[HN Gopher] Emoji Use in the Electronic Health Record is Increasing
___________________________________________________________________
Emoji Use in the Electronic Health Record is Increasing
Author : giuliomagnifico
Score : 91 points
Date : 2026-01-16 17:56 UTC (1 days ago)
(HTM) web link (jamanetwork.com)
(TXT) w3m dump (jamanetwork.com)
| anonlinc77 wrote:
| 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.
| jasonsb wrote:
| > 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 wrote:
| I just had Claude generate a readme for me and it added at
| least 10 emoji to it.
| kevin_thibedeau wrote:
| That's where they are prevalent. It's just mimicking its
| training set. If you use LLMs as Q&A oracles or code
| generators the emoji output is less frequent.
| nnnnico wrote:
| > 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
| Wowfunhappy wrote:
| Claude (the only model I use regularly) will definitely add
| emojis to non-code documentation and/or commit messages
| (which I almost never let it write, but it will sometimes
| try). However, I can't recall Claude ever adding emoji to
| code or in comments.
| zem wrote:
| it has added emoji to shell script status output for me
| (green ticks, red crosses, etc)
| Wowfunhappy wrote:
| Oh, yes it will do that sort of thing, I forgot about
| that. I don't think I mind in that context?
| jasonsb wrote:
| I always read and review the code and it's true that the
| old models from 2023/2024 were using a lot of emojis. But
| that code was garbage. Since LLMs have started to write
| decent code, I haven't seen one emoji.
| RicoElectrico wrote:
| In the conversational mode it shits them like crazy. Depends
| on a particular fine-tune though.
| bpt3 wrote:
| 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-system wrote:
| 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.
| jasonsb wrote:
| Well, it is. Let's say that AI adds emojis to my code/text.
| Me, a millennial who hates emojis, will tell the AI to
| delete those emojis and never use them again in my code or
| my official documents. The gen Z guy who got his first job
| last week will love to keep them.
| VanTheBrand wrote:
| Most people using LLMs wouldn't even know you could tell
| it not to produce emoji. You are thinking about this like
| a coder not like a doctor.
| johnisgood wrote:
| If you can tell it instructions, and you know you can
| tell it instructions, then how smart do you have to be to
| realize that "omit emojis" is an instruction you can use?
| If what you said is true, I have no hope...
| supriyo-biswas wrote:
| There's an option in ChatGPT's settings to lessen the use
| of emojis. Though most people never bother to change the
| default setting and I didn't know of it myself until
| recently.
| 0x1ch wrote:
| I'm Gen Z, also an engineer. I wouldn't bother removing
| them from the comments, but I wouldn't add them myself
| lol.
| kube-system wrote:
| Most people are not anything like anyone on this website.
| But even if your personal opinions were universally
| shared, there is no way that what you are suggesting
| could even be _mathematically_ possible. Gen-Z, being 15
| years wide, enters the workforce at approximately 7% per
| year.
|
| There were not ~800% more gen-z healthcare workers in
| 2025 than there were in 2024.
| randycupertino wrote:
| I've noticed coworkers starting to use them in
| communication (emails, Teams chats, meeting minutes) so
| now maybe I see others doing it I feel it is fun and
| acceptable and might throw some in too. I wouldn't put
| them in code or EDC or any source documentation but an
| email sure why not.
|
| I did have a scientist recently write a list of lab best
| practices and before he wrote the list he had a note
| "Follow instructions below" and then he had a finger
| pointing DOWN emoji pointing to the list... my work
| bestie and I actually screenshotted that and sent it to
| each other and were giggling about it, because he
| generally is a serious, smart, straight-laced dude and
| him putting in a garish down facing bright yellow finger
| emoji just seemed very silly compared to his personality.
| But it caught our attention and ensured we both read his
| list!
|
| I would say the uptick is also partly responsible from
| people using their phones more often during work
| communication, if he sent that email from his phone
| instead of his computer it was easier to throw in an
| emoji to emphasize his important list.
| nonethewiser wrote:
| 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 wrote:
| 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.
| zahlman wrote:
| > 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.
| tamimio wrote:
| > 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 wrote:
| 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.
| nonethewiser wrote:
| >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.
| randycupertino wrote:
| 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 wrote:
| > 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.
| randycupertino wrote:
| Heh, I didn't intend it to be satire. When you spend 7
| hours a day cleaning data, sending queries to research
| sites and doing patient profile review emojis spice it up
| and can be eye-catching and fun. Why not?
|
| I generally don't use them in routine practice but when I
| see some of my straight-laced coworkers strategically
| deploy them I don't hate it!
| goodmythical wrote:
| Jesus, my dude, lighten up a bit.
|
| Consider this: You're a grad student who's been reading
| page after page after page after page after page after page
| after page after page after page after page of lack and
| white text.
|
| How is marking a particularly explosive comment with a
| graphic representation of an explosion any different from
| highlighting it? Or from Davinci's marginal scribbles? or
| from Feynman's wave diagrams?
|
| Or, for that matter, simply bolding, italicizing, or
| underlining it?
|
| Shit, why even format it at all? Who needs page breaks and
| indented paragraphs in something as serious as a scientific
| paper?
|
| God forbid we ever go so far as to implement more than one
| font.
|
| Changes to the methods by which we communicate are made on
| a regular basis. If people find them useful enough to put
| them in their own communications, and they do not harm the
| clarity of the transmission, who are we (or you in
| particular) to cry about it on the sidelines?
|
| You remind me of the person in the back of the room trying
| to invalidate a proof based on a misspelling that in no way
| impacts the validity of the proof.
|
| As if adding an emoji somehow invalidates the months or
| years of work that went in to producing the content that
| you are consuming at no cost and will likely benefit from
| without having contributed to the project in any meaningful
| way.
|
| I mean, seriously. Imagine someone's finally created a
| genuine cure for all cancers. They've spent the entire
| lives of hundreds of people and billions of dollars, and oh
| no! What's this? Aww, damn there's an emoji in one of the
| graphs. Damn. Too bad, I guess it's not going to be good
| enough for freehorse. Better go ahead and send it back for
| revisions. Can't publish it like that. Not now, not ever.
| Curing cancer's going to have to wait until we can force
| the author of this paper to conform to our arbitrary
| preferences.
| thwarted wrote:
| > _You 're a grad student who's been reading page after
| page after page after page after page after page after
| page after page after page after page of lack and white
| text._
|
| What an interesting way to describe reading a book. It's
| amazing that anyone can read an entire book, composed of
| hundreds of pages, without getting bored of the black
| text.
| wormius wrote:
| The rise in illiteracy rates is really fucking disturbing
| and this attitude (the parent) is part of what's to
| blame.
|
| Looking at the examples in the comment above, I really
| hope it's not that bad.
|
| It's like the stupid "ROFL"/CLOWN by political fighters,
| and the (handclap) 500 times in a row, like. Or the ROFL
| by people who are trying to make their shit seem
| "funnier" than it every could be and only makes it more
| obnoxious.
|
| There's a difference between "making a powerpoint at a
| conference and using emojis as bullet points" and
| throwing emojis every other word to be cute and getting
| papers published, or medical records with that.
| b00ty4breakfast wrote:
| NO FUN IN MY SCIENCE ONLY SERIOUS BUSINESS LIKE GOD
| INTENDED
| OJFord wrote:
| Novelty doesn't _mean_ fun, it could have been a joke
| because the work of scientific research is literally
| finding novelty, that which is new, pushing boundaries of
| knowledge, etc.
| b00ty4breakfast wrote:
| Novelty can increase enjoyment which can imply that the
| activity is "fun" (though not all enjoyable activities
| can be categorized as "fun").
|
| However, using the context clues, I surmised that the
| original poster, that is the one who enjoys seeing emojis
| being used as bullet points in literature produced by his
| colleague, finds this to be "fun".
|
| Is that pedantic enough? AM I GOOD ENOUGH???? WILL YOU
| LOVE ME NOW DADDY?
| DavidPiper wrote:
| You're being downvoted, but I tend to agree that
| communication is not the part of science you want to
| "innovate" on. The purpose of (scientific) communication is
| to be understood, not to be novel.
|
| The science you're writing about is hopefully extremely
| novel of course.
|
| In general I've found "innovating on the wrong thing" is
| surprisingly common, especially from people who are bored
| and/or hungry for promotions, etc.
| randycupertino wrote:
| They're not putting emojis in peer review papers in
| Science and Nature or poster presentations at ASCO;
| they're putting them in emails, teams chats and meeting
| minutes.
|
| Believe it or not researchers enjoy humor around
| sometimes. There's a global shortage of a specific DAKO
| antibody we need for biopsy analysis right now and on a
| call with 50 people one of our chief scientists deadpans,
| "it's because I stopped making it in my basement."
| flexagoon wrote:
| > use AI in place of the bullets
|
| Did you mean "use emojis"?
| NewJazz wrote:
| Or maybe the robot face emoji?
| randycupertino wrote:
| Yes! :)
| whatshisface wrote:
| > _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
| tempodox wrote:
| That twin tower emoji with a plane rushing into it betrays
| a sense of humor.
| randycupertino wrote:
| Lol yeah those examples are clearly over the top, unhinged
| egregious bad taste emoji use! But I think strategically
| deployed occasionally used with some discernment they are
| fine. :shrug:
|
| I had examples in this comment of how I see people using
| them at work but hackernews apparently doesn't allow
| emojis!
| delusional wrote:
| > 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 wrote:
| This is abusive toxic positivity, no different than "it's
| just a joke bro."
| hackable_sand wrote:
| It's not
| ks2048 wrote:
| 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 wrote:
| reddit
| lotsofpulp wrote:
| Sprinkling in some reaction gifs would be helpful.
| rvnx wrote:
| 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.
| shagie wrote:
| > 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.
|
| It may be a TOS violation - but it is not a copyright
| violation.
|
| In the United States (and several other countries), human
| creativity as part of authorship is required for something
| to be copyrightable.
|
| https://www.congress.gov/crs-product/LSB10922
|
| https://www.copyright.gov/ai/Copyright-and-Artificial-
| Intell...
| GaryBluto wrote:
| It's to appeal to the lowest common denominator.
| anxoo wrote:
| lots of normal people like emoji. the kind of normal people
| who have never heard of hacker news
| rfv6723 wrote:
| 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.
| dawnerd wrote:
| Emojis when used like these models do, Mae text way harder
| for me to read. Its distracting and adds nothing to the
| text.
| Larrikin wrote:
| I find it makes list easier to read and think it actually
| looks nice. But it destroys my ability to sort. So, I use
| this style sparingly because most list information I
| would be looking at often enough to want to look nice, I
| also want to sort.
| Hamuko wrote:
| 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.
| flexagoon wrote:
| Why would it be 2025 though? LLM popularity happened a few
| years earlier
| NewJazz wrote:
| Adoption by health companies?
| greenacred wrote:
| At least there are some signals that AI was used without any
| review/clean-up.
|
| For example: , --, ..., " ", ' ', emojis, <|startoftext|>,
| <|endoftext|>, <|assistant|>, <|user|>, [BOS], [EOS], [PAD],
| [CLS], [SEP], [MASK], [UNK], U+00A0-U+00AD, U+200B-U+200F,
| U+2012-U+2015, U+202A-U+202E, U+2060-U+206F, U+FE00-U+FE0F,
| U+FEFF, U+FF01-U+FF5E, U+E0000-U+E007F.
| Simulacra wrote:
| 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 resume pre-digital, and
| there would be a mark/symbol on it, and it might meant the person
| is fat, black, wears glasses, etc...
| bpt3 wrote:
| 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 wrote:
| > I don't think emojis should be used at all in health
| records...
|
| Strike "in health records" and you've nailed it.
| derbOac wrote:
| 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 wrote:
| Agree with your first part. On the second part, what??
| stvltvs wrote:
| Plausible deniability on excluding people for BS reasons I'd
| guess.
| jawns wrote:
| 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 wrote:
| The study says exactly that. 41% are templated
| pingou wrote:
| Why is the maple leaf so commonly used? To mean autumn? Leaves in
| general? Canadians?
| reorder9695 wrote:
| Presumably generally representing leaves turning brown as
| happena with deciduous trees in autumn?
| nxobject wrote:
| 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 wrote:
| Weed
| zahlman wrote:
| I think the herb emoji is more often used to represent
| cannabis than falling leaves or a maple leaf are.
| TazeTSchnitzel wrote:
| > 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 wrote:
| Adding "No smalltalk and no emojis" to the instructions helps a
| lot.
| zahlman wrote:
| Probably, but wanting to use AI for these purposes in the first
| place correlates strongly with not caring on that level.
| hexbin010 wrote:
| I'll remember to ask the chef for no plastic shards in my food
| too
| self_awareness wrote:
| Of course, I'll remove emojis from my responses, let me know if
| I can do anything else! :smiling_face_emoji:
| i_love_retros wrote:
| 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 wrote:
| 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 wrote:
| 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 wrote:
| And those stupid stylised "fonts" that create problems for
| screenreaders by using obscure Unicode characters.
| hopelite wrote:
| 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 wrote:
| 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 wrote:
| What about the possibility that newer versions of GPT models
| are more likely to use emojis in their responses
| NooneAtAll3 wrote:
| 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
| tamimio wrote:
| 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 wrote:
| Bring on the total replacement of all languages worldwide with
| emojis
| coldtea wrote:
| AI slop
| Escapade5160 wrote:
| 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.
| wormius wrote:
| 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.
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(page generated 2026-01-17 23:01 UTC)