A Better Alternative to Copy & Paste

Provider concerns about the time required to enter records into the EHR have driven the widespread use of copying and pasting patient information into electronic health records. Back in 2009, a study published in the Journal of General Internal Medicine reported that 90% of physicians used the copy and paste function in their electronic health records. More recently, the Medscape 2016 EHR Report, which surveyed over 15,000 physicians, cited 66% of physicians use copy and paste at least occasionally today. Despite maintaining popularity among most healthcare providers, this practice has inherent risks. Without careful attention, inaccurate, outdated, inappropriate or otherwise extraneous information can easily be pasted from one patient record into another, or from one EHR screen to another. All these factors jeopardize patient safety, privacy and overall quality of care.

In fact, a 2015 report from The Joint Commission cited “several sentinel events leading to patient harm,” which “reported the copy and paste function as the specific root cause.”

Sentinel events aside, copying and pasting leads to lengthy and complex patient notes, where it’s often difficult to determine the most recent complaint or treatment plan. Lengthy patient histories would be tedious for any provider to retype, but are temptingly simple to copy and paste, making the patient note much more complex (and often confusing) than it needs to be.

Patient privacy can be compromised since it’s inherent in the copy/paste function that information copied onto the system clipboard resides there until either another copy operation is performed or the application is closed. In the meantime, the data is accessible to anyone else who might use that computer.

Accuracy, security and patient safety are all put in peril when copying and pasting from one patient note into another. In addition, an inaccurate record can result in delayed or denied reimbursements for the practice.

It’s not that physicians don’t recognize the risks. In the JGIM study, 61% of physicians said that using copy and paste made it more difficult to find the new information in patient notes; and 71% said that using copy and paste resulted in outdated information in patient notes.

An article by Sara Heath in the March 2, 2016 EHR Intelligence newsletter explains the reasons behind the guidelines for the safe use of copy and paste in patient documentation, published in February 2016 by the ECRI Institute’s Partnership for Health IT Patient Safety. According to the 58-pages of the ECRI Institute’s guidelines, adopting safer copy-and-paste practices would require each practice to implement a series of cumbersome steps, including establishing new levels of staff training and oversight, flagging pasted material for easy identification, distinguishing between appropriate and inappropriate times to copy/paste, and more. It’s clear that putting the new processes into action could undermine any speed improvements derived from copying and pasting. Fortunately, there is a better way to enter patient notes, and it meets the “better technology and workflow practices to quell the problem,” which Heath calls for at the conclusion of her article.

NoteSwift works with Dragon Medical speech recognition to dramatically accelerate the entry of patient documentation in Allscripts Professional EHR™ and Allscripts TouchWorks® EHR. NoteSwift combines the speed and ease of copying and pasting with the much higher standards of accuracy, safety and privacy that come from entering customized data for each patient record. With NoteSwift, completing patient notes is 40% faster because data entry is done via natural voice commands rather than tedious and time-consuming mouse clicks and keystrokes. A typical patient note is entered in less than 3 minutes and with fewer than 5 mouse clicks.

With copy and paste, any increased speed is confined to entering narrative text. With NoteSwift, the increased speed encompasses all aspects of the patient note, including entering narrative text and structured data, navigating from screen to screen, looking up complaints, and completing and sending prescriptions and lab orders. NoteSwift’s use of bookmarks and aliases further streamlines the process. NoteSwift users not only set aside the use of copy-and-paste, but their mouse as well. And, if a provider decides to persist with the use of copy and paste, NoteSwift makes that more secure, too, because NoteSwift automatically clears the clipboard immediately following each transfer of data into the patient note.


Art Nicholas is VP of Sales and Business Development at NoteSwift

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