Insights from the Front Lines of Medical Documentation
We explore the root causes of information chaos, designing for clarity, and the thoughtful application of AI in medicine.
Why Clinicians Copy-Paste: Designing for Persistence, Not Duplication
Clinicians aren’t copy-pasting out of laziness. They’re trying to preserve clinical context that still matters. In this post, we explore how our research into duplication in the EHR led us to rethink documentation persistence and build Problem Link, a feature that keeps medical problems connected over time.
Drowning in Documentation: The Cognitive Overload of Clinical Notes
Clinical documentation is no longer a tool for clarity—it’s a source of mental overload.
Today’s EHRs bury clinicians in duplicated notes, fragmented interfaces, and templated noise. The result? Slower decisions, missed signals, and mounting burnout. This week, we explore how cognitive overload is quietly eroding care quality—and what a better future could look like if documentation supported clinical thinking instead of sabotaging it.
Our Approach to Clinical Documentation: A Philosophical Shift
At River Records, we believe documentation shouldn’t start from a blank page every time. Clinical care is continuous, and the record should reflect that. In this post, we share the philosophy behind Stream—our AI-powered, problem-oriented documentation platform—and explain why copy-paste behavior is not clinician error, but a system failure begging for a better solution.
Notes Are Deadweight. Clinical Context Is the Future.
For years, the clinical note has been treated as the centerpiece of medical documentation. But in practice, it’s become a relic of a paper-based past—bloated with repetition, slow to navigate, and ill-suited to the way clinicians actually think. At River Records, we’re reimagining documentation not as a series of static notes, but as a living, structured reflection of the patient. By organizing everything around medical problems rather than encounters, Stream gives clinicians the context they need without forcing them to dig through layers of outdated text. The result is faster reviews, clearer updates, and documentation that actually supports care.
Rethinking Administrative Time and the EHR in Modern Medicine
The EHR suffers from the tragedy of the commons. Everyone dumps their data with little thought to organization or cleaning up after themselves. We need to buy tools that facilitate information stewardship not data littering.
Why EHRs Are Causing “Note Bloat”—And How We Can Fix It
It’s time to rethink documentation to avoid “note bloat” and bring focus back to what really matters in patient care.
The Challenges of Information Review in Primary Care
Ideally, clinicians shouldn’t need to search for or surface information at all—because the information should never be lost to begin with. There are several chart review work flows prevalent in primary care, yet EHRs are not built to support them, or the workflows of any clinicians, beyond search and filter.
Prevalence and Sources of Duplicate Information in the Electronic Medical Record
The prevalence of information duplication (copy-paste) in electronic medical records (EMRs) suggests that it is an adaptive behavior requiring further investigation so that improved documentation systems can be developed.