Be careful: Copying, pasting can create false EHR data

Relying on copying-and-pasting materials within a patient's electronic health record (EHR) could lead to the insertion of false information in the record, concludes a group of researchers from Brigham and Women's Hospital in a recent issue of the Archives of Internal Medicine.

"Previous research has shown that copying and pasting fragments of notes is common in EMRs. However, it was not known whether the resulting information was accurate," said Alexander Turchin, MD, a physician in the Endocrine Division at BWH and a Senior Medical Informatician at Partners HealthCare, in a statement. This study is the first to show in "a systematic way" that copy-and-pasted material may not be accurate, he added.

In their study, the researchers looked at EHRs of nearly 6,000 diabetic adults receiving care from their primary care physicians. They used specially designed software that tracked copied records of lifestyle counseling documentation in these patients' EMRs.

When comparing the average blood glucose levels for patients with and without copied EHR records, they found that copied lifestyle counseling documentation was not associated with improvements in glucose control--similar to having received no counseling at all.

Overall, the ongoing research has unveiled some "potential negative ramifications of copying and pasting documentation in EMRs," said Turchin, who explains the next steps include educating healthcare providers about this issue.

For more details:
- see the Archives of Internal Medicine abstract
- view the Endocrine Today article