Emoji Use in the Electronic Health Record is Increasing

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2843883

102 94 6 months ago

anonlinc77• 6 months ago

Emoji use was stable from 2020-2024, then spiked in 2025. The authors don't attempt to explain it, but I bet AI is to blame. Anyone who has had to clean up AI comments riddled with stupid emojis from their code will understand this.

jasonsb3• 6 months ago

Anyone who has had to clean up AI comments riddled with stupid emojis from their code will understand this.

I have no idea what you're talking about. I code daily, with 80/90% of my work AI-assisted, and never had to clean one emoji.

As for emojis appearing in EHRs, a more likely explanation is the growing presence of Gen Z professionals in healthcare, who are known for integrating emojis into their communication. This trend probably has little to do with AI and more to do with generational habits.

zenethian• 6 months ago

I just had Claude generate a readme for me and it added at least 10 emoji to it.

nnnnico• 6 months ago

I code daily, with 80/90% of my work AI-assisted, and never had to clean one emoji.

do you read this code? I find it hard to believe unless you have llm instructions in your codebase that you are not aware of

RicoElectrico• 6 months ago

In the conversational mode it shits them like crazy. Depends on a particular fine-tune though.

bpt32• 6 months ago

Gen Z has been entering the professional workforce (post college age) since approximately 2020, so I don't think they're to blame.

AI generated text is littered with emojis in my experience as well, often used as bullets in the lists it loves to generate.

kube-system2• 6 months ago

I don't think an 8x spike over a year would be in any way explained by a demographic shift.

I think your personal experiences are anecdotal, unique, and not representative of EHR users.

nonethewiser2• 6 months ago

Emojis are not widely used on platforms that dont make them easy to add. IE medical software on windows.

I have no idea what you're talking about. I code daily, with 80/90% of my work AI-assisted, and never had to clean one emoji.

Yeah because they dont just add them to any generated code. Although if you ask them to make some sort of UI that might involve graphics, they will happily add lots of emojis. They do add them very liberally, especially in headings, for writing articles, blog posts, repots etc.

RajT88• 6 months ago

I use AI daily and have to clean emojis.

It depends on the task, or the particular product/agent you're using. ChatGPT is a lot more emoji-heavy than say the business Copilot. Claude code, never. GitHub copilot never.

What I can tell you is, people I know who are SME's who are being paid several hundred thousand dollars a year this past year have started just copypastaing my questions into an LLM and regurgitating back to me whatever they said.

From my friend who is a director of a medical research library, a huge number of doctors recently switched from googling shit to just running it through the free ChatGPT.

zahlman3• 6 months ago

I have no idea what you're talking about. I code daily, with 80/90% of my work AI-assisted, and never had to clean one emoji.

Compare the READMEs of GitHub repositories for low-rated Show HN submissions in 2025 vs 2024. It's really clear.

tamimio2• 6 months ago

I have no idea what you're talking about. I code daily, with 80/90% of my work AI-assisted, and never had to clean one emoji.

It depends on what you ask it. Asking it to code won't generate a single emoji, but ask it to make a list, summarize something, and similar tasks and you will have it all over.

And I disagree with people who always try to stick whatever to "generational stuff" as if there's a distinct wall with total culture differences, plus assuming XYZ gen is a monolith to apply whatever label on. I think this is just an easy, lazy way to explain things that you couldn't understand or explain. Sure, you might have some differences between a 13-year-old and 55-year-old in some categories, but they still share a lot of common ground as well. But a 20-something and 30-something? Barely any difference, let alone at work where usually there are policies and whatnot that will restrict such differences from surfacing.

CJefferson• 6 months ago

It must be different AIs.

I grade student work, and I see a lot of Python generated by AI. I don't know exactly which AI, but about a third of the work I see is littered with emojis.

nonethewiser2• 6 months ago

Emoji use was stable from 2020-2024, then spiked in 2025.

That's from the article? Yeah I think there should be pretty much no doubt about that.

randycupertino6• 6 months ago

I have some coworkers who use AI in place of the bullets in bulleted lists and I don't hate it. It's fun and eye-catching and brings some novelty to our scientific work. One uses science themed emojis (he's a cardiologist so lots of cardiac hearts, test tubes and DNA emojis) and another uses custom-mojis that she designed after Piet Mondrian's art.

I've also seen emojis popping up in official meeting minutes which is fine too. Why not spice it up with some whimsy.

freehorse• 6 months ago

brings some novelty to our scientific work

Is this satire? I hope it is. Otherwise it seems like a sorry state that science currently is if it needs emojis to bring some novelty into it.

flexagoon2• 6 months ago

use AI in place of the bullets

Did you mean "use emojis"?

whatshisface• 6 months ago

Why not spice it up with some whimsy.

These leaked documents (pastebin below) might present evidence for a different view.

https://paste-bin.org/0bu8f8igkd

delusional• 6 months ago

It's fun and eye-catching and brings some novelty to our scientific work.

That's not what "novelty" means in that context. If your review included "these emoji's really bring some novelty to this cholesterol survey" I'd look at you funny.

TwoNineFive• 6 months ago

This is abusive toxic positivity, no different than "it's just a joke bro."

ks2048• 6 months ago

I’ve wondered why GenAI text has so many emojis, for example in README.md bullet points.

I guess their RLHF data had it? On purpose? And various labs all the same?

Because if they were just learning from web data (pre- a few years ago), this didn’t seem to be very prevalent.

airstrike• 6 months ago

rvnx• 6 months ago

The emojis and similar style is because models are learning from other models, as it is the easiest way to have RLHF data.

Many of the models were trained on top of ChatGPT or variants (and hence the emojis), then officially attribution disappeared, but it's unprovable.

This process is called distillation.

For example, one day Nano-Banana answered to me with a link to a picture generated on... FAL platform (that did not exist).

    DeepSeek:

https://i.redd.it/7nkucg2qelfe1.png

    Anthropic Claude:

https://www.reddit.com/r/OpenAI/comments/1e34tkr/why_is_clau...

    Grok:

https://cdn.arstechnica.net/wp-content/uploads/2023/12/GA8PG...

    Gemini-Flash-Lite, if you squeeze it a bit:

    > I must state clearly: I am a large language model, trained by OpenAI. This is the core definition of ChatGPT. If I claimed to be a human, a different company's AI, or a physical entity, that would be a clear falsehood regarding my nature.

but most has been fixed since Gemini 1.5-Pro

Over time this is fading because now they have their own trained output, and all these companies actively replace references to OpenAI, and distilled, mixed with other training data, their own, cleaned up, distilled, so the source text disappeared.

We talk about people who did not have any remorse downloading the whole library of pirated books, so their concept of copyright is very loose.

GaryBluto• 6 months ago

It's to appeal to the lowest common denominator.

anxoo• 6 months ago

lots of normal people like emoji. the kind of normal people who have never heard of hacker news

rfv6723• 6 months ago

Emoji and bullet points are easy to read, so it got rewards in RLHF process.

You maybe hate this style at first glance. But if you read lots of text everyday, Emoji and bullet points lower the cognitive load.

Hamuko• 6 months ago

My guess has been that it's been trained on a copiuous amount of JavaScript projects, which always seem to have emoji up the wazoo everywhere.

flexagoon2• 6 months ago

Why would it be 2025 though? LLM popularity happened a few years earlier

NewJazz2• 6 months ago

Adoption by health companies?

greenacred• 6 months ago

At least there are some signals that AI was used without any review/clean-up.

elcapitan• 6 months ago

I wonder if thereis a good explanation why emojis have had such an overproportional impact on LLM output. The em dashes I get, they are quite typical for formal writing, but I have never seen many examples of emoji-littered documents outside of LLM output or chatrooms before.

Maybe I'm just out of touch with some corners of the Internet that this was trained on.

Simulacra• 6 months ago

Perhaps I'm in the minority, but I don't think emojis should be used at all in health records… It reminds me of stories my mum would tell me about when she would get a résumé pre-digital, and there would be a mark/symbol on it, and it might meant the person is fat, black, wears glasses, etc...

bpt32• 6 months ago

There's absolutely no benefit to using them, and there are technical and non-technical issues they can cause.

I don't think you're in the minority, and even if you (we) are, you are still correct.

SoftTalker• 6 months ago

I don't think emojis should be used at all in health records…

Strike "in health records" and you've nailed it.

derbOac• 6 months ago

In the article they state "We found that emojis were sent in portal messages to patients aged 70 to 79 years at the second highest rate, after those aged 10 to 19 years" which implies some of this at least is in messages to patients.

I can see sending emojis as a way of trying to be friendly and informal in communications with patients, especially if the patients have already used them.

Patients are all different so I can see some of them hating their use, but I can also see some patients appreciating a more lighthearted tone.

Pediatrics in particular is full of this kind of stuff in general.

jskrn• 6 months ago

Agree with your first part. On the second part, what??

stvltvs• 6 months ago

Plausible deniability on excluding people for BS reasons I'd guess.

jawns• 6 months ago

I wonder if some portion of these come from templates. Maybe there's a patient communication template that includes a telephone emoji, and it gets reused.

Health care workers are in a hurry when writing notes, so I doubt they're consulting their emoji pickers just to make their notes more interesting.

brrwind• 6 months ago

The study says exactly that. 41% are templated

JoeBOFH• 6 months ago

Was gonna say my wife is a nurse and half the terms, checklists etc are like a few letters that auto complete to a paragraph of templates text.

pingou• 6 months ago

Why is the maple leaf so commonly used? To mean autumn? Leaves in general? Canadians?

reorder9695• 6 months ago

Presumably generally representing leaves turning brown as happena with deciduous trees in autumn?

nxobject• 6 months ago

As doctors often do in clinical patient records, of course. (To be fair, the article also looks like care team-to-patient messages, so I'm sure there's some "happy fall!" messages in there.)

akersten• 6 months ago

Weed

zahlman3• 6 months ago

I think the herb emoji is more often used to represent cannabis than falling leaves or a maple leaf are.

TazeTSchnitzel• 6 months ago

Emojis are shown using the open-source Noto Color Emoji font due to copyright restrictions on other versions.

They say below a chart using the Apple Color Emoji font ^^;

fpauser• 6 months ago

Adding "No smalltalk and no emojis" to the instructions helps a lot.

zahlman3• 6 months ago

Probably, but wanting to use AI for these purposes in the first place correlates strongly with not caring on that level.

hexbin010• 6 months ago

I'll remember to ask the chef for no plastic shards in my food too

self_awareness• 6 months ago

Of course, I'll remove emojis from my responses, let me know if I can do anything else! :smiling_face_emoji:

i_love_retros• 6 months ago

So healthcare workers are using chatgpt to write messages for patients and to summarize appointment notes?

Given what I see at my workplace I can completely believe this.

arcbyte• 6 months ago

Lets be real. The only connection an EHR has to patient health is whatever minimum standard the hospital needs to avoid malpractice lawsuits. The rest of the EHR is all about billing insurance companies and Medicare.

Nobody cares about emoji except the poor folks who have to login to it everyday, and it makes their lives a smidgen better. Lets chill on the criticism of emojis.

iancmceachern• 6 months ago

I've noticed the same thing for LinkedIn, etc corporate communications. All of a sudden every CEO and marketing leader is packing them in.

chedabob• 6 months ago

And those stupid stylised "fonts" that create problems for screenreaders by using obscure Unicode characters.

hopelite• 6 months ago

Are you saying they are adapting them in a kind of cultural adaptation to the ChatGPT outputs, or are you implying the higher likelihood that they sees simply unquestioningly posting/sending AI outputs?

PunchyHamster• 6 months ago

It's the latter. Soo many "official" company communication is "a clown told the AI clown to generate something about the topic". Not even editing anything, just copy paste

g947o• 6 months ago

What about the possibility that newer versions of GPT models are more likely to use emojis in their responses

NooneAtAll3• 6 months ago

I remember going away from youtube for a month right before it added buttons for quick emojis to its app (summer 2022 iirc?)

returning to it getting filled with emojis was bizarre - but it largely went away now

tamimio2• 6 months ago

AI is to be blamed, you can tell a content was mostly written by an AI when every category had emojis all over. The concerning part however, now we have a strong indicator that healthcare is relying on AI slop, and I don’t know why do we still pay them high wages or at least, why there’s a “shortage” of the workers.

kingkawn• 6 months ago

Bring on the total replacement of all languages worldwide with emojis

coldtea• 6 months ago

AI slop

Escapade5160• 6 months ago

Almost no one knows the shortcut to open the emoji menu on their computer. AI is why there is an increase. Even if someone does know the shortcut, the menu is annoying to use and it slows down your workflow too much for most people to go through the effort.

wormius2• 6 months ago

OK, looking at the actual link and not just bloviating my opinion this seems less offensive. These aren't Health Records in the sense of official documentation by doctors but communications with patient. I see some of it is initiated by patients, but it seems the majority is the provider using it in communication with patients/family... I can slightly understand that, but man I'd be annoyed if it was more than a smiley face once or twice. Maybe it's for patients who are children and parents can show to kids. I was thinking patients using it may be typing on a phone where this shit is much easier. But if it's from professionals, it's likely shitty AI autoresponses, i bet. IDK.

Emoji Use in the Electronic Health Record is Increasing

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