LAUSR

enance data (eg, physical examination). Future analysis will examine how copied and imported text is used to fulfill the various functions of a note, such as billing or clinical history recall. This finding could spur EHR design that makes copied and imported information readily visible to clinicians as they are writing a note but, ultimately, does not store that information in the note. For example, copied text used as a hospital course record to facilitate the creation of a discharge summary may represent an opportunity for the EHR to provide an alternative space for discharge information. Alternately, copied text that represents a belief that more text leads to higher billing suggests an opportunity for educating clinicians in how notes are coded. As mentioned, this study’s limitations included its singlecenter, single-service focus and inability to access sectionspecific provenance data. Clinicians spend time every day writing progress notes. Understanding their practice and the needs of their audience could spur improvements that restore the utility of this documentation.