When the Chart Comes Up Empty
A hapless clinician waits, underwhelmed with more questions than answers.
How Information Underload Derails Clinical Care
Information Chaos Series – Part 3: Underload
We spend a lot of time talking about having too much information—too many notes, alerts, messages. But sometimes the problem is the opposite.
Sometimes, you open the chart and… there’s just nothing there.
What is Information Underload?
Information underload, as defined by Beasley et al. in their framework for Information Chaos, occurs when key clinical information is missing or unavailable when a clinician needs it.
It’s the med list that hasn’t been reconciled.
It’s the outside referral note that never came.
It’s the patient who says, “I think I had a procedure a couple years ago… not sure where.”
It’s clicking through five empty notes with no real history in any of them.
And when it’s not in the chart, the burden shifts to you to piece it together from scratch.
Why underload leads to risk and burnout
Underload slows you down and raises the stakes.
You waste time trying to get basic information
You rely on recall or assumptions instead of records
You miss opportunities for early diagnosis, safety netting, or care coordination
You spend more time documenting what isn’t known than acting on what is
And perhaps worst of all: you feel alone in the care.
Like the system forgot what it was supposed to help with.
When the chart doesn’t help you think, you end up carrying everything yourself.
That’s a fast track to burnout.
How we’re addressing underload with Stream
At River Records, we think the solution to underload isn’t just adding more data.
It’s building continuity into the documentation process itself.
That’s why we built Stream to be problem-oriented and longitudinal—so that every new visit adds to a shared thread, not a blank slate.
If a patient’s anxiety came up six months ago, it’s there.
If a hospital stay triggered new follow-up, it’s threaded to the relevant problems.
If someone mentioned a new finding two visits ago, it didn’t get lost; it got recorded, structured, and tied to the plan.
Stream helps you build a record over time, not just capture a snapshot.
That means fewer “what’s going on here?” moments—and more visits where you’re ready to move forward.
Continuity is care
Documentation shouldn’t be an empty form.
It should reflect what we know and help us remember what we’ve learned.
By preserving the clinical story, Stream helps fill in the gaps the system too often leaves behind.
Because when information underload becomes the norm, care slows down, decisions suffer, and clinicians burn out.
Let’s build systems that help us carry the story forward.
Ready to stop starting from scratch?
