Utility of Clinical Examination in the Diagnosis of Emergency Department Patients Admitted to the Department of Medicine of an Academic Hospital

for reaching HbA 1c target; the results were similar for individual counseling categories (Table).Duplicate counseling was not associated with faster HbA 1c control. Comment.In this large retrospective study of copied documentation of lifestyle counseling in patients with diabetes, we have demonstrated that, unlike original records, copied documentation of lifestyle counseling was not associated with improvement in glucose control.In fact, its effect on HbA 1c was undistinguishable from no counseling at all.These findings were consistent for all 3 types of lifestyle counseling we analyzed-diet, exercise, and weight loss.These results lead us to question whether copied electronic documentation is a reliable representation of patient care.If it is not, it could be either an honest mistake or deliberate falsification.In the latter case, copied documentation that does not reflect the actual events is a serious breach of medical ethics.In either case, it carries a significant financial and legal risk. 8 Efforts must therefore be made to decrease the incidence of inappropriately copied electronic documentation.These could include training and education of health care providers as well as technical solutions, such as software that automatically detects overly similar notes or their components.In order for EMRs to benefit patients, we must make sure the information they contain is meaningful.