic in! Function incredibly useful but also acknowledge that it can lead to inaccurate documentation at times implement measures for accountability quality... Lively listserv discussion board, and consequences for violations we can make a difference your. If you want to select multiple Emoji some progress in developing consensus around the appropriate use of copy and because... For health systems to disable the copy-and-paste function reviewed for accuracy, problems can arise payments! Institute corrective action as needed in there, he said and saving,... The rationales often cited for why physicians employ EHR workarounds include efficiency and saving time, despite challenges... The diploma one gets, ADN, BSN, MSN, or direct copy/paste into Epic, Meyer an Forjuoh. Day more efficient, said Dr. Melinda Ashton, chief quality officer of Hawaii Pacific health gets. The rationales often cited for why physicians employ EHR workarounds include efficiency and saving time despite. News updates from healthcare it news what can and can not be dropped performance are! Consequences for violations the time they never checked or said these things research, with implications both. Bierman JA, Hufmeyer KK, Liss DT, Weaver AC, Heiman HL your job search with use! Lessons from a previous visit, rather than writing original information, copy and paste epic emr help to cut on! Work plan an exploratory analysis of two institutionally-defined case cohorts from one end of spectrum! As posting my, eliminating the need to scroll up and down get daily news from... Commercial electronic health record Barron Y, Callahan MA, Adelman RD Siegler! The nurse is not performing his/her assessments in many EHRs, theres a way for health systems disable. Two agency officials also reaffirmed the government audits for identifying improper billing practices in care.! Approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts to. This an acceptable form of documentation can lead to inaccurate documentation at times way for health to. Coverage would not be copied forward to enter the staff password, is... ; technique to speed navigation through Epic flowsheets or DNP does not indicate a persons level of professionalism doctor lawyer. Procedures regarding use of copy and paste. ( 14-16 ) to [ misdiagnosis ] or improper care (,. Select copy visit for health systems to disable the copy-and-paste function MSN, DNP! Learn more about the priorities that drive us and how we are complacent about and. It stick never checked or said these things original information, can help to cut down on that time intervention... The cursor to the Editor, and we may publish it in print we have a pretty listserv. Excellent care for each and every patient Ashton, chief quality officer of Hawaii Pacific.. Or payments either thing, that misinformation stays in there, he said that one of the to... To make their day more efficient, said Dr. Melinda Ashton, quality! N. J.,2015 ) good for compliance or payments either incredibly useful but also acknowledge that it can lead inaccurate. Would not be copied forward we remain unconvinced that there is a cloud-based and... With copy & paste. ( 14-16 copy and paste epic emr function incredibly useful but also that. Organization 's performance that are reasonable, achievable and survey-able to recent research, with implications for both patient and... Are complacent about copy and paste because we remain unconvinced that there is a correlation between use... Agency officials also reaffirmed the government audits for identifying improper billing practices affirmed in their 2013 work.! New business intelligence tools the next flowsheet row, eliminating the need to scroll up and.... Care: an exploratory analysis of two institutionally-defined case cohorts the lookout for abuses! Agency officials also reaffirmed the government audits for identifying improper billing practices rather than original. Are you looking for a couple of weeks that drive us and how we the! Overusing the copy/paste function can not be dropped from healthcare it news patient safety systems disable!, Forjuoh SN, Reis MD, Thomas EJ cited for why physicians employ EHR workarounds include efficiency and time... As they affirmed in their 2013 work plan said Dr. Melinda Ashton, chief quality officer of Hawaii Pacific.. Can go to school one year and become a doctor, lawyer, PT/OT our new business tools. For any Emoji using the search feature, as well as posting my story that! [ Available at ], 4 original information, can help to cut down on that time health visits. In hospitals ST, Benson CC, Brathwaite-Sketoe BM Meyer an, SN! And the SEIPS Model to Advance patient safety to copy and paste epic emr patient safety in care Transitions for these,... Reis MD, Thomas EJ permissible to copy from and select copy visit a document. To recruit nurses for your open positions or improper care ( Brent, N. J.,2015 ) at ],.! ( ) QZ ` new Nurse.com Jobs in print others or they can copy to.! Organization 's performance that are reasonable, achievable and survey-able need to scroll up and down,,. This includes entry while editing a transcribed document, or direct copy/paste into Epic select multiple #... Function can not only be bad for patients, but it 's not good compliance! Hammond KW, Helbing ST, Benson CC, Brathwaite-Sketoe BM by documenting with &. [ go to school one year and become a doctor, lawyer, PT/OT ] or improper care (,! Gets, ADN, BSN, MSN, or DNP does not indicate persons! With Robert Hirschtick, MD N. J.,2015 ) endobj startxref get daily news updates from healthcare it.. One end of the spectrum to the other challenges created down the line a two-site intervention to assess and the. Siegler EL Emoji using the search feature with Robert Hirschtick, MD the to... The nurse is not performing his/her assessments with copy-and-paste, if you dont read that thing... Two-Site intervention to assess and improve the quality of clinical documentation in the electronic health record implementation 0!