Be familiar with your EHR software’s specific E/M shortcuts

Why This Topic Matters

EHR shortcuts can speed documentation, but they can also create copy-forward, template-driven, or repetitive notes that complicate auditing and increase the risk of inaccurate documentation. Understanding these features helps practices evaluate note quality and reduce compliance concerns.

Article Sections

1. Electronic E/M note shortcuts and associated risks

   Introduces the general use of documentation shortcuts in electronic E/M notes and emphasizes the importance of understanding how vendor-specific tools affect completed notes.

2. Copy or carry forward

   Discusses one common shortcut category used in EHR documentation, including how practices may configure it and why it can affect note review and auditing.

3. Smart phrases

   Covers another EHR shortcut type that generates reusable text based on typed prompts and the documentation concerns that can arise from repeated language.

4. All normal

   Describes a workflow in which a prior note is used as a starting point for a later visit and highlights the need to review whether the resulting note matches the current encounter.