Building a Better Health Record: Where's the Bloat?

Building a Better Health Record (BBHR)
Bloat Busters - Where's the Bloat?

Our Bloat Busters series can help clinicians prevent "note bloat", a digital health record affliction that decreases the signal-to-noise ratio of clinical documentation. 

Clinicians reviewing others' notes may not always appreciate how much of it is copied from elsewhere and how much is original to the current note. The author may have copied-forward a prior note and then edited it to reflect current state and saved it as a new note. But the reader's interest may focus on how the patient's condition is changing or progressing. 

There is a documentation tool that helps. 

When a documentation object (e.g., progress note) is open for review, look to the top right of the note display to find a hovering option menu with checkboxes for "Hide copied text" and "Hover for details":

Select the "Hide copied text" checkbox and note how content copied from elsewhere is greyed. This helps the reader get a quick sense of what is newly authored in the current note. The personalization icon can be used to have this feature persistently enabled.

Better still? Provide feedback to the author that their documentation of important changes might be clearer if they were to focus progress notes on what's new and use tools like the Hospital Course or links to other notes to reference what is stable.