Copy-Forward in Electronic Health Records: Lipstick on a Pig

      Putting lipstick on a pig” is a porcine proverb about how superficial changes, such as lipstick, are used in an attempt to disguise the true nature of something, as also reflected in the use of copy-forward functionality in the electronic health record (EHR). Copy-forward is a form of electronic documentation that allows EHR users to copy past electronic documentation forward to a current location without retyping it,
      • Tsou A.Y.
      • et al.
      Safe practices for copy and paste in the EHR. Systematic review, recommendations, and novel model for health IT collaboration.
      and the EHR is often viewed as an electronic documentation system.
      • Arrowood D.
      • et al.
      Integrity of the healthcare record: best practices for EHR documentation.
      However, the EHR was never intended to be a documentation system.
      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Joint Commission Journal on Quality and Patient Safety
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tsou A.Y.
        • et al.
        Safe practices for copy and paste in the EHR. Systematic review, recommendations, and novel model for health IT collaboration.
        Appl Clin Inform. 2017; 8 (Jan 11): 12-34
        • Arrowood D.
        • et al.
        Integrity of the healthcare record: best practices for EHR documentation.
        J AHIMA. 2013; 84: 58-62
        • US Department of Health and Human Services
        • Office of the National Coordinator for Health Information Technology
        Federal Health IT Strategic Plan, 2015–2020.
        (Sep 21; Accessed April 27, 2017)
        • US Department of Health and Human Services
        • Office of the National Coordinator for Health Information Technology
        Adoption of Electronic Health Record Systems Among U.S. Non-Federal Acute Care Hospitals: 2008–2014.
        (Charles D, Gabriel M, Searcy T. ONC Data Brief, no 23; Apr; Accessed April 27, 2017)
        • Middleton B.
        • et al.
        Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.
        J Am Med Inform Assoc. 2013; 20: e2-8
        • Graber M.L.
        • Johnston D.
        • Bailey R.
        Report of the Evidence on Health IT Safety and Interventions: Final Report.
        (Washington, DC: US Department of Health and Human Services, Office of the National Coordinator for Health Information Technology; Accessed on April 27, 2016)
        • Shanafelt T.D.
        • et al.
        Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction.
        Mayo Clin Proc. 2016; 91: 836-848
        • Zhang J.
        • Walji M.
        TURF: toward a unified framework of EHR usability.
        J Biomed Inform. 2011; 44: 1056-1067
        • Staggers N.
        • et al.
        Nursing-centric technology and usability: a call to action.
        Comput Inform Nurs. 2015; 33: 325-332
        • Zahabi M.
        • et al.
        Usability and safety in electronic medical records interface design: a review of recent literature and guideline formulation.
        Hum Factors. 2015; 57: 805-834
        • Neri P.M.
        • et al.
        Emergency medicine resident physicians' perceptions of electronic documentation and workflow: a mixed methods study.
        Appl Clin Inform. 2015; 6 (Jan 21): 27-41
        • Adler-Milstein J.
        • et al.
        Crossing the health IT chasm: considerations and policy recommendations to overcome current challenges and enable value-based care.
        J Am Med Inform Assoc. 2017; (Epub; Mar 15; Accessed Apr 27, 2017)
        • PRWeb
        Hospital Nurses Forced to Develop Creative Workarounds to Deal with EHR System Flaws.
        (Outdated Technologies and Lack of Interoperability, Reveals Black Book; Oct 17; Accessed Apr 27, 2017)
        • Harrington L.
        • Harrington C.
        Usability Evaluation Handbook for Electronic Health Records.
        (Chicago: Healthcare Information and Management Systems Society)2014
        • TechTarget
        Swimlane Diagram.
        (WhatIs.com; Accessed Apr 27, 2017)
        • TechTarget
        Business Process Map.
        (WhatIs.com; Accessed Apr 27, 2017)
        • National Research Council
        Computational Technology for Effective Health Care: Immediate Steps and Strategic Direction.
        National Academies Press, Washington, DC2009
        • Horsky J.
        • Zhang J.
        • Patel V.L.
        To err is not entirely human: complex technology and user cognition.
        J Biomed Inform. 2005; 38: 264-266
        • Peute L.W.
        • et al.
        Reducing clinicians' cognitive workload by system redesign; a pre-post think aloud usability study.
        Stud Health Technol Inform. 2011; 169: 925-929
        • TechTarget
        Waterfall Model.
        (WhatIs.com; Accessed April 27, 2017)
        • TechTarget
        Agile Software Development (ASD).
        (WhatIs.com; Accessed April 27, 2017)
        • Boehm B.
        Software engineering.
        IEEE Trans Comput. 1976; 25: 1226-1241
        • Patterson E.S.
        • et al.
        Safe practice recommendations for the use of copy-forward with nursing flow sheets in hospital settings.
        Jt Comm J Qual Patient Saf. 2017; 43: 375-385
        • ECRI Institute
        Copy/Paste: Prevalence, Problems, and Best Practices.
        (Health Technology Assessment Information Service™ Special Report; Oct; Accessed Apr 27, 2017)
        • Clendenin M.
        • et al.
        Inter-operator and inter-device agreement and reliability of the SEM Scanner.
        J Tissue Viability. 2015; 24: 17-23
        • Bates-Jensen B.M.
        • et al.
        Subepidermal moisture predicts erythema and stage 1 pressure ulcers in nursing home residents: a pilot study.
        J Am Geriatr Soc. 2007; 55: 1199-1205
        • Bates-Jensen B.M.
        • et al.
        Subepidermal moisture differentiates erythema and stage I pressure ulcers in nursing home residents.
        Wound Repair Regen. 2008; 16: 189-197
        • Wounds International
        Scanner Could Hold Key to Cost Savings in Pressure Ulcer Prevention.
        (Jan 20; Accessed Apr 27, 2017)

      Biography

      Linda Harrington, PhD, DNP, RN-BC, is Professor, Baylor College of Medicine, Houston, and Digital Strategy Consultant.