MADISON, Wis — A study from the University of Wisconsin School of Medicine and Public Health showed medical notes — referred to as a chart biopsy — have massively grown in size over the last 17 years, making it more difficult for doctors to sift through an ocean of information during emergency visits.
The study, comically entitled Call me Dr. Ishmael — a reference to Herman Melville's Moby Dick and the length of chart biopsies — shows that at two UW Health emergency rooms, one in five patients come in with a chart with more than 206,000 words.
This is no novel conundrum, and around 4 percent of patients have charts over double the length at about 560,000 words — near the length of Leo Tolstoy's War and Peace.
Typically, doctors skim a chart biopsy to get the necessary information about the patient's medical history to help them with a diagnosis. This is often in a few-minute window. Now with all the additional information, it can be difficult to find what is important.
"Unfortunately we've become victims of our own success, and in many cases, we've shifted from not knowing enough about a patient to having an overwhelming amount of information about a patient to review in one sitting," said Dr Brian Patterson, lead author and associate professor of emergency medicine at UW Heath.
The study began back in 2006 when UW Health began to use digital health records and it spans up to 2023. In the beginning of the study, the average patient would have about five notes in their file, but by the end of the study, the average was about 359 notes.
The researchers, including Frank Liao, senior director of digital health and emerging technologies and co-author of the study, used a program to go through the charts and determine their size.
Several factors were recorded by the program, including the total number of words, notes and tokens which are clusters of characters used by artificial intelligence to represent text.
There is not yet a solution to sifting through all the data to make the charts more user-friendly, but the study referenced potentially using AI to bring important information front and center.
The study does not mention if this is a problem at other large healthcare systems but indicates there is a general need for better organization for the medical notes.
Findings from the study were published in the Journal of the American Medical Informatics Association.
Daniel Hekman, Dr. Azita Hamedani, Dr. Manish Shah and Dr. Majid Afshar also contributed to the study.
It’s about time to watch on your time. Stream local news and weather 24/7 by searching for “TMJ4” on your device.
Available for download on Roku, Apple TV, Amazon Fire TV, and more.
