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.
When the Chart Comes Up Empty
Sometimes the chart isn’t too full—it’s too empty. When key clinical information is missing, clinicians are forced to piece together the story themselves. In this post, we explore how information underload slows care, increases risk, and contributes to burnout—and how Stream helps preserve continuity over time.
Too Much Information, Too Little Time
Information overload is more than a nuisance—it’s a major contributor to clinical burnout. When alerts, messages, and chart clutter pile up without prioritization, cognitive load skyrockets. In part two of our Information Chaos series, we break down how overload disrupts clinical reasoning—and what we’re doing about it.
“I Know I’ve Seen This Before”: How Information Scatter Drives Clinician Burnout
Information scatter is when relevant clinical data is present—but spread across inboxes, scanned faxes, old notes, and your memory. It forces clinicians to reconstruct the story over and over, increasing cognitive load and driving burnout. Here’s why it happens—and how we can fix it.
Why “Faster Notes” Won’t Fix Cognitive Overload
Notes that write themselves are handy—but they don’t cure information overload. Clinicians still scroll through dozens of encounters to recover context. In this post we unpack why “faster notes” isn’t enough, show how persistent, problem-oriented threads cut cognitive load, and share what we’re building at River Records to keep every detail—labs, meds, follow-ups—exactly where you need it, every 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.
The Hidden Danger of Perfect-Looking Notes: Why Surface-Level Completeness Isn't Enough
In medicine, uncertainty is normal. Our notes should reflect that. Learn how to reclaim clinical reasoning in documentation — and avoid the dangers of perfect-looking but hollow notes.
The Real Cost of Note Bloat: Clinical Clarity at Risk
Medical documentation is a clinical act, not just a clerical task. Learn why note bloat undermines patient care and how clinicians can rebuild clean, useful, clinically-driven notes through thoughtful, evidence-informed practices.
Why EHRs Actively Constrain Ideal Clinical Workflows
The rigidity of the EHR is a straightjacket on efficient workflows. The systems simply don’t match the ways clinicians think.
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.
Part 2: Siloed Documentation in a Collaborative World
The clinical note has been a cornerstone of medical documentation for decades. While this structure may have worked in the past, the note paradigm is increasingly out of place in today’s healthcare environment. In this post, we’ll explore how notes — organized around visits and not around problems— create information chaos in healthcare and why we need to move toward a new documentation model.
The Future of Live Documentation - Addressing the Growing Problem of Medical Documentation Overload
As AI continues to transform healthcare, many assume it can fix the growing issue of documentation overload. While AI offers just-in-time summaries and automation, relying solely on it without improving how data is structured leads to bloated, disorganized charts. In our latest post, we explore why better organization—through problem-oriented documentation and structured data—is key to streamlining workflows, reducing costs, and enhancing patient care.
Part 1: The Note, A Relic of the Paper Era
A brief history of the medical note and how it has come to frustrate clinicians and patients across the world.
Clinical Notes – Not the Revolution We Were Promised
Written by: Alex Butler, MD, MS - Pediatrician & Chief of Product
Documentation Sucks: How did we get here?!
Written by: Abhinav Sharma, MD - Primary Care Physician & CEO