Use of Emojis in Electronic Health Records Increased in 2024 to 2025

FRIDAY, Jan. 23, 2026 (HealthDay News) — Emojis are increasingly being used in electronic health record (EHR) notes, according to a study published online Jan. 14 in JAMA Network Open.

David A. Hanauer, M.D., from the University of Michigan Medical School in Ann Arbor, and colleagues characterized emojis within EHR clinical notes, including patient portal messages. The analysis included 218.1 million notes from 1.6 million patients created between Jan. 1, 2020, and Sept. 30, 2025.

The researchers identified 372 distinct emojis used within 4,162 notes. Nearly one-quarter of notes (24.3 percent) contained more than one emoji (maximum, 32; median, four). From 2020 to 2024, emoji usage rates remained mostly stable at 1.4 notes with emojis per 100,000 notes, but by quarter 3 of 2025, it increased to 10.7 per 100,000 notes. 

“Given the small but growing presence of emojis in clinical documentation, we recommend that health care institutions proactively develop guidelines for their use to maintain clarity and professionalism in clinical communications,” Hanauer said in a statement. “One of the first steps to understanding the impact of emojis is simply being able to measure their use, which is still a challenging task. Future work should investigate how emojis might affect patient understanding, trust and outcomes — and explore whether these playful digital symbols offer new opportunities or pose unintended challenges in electronic health record communication.”

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