Evidence mapPaperPMID 40012671Full record

ArticleJournal of the American College of Emergency Physicians open2025

Addressing Note Bloat: Solutions for Effective Clinical Documentation.

Nicholas Genes, Joseph Sills, Heather A Heaton, Bradley D Shy, Jean Scofi

Abstract read
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. To the Editor: Re: Making Progress on Progress Notes.Journal of graduate medical education · 2025
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nicholas GenesDepartment of Emergency Medicine Ronald O. Perelman, NYU Grossman School of Medicine, New York, New York, USA.
Joseph SillsUMass Chan Medical School - Baystate, Springfield, Massachusetts, USA.
Heather A HeatonMayo Clinic, Rochester, Minnesota, USA.
Bradley D ShyUniversity of Colorado School of Medicine, Aurora, Colorado, USA.
Jean ScofiEmergency Medicine Service Line, Northwell Health, New Hyde Park, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clinical documentation in the United States has grown longer and more difficult to read, a phenomenon described as "note bloat." This issue is especially pronounced in emergency medicine, where high diagnostic uncertainty and brief evaluations demand focused, efficient chart review to inform decision-making. Note bloat arises from multiple factors: efforts to enhance billing, mitigate malpractice risk, and leverage electronic health record tools that improve speed and completeness. We discuss best practices based on available evidence and expert opinion to improve note clarity and concision. Recent E/M coding reforms aim to streamline documentation by prioritizing medical decision-making over details of historical and physical examination, though implementation varies. New technologies such as generative artificial intelligence present opportunities and challenges for documentation practices. Addressing note bloat will require ongoing effort from clinical leadership, electronic health record vendors, and professional organizations.

Indexed as

clinical informaticsdocumentationelectronic medical recordsreimbursement

Identifiers

PMID40012671
PMCPMC11852943

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.