Letters to the Editor
My colleagues and I thank Drs. Pippitt, Stevenson, and Samuelson for emphasizing this component of our article. As they point out, one factor at play in limiting medical student access to electronic charting is the fear of running afoul of guidelines established by the Centers for Medicare and Medicaid Services, despite Medicare claims process guidelines stating otherwise.
We agree that medical student documentation is an essential component of medical education and refer to Gliatto and colleagues’ excellent description of the considerations at stake in the decision of whether to allow medical students to document in the electronic medical record (EMR).1 As we note in our article, the educational and clinical value of medical student documentation may be enhanced by customizing note templates for medical learner use and emphasizing the Reporter-Interpreter-Manager-Educator/EMR scheme as a means of bolstering thoughtful and guided use of EMR charting by medical trainees.2
Michael J. Tierney, MD
Staff physician, Compensation and Pension and Ambulatory Care, VA Palo Alto Healthcare System, Palo Alto, California; Michael.Tierney@va.gov.
Christopher A. Longhurst, MD, MS
Chief medical information officer, Lucile Packard Children’s Hospital, and associate professor of clinical pediatrics, Stanford University School of Medicine, Palo Alto, California.
Natalie M. Pageler, MD
Medical director of clinical informatics, Lucile Packard Children’s Hospital, and assistant professor of clinical pediatrics, Stanford University School of Medicine, Palo Alto, California.
1. Gliatto P, Masters P, Karani R. Medical student documentation in the medical record: Is it a liability? Mt Sinai J Med. 2009;76:357–364
2. Stephens MB, Gimbel RW, Pangaro L. Commentary: The RIME/EMR scheme: An educational approach to clinical documentation in electronic medical records. Acad Med. 2011;86:11–14