Clinical Report: The Surprising Rise of Emojis in EHRs

Overview

A recent study analyzed over 218 million electronic health record notes and found that while emoji use in clinical documentation remains uncommon, it is increasing. By the third quarter of 2025, the rate of emoji-containing notes rose significantly, primarily in patient-facing communications.

Background

The integration of emojis into electronic health records (EHRs) reflects evolving communication practices in healthcare. As patient engagement through digital platforms grows, understanding the implications of emoji use is crucial for maintaining clarity and professionalism in clinical documentation. This trend raises questions about the effectiveness and appropriateness of using such symbols in patient communications.

Data Highlights

Key Findings

• 372 different emojis were identified across 4,162 notes.
• 24% of emoji-containing notes included multiple emojis, with a median of four emojis per note.
• Most emojis were used in patient-facing communications (36% in portal messages, 29% in telephone encounters).
• 89% of emojis were added by clinicians or staff, not patients.
• Emojis were primarily used for emotional tone and visual cues rather than as substitutes for words.

Clinical Implications

Propose a framework for clinicians to follow when incorporating emojis into their communications.

Conclusion

The rising use of emojis in EHRs highlights a shift in clinician-patient communication, necessitating careful consideration of their implications for clarity and understanding in clinical settings.

References

1. JAMA Network Open, 2026 -- Emoji Use in the Electronic Health Record
2. Joint Commission, Official “Do Not Use” List
3. npj Digital Medicine, 2025 -- Addressing the Obstacles in Optimizing Electronic Health Record Systems
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10. Official “Do Not Use” List
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