Use of Emojis in Electronic Patient Records on the Rise

The inclusion of emojis in electronic health records is increasing, according to a comprehensive study that examined over 218 million medical notes from approximately 1.6 million patients. Researchers identified around 4,200 instances containing emojis, representing 372 unique icons. Although these figures may appear minor relative to the total number of records, the diversity and frequency of emoji usage have notably grown.

Emojis--small digital images used to convey emotions, ideas, or concepts--are becoming a regular feature within electronic communication systems in healthcare. The study, published in a prominent medical journal, found that emojis are not only more frequently used than in the past, but also that their variety within clinical correspondence has expanded.

The analysis highlighted preferences in emoji selection among healthcare professionals. Smileys and emoticons accounted for 58.5% of emoji usage, making them the most common category. This was followed by object-related emojis at 21.2%, and those depicting people or body parts at 17.6%. Many clinical messages to patients or their families featured multiple emojis within a single communication.

Among the most frequently used icons was the smiling face with smiling eyes, appearing 1,772 times. The telephone receiver and the calendar followed, with 544 and 429 instances respectively. By contrast, medical-specific icons such as pills, stethoscopes, and hospital buildings were far less common. The study noted that while some symbols are straightforward to interpret, others--such as fire, rainbow, or maple leaf emojis--may be more ambiguous in a clinical context.

The researchers observed that emojis were typically found in short messages sent by clinical teams to patients or their relatives. These icons rarely replaced words; instead, they were used primarily for emphasis or to add a friendly tone to messages.

Although the overall occurrence of emojis in medical documentation remains relatively low, the study revealed a notable increase over recent years. Between 2000 and 2024, the rate of emoji usage remained stable at approximately 1.4 emojis per 100,000 notes. However, by the third quarter of 2025, this figure had risen sharply to 10.7 per 100,000 notes. The authors indicated that the reasons for this increase are not yet clear.

Interestingly, the patient records with the highest frequency of emojis belonged to individuals aged 10 to 19 and those between 70 and 79 years old. The increased use of emojis among older patients raised concerns among the researchers about the potential for miscommunication or misunderstandings, particularly in this demographic.

In response to these findings, the study's authors recommend that healthcare institutions establish clear guidelines regarding the appropriate use of emojis in clinician-patient communications. Such policies would help ensure that the integration of visual symbols enhances, rather than hinders, effective communication and patient care.