Pancreas organ weight in individuals with disease-associated autoantibodies at risk for type 1 diabetes.

improve EMR note quality. In the absence of evidence, only expert opinion remains. It is my opinion as a medical educator, experienced if not expert, that training has minimal lasting impact. Mark Twain wrote, “I didn’t have time to write a short letter, so I wrote a long one instead.” With EMR features such as copy-and-paste and one-click data import, it takes less time and effort to write long random notes than it does to write short structured ones. Until EMR systems are modified to reverse this time incentive, long notes will remain the norm. A similar situation existed with regard to handwashing by health care workers. Decades of training and cajoling did little to improve handwashing compliance rates. Compliance improved only after it was made easier and faster to comply—by installation of conveniently located hand sanitizer dispensers. If short, cogent EMR notes are the goal, EMR system redesign is necessary. I am impressed that Cornell’s Department of Medicine has committed faculty time and money to these efforts. However, while I sincerely hope that Dr Siegler proves me wrong, I remain skeptical regarding the efficacy of training in improving EMR notes.