Imagine opening your medical record and finding a smiley face staring back at you. Sounds unusual, right? But it’s happening more often than you might think. Researchers have uncovered a surprising trend: hundreds of emojis are popping up in patient records, and it’s raising eyebrows—and questions—across the healthcare industry.
In a groundbreaking study published in JAMA Network Open (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2843883), researchers analyzed 218.1 million notes from 1.6 million patients’ electronic health records. Between 2020 and 2025, they discovered 372 unique emojis scattered across 4,162 notes. That’s right—emojis, those playful symbols we associate with texts and social media, are making their way into clinical documentation.
But here’s where it gets controversial: this isn’t just a rare occurrence. The study found that emoji use in medical records is on the rise, outpacing previous findings in clinical texting systems (https://pubmed.ncbi.nlm.nih.gov/37310737/). “We were surprised to uncover hundreds of distinct emojis being used,” said Dr. David A. Hanauer, lead author and Clinical Professor of Pediatrics and Learning Health Sciences at the University of Michigan Medical School. “While still uncommon, their presence is growing, and it raises important questions about how we communicate in healthcare.”
Most emojis appeared in messages sent from clinical teams to patients via portals. Interestingly, the University of Michigan’s patient portal doesn’t allow patients to add emojis directly, so most patient-originating emojis were copied from emails or texts. The most popular emojis? Smileys and emoticons (58.5%), followed by objects (21.2%) and people/body symbols (17.6%). The smiling face with smiling eyes topped the list with 1,772 instances, while the hospital building emoji ranked a modest 30th with just 30 uses.
And this is the part most people miss: only 1% of emojis replaced words, like using a pill emoji instead of typing “medicine.” The majority were used for emphasis or simply for their own sake. But does this playful approach enhance communication, or does it risk confusion? Researchers worry about miscommunication, especially among older patients. Surprisingly, records for patients aged 70–79 had the second-highest emoji count, right after 10–19-year-olds.
Dr. Hanauer emphasizes the need for action: “Healthcare institutions should develop guidelines for emoji use to ensure clarity and professionalism in clinical communications.” But the challenge doesn’t end there. Measuring emoji use in health records is still tricky, and we’re only beginning to understand their impact. Do emojis improve patient understanding and trust, or do they introduce unintended challenges? Could these symbols offer new ways to connect with patients, or are they a distraction?
Here’s where we want to hear from you: Do you think emojis belong in medical records, or should they stay in the realm of casual communication? Share your thoughts in the comments—let’s spark a conversation about the future of digital healthcare communication.
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