NIST: Copy and paste in EHRs inefficient and prone to errors

Copying and pasting information in electronic health records (EHR) increases errors and makes it difficult for clinicians to determine what information is relevant, according to a report from the National Institute of Standards and Technology (NIST) released in January.

The report looks at how copy and paste is used by physicians and nurses, if and when they use it, and whether it can lead to errors that impact patient safety. The report found staff participating in the study were concerned about the integrity of copied and pasted information and felt that there was a high potential for error when using the copy and paste function.

Staff were also concerned about the quality of information copied and pasted, and felt it contributed to what the report calls “note bloat:” large amounts of less relevant information that makes it difficult for clinical staff to identify accurate, timely, and more relevant information.

The report found that copied and pasted information may be more likely to be incorrect than information entered directly. One common cause for error is that clinicians are frequently interrupted and often don’t have time to properly review and edit copied and pasted information. Most EHRs lack features that allow efficient editing of copied and pasted information, making the process more difficult in the clinical environment.

The report also found that attribution may be lost when copy and paste is used, leaving it unclear who originally entered the information, when it was entered, and when and by who it was subsequently copied.

NIST makes specific recommendations for user interface design that would improve the usability and integrity of copied and pasted information and says that certain types of information, such as blood bank information, should be blocked from being copied and pasted.