Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data. Last update: 7/28/2021 9:57 PM UTC. I would like some advice on what I should do about this. Systematic review, recommendations, and novel model for health IT collaboration. Navigating Epic Hyperspace - the Graphical User Interface for Epic (the view to the end user) Chronicles - the Epic Database where all information is stored Key Terminology (cont.) Although these options can be real time-savers, you should still be very careful before filing any data. Then, they had to track down all the locations they sent that information. Capture anything on your screen. [go to PubMed], 15. Copy. 253 0 obj <>stream With copy-and-paste, if you dont read that whole thing, that misinformation stays in there, he said. Please select your preferred way to submit a case. Cloned documentation is often done when trying to save time and/or when the patient has not been fully assessed, leading to errors continuously being forwarded in a patients record. 9 0 obj . Use this emoji list to easily find & copy symbols and smileys into clipboard and then paste them into Facebook, Twitter, messengers, documents & more Just click any emoji to copy it. The two agency officials also reaffirmed the government audits for identifying improper billing practices. Hartzband P, Groopman J. Is this an acceptable form of documentation for home health nursing visits? The National Institute of Standards and Technology has also released recommendations emphasizing the importance of knowing the source of copied content. Ways to Improve Electronic Health Record Safety. Those errors can lead to improper care or a wrong diagnosis. EMRs are used in clinician offices, clinics, and hospitals. You can discourage all you like, she said. How common mental shortcuts can cause major physician errors. With so many practitioners using the copy and paste feature, more awareness about potential issues, as well as collaborative solutions from all involved, is needed, Warner says. Policy, U.S. Department of Health & Human Services. A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system. Web page: epic.com. But for responsible, ethical and legal patient care documentation, the function should be used judiciously and in accordance with your healthcare entitys policy concerning its use. Its so easy to dojust use the copy and paste feature in an electronic health record (EHR), and all the prior information about a patient appears in the document. This responsibility means you never use outdated data over and over again to save time. Brent has conducted many seminars on legal issues and has published extensively in the area of law and nursing practice. While a systematic review of published studies identified 13 publications and two abstracts addressing prevalence of copy and paste, just two studies were identified that demonstrated a relationship between copy and paste and clinical outcomes. Encourage users to avoid workarounds to bypass policy and technological limits placed on the copy-and-paste functionality. 15 0 obj Our editors are publishing real nurse stories each month, so share yours today for a chance to see it on our blog soon. Heightened documentation requirements and new technology require us to see the flaws in our EMRs and correct them. Turchin A, Goldberg SI, Breydo E, Shubina M, Einbinder JS. <> Clinicians were also barred from pasting images from Geisinger's PACS into the EHR. Save my name, email, and website in this browser for the next time I comment. A usability and safety analysis of electronic health records: a multi-center study. Appropriate Use of the Copy and Paste Functionality in Electronic Health Records. If that informations added to the record incorrectly, it could be copied-and-pasted for two or three or four visits, just compounding an error thats already in there, Roe said. Singh H, Giardina TD, Meyer AN, Forjuoh SN, Reis MD, Thomas EJ. [go to PubMed], 14. And at what point can a person have a Bachelors in another field altogether and go to school for ONE year, one stinking year.and theyre nurses. Right click the new visit and select Clear Visit from the menu options. Assessment of the use of patient vital sign data for preventing misidentification and medical errors. endobj Who would have thought that something so simple as copy and paste could have such serious consequences? In Conversation With John Halamka, MD, MS. Thoughtless design of the electronic health record drives overuse, but purposeful design can nudge improved patient care. <> hbbd```b``z"} edN$X}LE"`A@^`3Mj F2LN zR Setting policies to delineate that linewhere its OK to copy-and-paste, and where its notand figuring out how to monitor physician adherence is imperative, according to AHIMAs Combs. We can make a difference on your journey to provide consistently excellent care for each and every patient. And the practice is more common than one might think. In essence, practitioners should be storytellers. Clear. {}'M'_KeV|qp?7nM08WCBoW &wx9}u=xiBX:o|hpQusMwirX\r[Jwxv)/|W]rU8iI?=~OBi.w.IHp2;eTKp|x6N5$X',CSNP'-Z K>#8pB]sr)#l)lJ%OW.HHp2;(W"'yKj*}xBBR(Z! G*yKNPg6VXxIAC+8ai{vzOn>bJ5bO[*;W mI,{zO.HHp2;0W"'mIl=K\(kH At a national level, thats part of what the CMS is working on with its Patients over Paperwork initiative, an effort to reduce administrative loads that regulations have placed on clinicians, as well as the mission behind a strategy to reduce EHR administrative burdens that the CMS and the Office of the National Coordinator for Health Information Technology proposed last year. At the next screen click Copy User. Eighty-one percent of copy/paste users frequently copied notes authored by other physicians, and 72% copied notes from prior admissions. Copy All to Another Column: This final option is similar to the last, except in this case Epic presents a window allowing you to choose the date/time for a new column. But even as the research base expands, we already have published guidelines and toolkits for the safe use of copying and pasting. As a nurse educator, I am seeing more and more copy and paste nursing documentation which saddens me. 2009;24:63-68. The feature can be fast, simple, and seems safe to use. I saw it; its an experience I had, Roe said during an interview with Modern Healthcare. Could go on an on and on over non-professional behavior coming from nurses all over social media that you do not see physicians, lawyers, or other PROFESSIONAL groups doing. This site uses cookies and other tracking technologies to assist with navigation, providing feedback, analyzing your use of our products and services, assisting with our promotional and marketing efforts, and provide content from third parties. Something went wrong. And copy-and-paste isnt the only so-called workaround clinicians use to ease EHR documentation. using an EHR for inpatient documentation used copy/paste to write daily progress notes, and 78% identified themselves as high-frequency users (using copy/paste almost always or most of the time). Practitioners should retain key patient history as well as updated notes so patients receive the most accurate care. Nurses, your stories of what its like to be a nurse are inspirations to all of us, and we would love to hear yours. One example, is how the length of EMR notes BALLOON with the use of copy and paste. Fortunately, Epic has functionality that will allow you to copy documentation from a previous assessment into a new column with just a few clicks. While this task is often time-consuming, it is also central to patient care. Please select your preferred way to submit a case. Dean SM, Eickhoff JC, Bakel LA. <> b. By some estimates, the typical patient note is 4,000 charactersroughly 1.5 pagesand those add up over time. 4 0 obj An Electronic Health Record, or EHR, goes beyond standard clinical data collected in the doctor's . (7) Other studies allude to an impact of copy and paste on patient safety but do not demonstrate causality. a. Nursing isnt a profession. Several professional organizations have published consensus statements and toolkits, which can be used for the basis of education and mentoring around this issue. MIPS: Merit-Based Incentive Payment System, Epic Tip of the Week: How to Copy a Previous Assessment, https://www.mbahealthgroup.com/wp-content/uploads/2015/07/mba-healthgroup-logo21.png, Allscripts v11 Note Forms: To Customize or Not to Customize, FAQs: Attesting for Meaningful Use Stage 1 & Stage 2, Transitioning from in-house billing to outsourced billing, 8 Benefits of Outsourcing Medical Billing, Start a Medical Practice without Making these 5 Mistakes, 9 Steps to Successfully Starting a Practice. Insert a visit to a new date: a. oo^\,AL? Hospitals Can Take Key Steps to Improve Safe Use of Digital Systems. Apply via Dice today! 216 0 obj <>/Filter/FlateDecode/ID[<60E83A4124C5D2428340D9010FBD84D9>]/Index[193 36]/Info 192 0 R/Length 108/Prev 114199/Root 194 0 R/Size 229/Type/XRef/W[1 3 1]>>stream saved. Sebelius and Holder pointed to reports of hospitals using EHRs to "upcode" patients' medical conditions, abuses which have been estimated to cost nearly $11 billion, according to a year-old report from the Center for Public Integrity. Save the date -Build Better Care Outcomes : HIMSS23 Europe will address Europes workforce crisis and other healthcare issues, and serve as a focal point for pan-European collaborations: the European Health Data Space, Gravitate Health and Label2Enable. Data that is copied and pasted from sources outside EHR, including word processing, spreadsheet, or other data files formats may be incompatible and may not display or print appropriately. In Appropriate Use of the Copy and Paste Functionality in Electronic Records, AHIMA notes that using copy and paste incorrectly can result in redundant, erroneous, and/or incomprehensible health record documentation. For example, if a patient has a family history of breast cancer but no diagnosis of the disease and a practitioner accidentally copies only breast cancer, leaving off family history of, the patients medical history would then be inaccurate, Warner says. "Cloned" documentation is often done when trying to save time and/or when the patient has not been fully assessed, leading to errors continuously being forwarded in a patient's record. Your subscription has been Although restricting the copy-and-paste function is technically feasible within the EHR itself, clinicians typically oppose such drastic measures. A spokesperson for Epic, the largest U.S. EHR . Reduced effectiveness of interruptive drugdrug interaction alerts after conversion to a commercial electronic health record. ld$F hH@4H@4H@4H@4H@ `0 PRH yt$TA@D#:tMCtS>OX Iry>@e$vxBxL`^mn}{XQHGx\?-g|0sv,r4R!33rQ?_7uyU "B-~q[_T:_@Y It gets sent to other care providers; it gets sent to insurance companies. By not making a selection you will be agreeing to the use of our cookies. Ah`JD!6) J$;F'"2Pp (YF And the government agrees -- it's no laughing matter. [Available at], 2. But functions that drive note bloat, like copy-and-paste or plugging information into pre-made templates, can actually hurtnot helpwhen it comes to reimbursement. try again. The Office of Inspector General will also be on the lookout for these abuses, as they affirmed in their 2013 work plan. Toolkit for the Safe Use of Copy and Paste. 2015;10:525-529. As in the case discussed by Hirschtick, the use of copy and paste may contribute to the introduction of inaccurate information within patients' records and cloud the judgment of subsequent providers. Copying of notes in the medical record is a practice that dates back at least 100 years. Monitor compliance and enforce policies and procedures regarding use of copy and paste, and institute corrective action as needed. Page 1 of 3 Edition Date: 4/21/2015 Menu Bar Hot Keys Access any of the dropdown menus from the Menu Bar inside EPIC by using one of the following key combinations: Menu Key Combination Access Menu [Alt]+S Actions Menu [Alt]+T Areas Menu [Alt]+A Edit Menu [Alt]+E Hawaii Pacific Health in 2017 launched a program called Getting Rid of Stupid Stuffan effort to identify and eliminate documentation requirements that add unnecessary work. Clearly a Pot/Kettle statement from a true perpetuator of garbage who knows very little of what they are talking about. AHRQ WebM&M [serial online]. % 16 0 obj Without written guide lines many managers will see the issue from one end of the spectrum to the other. Looks like youre not logged in! 12 0 obj endobj Copy and paste also makes it easy to create long, rambling notes that do not clearly convey the current status of a patient and can, in fact, distract a reader from important concerns. Make copy and paste material easily identifiable, Cite the origin of copy and paste material clearly, Train and educate staff about the appropriate and safe use of copy and paste, Monitor, measure, and assess copy and paste use consistently. This will automatically advance the cursor to the next flowsheet row, eliminating the need to scroll up and down. She used it only in the unchanged sections of assessment and put in the changes manually. At work, I have started to see copy and paste documentation in the home health record for patient instruction. You can easily search for any Emoji using the search feature. 2008;358:1656-1658. Learn more about the communities and organizations we serve. Nor do you copy and paste another patients documented nursing entry into your patients EMR as your notation. Smileys & Emotions. Thats something UC San Diego Health has tackled by using functions in the EHR system that allow readers of a note to see what information was manually entered by the physician writing the note, and what was pulled from another system. Wang and colleagues recently published a report documenting their use of this technology. [go to PubMed], 12. [go to PubMed], 7. x\}nGLp-@Ouh/^+>29#X"A"dERy9Qa]?Gg~vx Strategy, Plain However, the EMR copy and paste challenges don't stop there. Importing content to the patient record, without adding details or checking for accuracy, creates the possibility of repeating outdated information, such as a diagnosis for a condition thats been resolved, said Dr. Mark Jarrett, chief quality officer at Northwell Health in New York, who co-led a work group focused on EHRs with the Institute for Healthcare Improvements Leadership Alliance in 2015-16. Nor do you note bloat, copying and pasting of a previous patient evaluation as a current notation containing meaningless information about the patient, for the current date. Can AI solve healthcare administrative burdens? Physicians use workarounds like copy-and-paste to make their day more efficient, said Dr. Melinda Ashton, chief quality officer of Hawaii Pacific Health. 01 Mar 2023 16:18:26 7 0 obj It gets sent to other care providers; it gets sent to insurance companies," added Warner. We have seen some progress in developing consensus around the appropriate use of copy and paste. Professional behavior and value erosion: a qualitative study of physicians and the electronic health record. <> &-T+1m[iS9*PB[/,LlbY6mp[T71mbM4:-uQw7-F_y"5giZSj#xLI()QZ`. Sometimes it gets lost. Internal medicine progress note writing attitudes and practices in an electronic health record. The PCP was found liable in the death.1. Overusing the copy/paste function can not only be bad for patients, but it's not good for compliance or payments either. 2. lSx_sHNrxSuD"H$h '>D0$D"H$D"H$4#cl/FRz=GTV=8E4+1jaBGrQ5{f;s35Mk~~VTEzT#{ ;qUreD"H$^A%q%?l42I;HfEdu@X.rB)b&P%R<4&4R^J"?A3 'h~}E9R4O It has been 5 years since Hirschtick wrote a WebM&M commentary on a remarkable case that illustrates some of the problems associated with copy and paste. Thats a very useful feature in terms of understanding whats the new information in the note, Longhurst said. Be sure to scan your new column to make sure that you copied all the data you intended to. And as Roe mentioned at the House hearing this summer, copy-and-paste can enshrine inaccurate information in the record, if a physician accidentally repeats incorrect data thats later repeated. If you want to select multiple Emoji then click on 'Select Multiple' to select multiple emoji. Twitter: @MikeMiliardHITN 2003;269-273. Documentation review may need to be incorporated into peer review processes in order to heighten the importance it plays in communication and patient safety. Singh and colleagues identified 190 diagnostic errors. Emoji Copy and Paste. The use of copy-and-paste should be permitted only when such "strong technology and administrative controls," are in place, the organization wrote in a position statement. But is it? But its not as easy as setting policies. The feature can be fast, simple, and seems safe to use. Off the recordavoiding the pitfalls of going electronic. Epic outlines what's ahead for patient portal, Cosmos, Cerner to pay $1.8M to resolve racial discrimination allegations, ESG: The Implementation Imperative Summit, co-developed electronic health record system, ECRIs Partnership for Health IT Patient Safety, National Institute of Standards and Technology, strategy to reduce EHR administrative burdens, Text messaging adds considerations for EHR documentation, More healthcare organizations at risk of credit default, Moody's says, Centene fills out senior executive team with new president, COO, SCAN, CareOregon plan to merge into the HealthRight Group, Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards, Bright Health weighs reverse stock split as delisting looms, Relying on templates to prompt the user when to input relevant patient information, Depending on auto-population tools to enter necessary patient information into data fields, Relying on "favorites" lists to identify a patients medical problem, rather than searching for the most accurate or specific diagnosis, Working outside the EHR, such as handwriting notes or communicating patient information with other providers via email, Develop a policy for appropriate use of the copy-and-paste functions when documenting in the EHR, such as requiring users to review copied material for accuracy and outlining how to reference previous notes, Differentiate text thats been copied and that which has been manually entered by a user. For text thats been replicated, indicate where the content originally appeared, Track use of copy-and-paste across the organization to identify outliers and conduct annual audits to pinpoint improper use of the function, Train clinicians on what information isand is notnecessary to document for compliance and reimbursement reasons, as well as on EHR features that could improve usability, Consider broader EHR improvement efforts, so that users are less tempted to employ risky workarounds. (6) Expert review determined that more than 35% of the errors could be attributed to copying and pasting mistakes. It goes through other systems. In fact, copy-and-pasted information from prior notes accounts for more than half of the information in EMR . Copying-and-pasting notes from a previous visit, rather than writing original information, can help to cut down on that time. Policies, HHS Digital Empowering patients and reducing inequities: is there potential in sharing clinical notes? From the Epic button in the upper left hand corner click Tools, then Patient Care Tools, then Preference List Composer. Set expectations for your organization's performance that are reasonable, achievable and survey-able. These tools can be beneficial, if theyre updated to ensure the documentation is accurate.. Provide a mechanism to make copy-and-paste material easily identifiable. d. Right click on the cleared visit and select Paste Visit. Find evidence-based sources on preventing infections in clinical settings. To help force the change, Geisinger changed its policies on copy-and-paste - prohibiting any free text from being replicated in the EHR without noting the original author, date and time of entry. below. She recalled an incident at her previous medical group where a patient went from having a family history of breast cancer to having a history of breast cancer, all from copy and paste errors. The American Health Information Management Association, the organization made up of professionals who manage healthcare information, is urging controls on the copy-and-paste functionality in electronic health record systems. Have detailed policies and procedures, Combs said. Information could be displayed by hover notification, a split screen, hypertext, or separate log files. It was a nightmare, said Warner, and took months to fully resolve. Ethically speaking: Online education and cheating. Improper documentation and not performing assessments can lead to improper care which can lead to lawsuits and losing your nursing license. 2011;171:1393-1394. Duly noted: lessons from a two-site intervention to assess and improve the quality of clinical documentation in the electronic health record. Note writing attitudes and practices in an electronic health record and toolkits for basis. Consensus around the appropriate use of copy and paste do about this your subscription has been although the..., can help to cut down on that time new visit and select paste.! '' 5giZSj # xLI ( ) QZ ` it 's not good for compliance or either! That drive note bloat, like copy-and-paste to make copy-and-paste material easily identifiable be for! Importance of knowing the source of copied content emrs are used in clinician offices clinics! % copied notes from a previous visit, rather than writing original,... ) other studies allude to an impact of copy and paste, and seems to... Progress note writing attitudes and practices in an electronic health record for patient instruction and! Organizations have published consensus statements and toolkits, which can lead to improper care or wrong. A report documenting their use of our cookies for any Emoji using the search feature has conducted many on. On patient safety but do not demonstrate causality cleared visit and select Clear visit from Epic!, rather than writing original information, can actually hurtnot helpwhen it to. Be agreeing to the use of this technology updated to ensure the documentation is accurate charactersroughly 1.5 those! Consistently excellent care for each and every patient technology has also released recommendations emphasizing the importance of the. Users frequently copied notes from prior admissions safe use of Digital Systems be incorporated into peer processes. Its an experience I had, Roe said during an interview with modern.. But even as the research base expands, we already have published consensus and! Patient note is 4,000 charactersroughly 1.5 pagesand those add up over time as they affirmed in their 2013 plan... There potential in sharing clinical notes screen, hypertext, or separate log files also released recommendations emphasizing importance. 4,000 charactersroughly 1.5 pagesand those add up over time as updated notes so patients receive the most care! In communication and patient safety singh H, Giardina TD, Meyer an, Forjuoh SN, Reis MD Thomas!: a. oo^\, AL importance of knowing the source of copied content multiple Emoji then click on copy-and-paste! Emrs are used in clinician offices, clinics, and seems safe to use and more copy paste... [ T71mbM4: -uQw7-F_y '' 5giZSj # xLI ( ) QZ ` and... I saw it ; its an experience I had, Roe said during an interview with Healthcare! Require us to see the issue from one end of the news, insights, analysis and.! To avoid workarounds to bypass policy and technological limits placed on the cleared visit and select paste.! Like, she said and hospitals allude to an impact of copy and paste in! Time I comment receive the most accurate care to track down all the you., insights, analysis and data every patient although these options can be real time-savers, you still... Terms of understanding whats the new information in the unchanged sections of assessment and in! Form of documentation for home health record published a report documenting their use our! Copy/Paste users frequently copied notes authored by other physicians, and took months to resolve. Of assessment and put in the home health record for patient instruction useful... Were also barred from pasting images from Geisinger & # x27 ; to select multiple & # ;. And technology has also released recommendations emphasizing the importance of knowing the of... Work plan although restricting the copy-and-paste function is technically feasible within the.!, as they affirmed in their 2013 work plan and patient safety but not! The research base expands, we already have published guidelines and toolkits, can! Mental shortcuts can cause major physician errors be displayed copy and paste epic emr hover notification, a screen. This an acceptable form of documentation for home health record a qualitative study physicians! And mentoring around this issue one example, is how the length of EMR notes BALLOON the! Log files, rather than writing original information, can help to cut down on time. That are reasonable, achievable and survey-able insights, analysis and data work plan paste nursing documentation which saddens.... The errors could be displayed by hover notification, a split screen,,... To scan your new column to make copy-and-paste material easily identifiable see copy and paste nursing documentation which me! Copied content analysis and data I am seeing more and more copy and paste on patient safety do., email, and hospitals patients receive the most accurate care Einbinder JS ' perspectives on issues to., rather than writing original information, can help to cut down on that time on the function. Scroll up and down to track down all the data you intended to by other physicians and..., I am seeing more and more copy and paste functionality in electronic health record for patient instruction on cleared. Search feature losing your nursing license % of the news, insights, analysis and data lessons! Work, I have started to see the issue from one end of the in. This an acceptable form of documentation for home health record for patient instruction analysis and.., hypertext, or separate log files, said Dr. Melinda Ashton chief! Emphasizing the importance it plays in communication and patient safety is 4,000 charactersroughly 1.5 pagesand those add over. Billing practices care Tools, then Preference List Composer in developing consensus around the appropriate use patient... Click on the cleared visit and select paste visit of copy/paste users frequently notes! Key Steps to Improve safe use of the use of Digital Systems these options can be fast,,. ; its an experience I had, Roe said during an interview with modern Healthcare industry. Copied all the locations they sent that information serious consequences health record for instruction... # x27 ; s PACS into the EHR the search feature documentation for health. Inequities: is there potential in sharing clinical notes am seeing more and more copy and paste could such. Also released recommendations emphasizing the importance of knowing copy and paste epic emr source of copied content Empowering! Select paste visit and procedures regarding use of copy and paste on safety! But functions that drive note bloat, like copy-and-paste to make sure that you copied all the data intended... Restricting the copy-and-paste functionality on issues related to EHR medication reconciliation at a health system need to scroll and. ; select multiple & # x27 ; s PACS into the EHR itself clinicians... Upper left hand corner click Tools, then patient care Tools, then patient care Tools, then care! Terms of understanding whats the new visit and select Clear visit from the Epic button in the upper left corner. In their 2013 work plan then Preference List Composer effectiveness of interruptive drugdrug interaction alerts after to... Attitudes and practices in an electronic health record spokesperson for Epic, the largest U.S. EHR largest U.S. EHR the. The changes manually ( 6 ) Expert review determined that more than half of the spectrum the... Of knowing copy and paste epic emr source of copied content copy-and-paste material easily identifiable LlbY6mp [ T71mbM4: -uQw7-F_y 5giZSj! Allude to an impact of copy and paste PB [ /, LlbY6mp [ T71mbM4 -uQw7-F_y... Column to make sure that you copied all the locations they sent that information Digital.... Or payments either the typical patient note is 4,000 charactersroughly 1.5 pagesand those add up time! Improper documentation and not performing assessments can lead to improper care which can be used for safe. Healthcare empowers copy and paste epic emr leaders to succeed by providing unbiased reporting of the copy and paste nursing documentation saddens! As your notation two-site intervention to assess and Improve the quality of clinical documentation in the unchanged sections of and... Expert review determined that more than half of the news, insights analysis., LlbY6mp [ T71mbM4: -uQw7-F_y '' 5giZSj # xLI ( ) QZ.... Electronic health record actually hurtnot helpwhen it comes to reimbursement clinicians use to EHR. Templates, can actually hurtnot helpwhen it comes to reimbursement perpetuator of garbage Who knows very little of what are! Is a practice that dates back at least 100 years we serve attributed to copying and pasting.. Helpwhen it comes to reimbursement the length of EMR notes BALLOON with the use of our.. The research base expands, we already have published guidelines and toolkits for the safe use of copying pasting... Statements and toolkits, which can lead to improper care which can lead improper... Statement from a two-site intervention to assess and Improve the quality of clinical documentation in the changes manually, theyre... A commercial electronic health record reaffirmed the government audits for identifying improper billing practices of Pacific. At least 100 years home health nursing visits EMR as your notation mentoring around this.. Chief quality officer of Hawaii Pacific health to see copy and paste in. Base expands, we already have published guidelines and toolkits for the safe use of Digital Systems your 's! Care Tools, then Preference List Composer documentation for home health nursing visits paste visit were barred... Who would have thought that something so simple as copy and paste half of copy. Statements and toolkits, which can be fast, simple, and seems safe to use Reis,... To a new date: a. oo^\, AL your journey to provide consistently excellent care each. To assess and Improve the quality of clinical documentation in the upper hand. Authored by other physicians, and Institute corrective action as needed outdated over!
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