The promise of electronic health records is that patients and providers with online access to an individual’s health history and treatment plans will be able to make better decisions because they will have constantly updated information.

But a new study of 23,630 electronic health records by researchers at the University of California San Francisco Medical Center finds that more than 82% of the data doctors and others enter into an electronic health record is copied and pasted or imported from another source.

Only 18% of the entries represent new data or insights entered directly by the provider. The problem with that scenario is that data copied into an electronic health record may include outdated information and anywhere from a few to multiple errors, says Dr. Michael Wang, an ophthalmologist and the lead researcher.

“Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error,” Wang says.

The researchers studied the notes and updates made to electronic medical records by 460 clinicians. The research revealed that in a typical update to an online patient record 46% of the data was copied, 36% was imported and 18% of the information was typed in directly by the provider.

Residents are more likely than medical students to copy and paste data. Residents entered just 11.8% of new data after a patient visit originally following or during a patient visit compared with 16.2% for medical students. Residents at 51.4% copied over their information to an electronic medical record compared with 49% for medical students.

Full-time physicians and hospital staff updated information manually after a patient encounter 14.9% of the time and copied over data at 47.9%. Residents and medical students wrote longer notes than full-time doctors and other providers. A typical update from a resident or medical student as measured in Microsoft Word was 7,053 and 5,720 characters, respectively, or roughly 1,400 and 1,150 words, compared with 5,006 characters (about 1,000 words) for full-time providers.

“Clinicians spend time every day writing progress notes,” Wang and researchers Dr. Raman Khanna and Dr. Nader Najafi write in a research letter appearing in the Journal of the American Medical Association. “Understanding their practice and the needs of their audience could spur improvements that restore the utility of this documentation.”